Baseline Serum Vitamin C Levels in Pediatric Sepsis: Hazard of Mortality and Organ Dysfunction in a Single-Center...

Area of Science:

• Pediatric critical care medicine
• Nutritional biochemistry
• Sepsis research

Background:

• Sepsis is a leading cause of mortality in children.
• Vitamin C plays a crucial role in immune function and antioxidant defense.
• The role of vitamin C status in pediatric sepsis outcomes is not well-established.

Purpose of the Study:

• To investigate the association between baseline serum vitamin C levels and 28-day mortality in pediatric sepsis.
• To examine the relationship between serum vitamin C and organ dysfunction, assessed by the pediatric Sequential Organ Failure Assessment (pSOFA) score, in critically ill children.

Main Methods:

• A prospective cohort study was conducted in a tertiary children's hospital PICU in China from 2021 to 2023.
• Serum vitamin C levels were measured within 24 hours of admission in 141 pediatric patients (≤18 years) with suspected infection and organ dysfunction.
• Multivariable regression analyses (Cox and linear) and restricted cubic spline analyses were used to assess associations with 28-day mortality and pSOFA scores.

Main Results:

• A quarter of the pediatric cohort had vitamin C deficiency (< 2.5 μg/mL).
• Each 1 standard deviation increase in serum vitamin C was associated with a 52% reduction in 28-day mortality (aHR 0.48) and a decrease in pSOFA score (β -0.67).
• Higher vitamin C quartiles correlated with significantly lower mortality and less severe organ dysfunction, particularly in subgroups not receiving corticosteroids or with normal renal function.

Conclusions:

• Serum vitamin C levels measured within 24 hours of PICU admission are significantly associated with 28-day mortality and organ dysfunction in children with sepsis.
• These findings highlight the potential importance of assessing vitamin C status in critically ill children with suspected infection.