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Contemporary Scurvy in Vulnerable Populations in High-Income Countries: A Systematic Review and Multilevel
Nina Cadeau-Comte1,2, Erika Meléndez-Oliva1,3,4, Juan Nicolás Cuenca-Zaldívar1,5,6
1Interdisciplinary Research Group on Musculoskeletal Disorders, 28014 Madrid, Spain.
Nutrients
|July 28, 2026
Summary
Scurvy, a vitamin C deficiency, is re-emerging in high-income countries, predominantly affecting vulnerable groups with multiple organ system involvement. Early nutritional assessment in at-risk populations is crucial to prevent delayed diagnosis and reduce morbidity.
Area of Science:
- Nutrition and Dietetics
- Public Health
- Internal Medicine
Background:
- Scurvy, historically eradicated in high-income countries (HICs), is now re-emerging.
- This resurgence is linked to identifiable vulnerability clusters, challenging assumptions of nutritional adequacy in affluent settings.
Purpose of the Study:
- To systematically characterize the contemporary clinical and epidemiological profile of scurvy in HICs.
- To quantify the multisystem burden of scurvy in these populations.
Main Methods:
- A systematic review and meta-analysis adhering to PRISMA 2020 guidelines.
- Searched major databases (PubMed, Embase, Web of Science, Scopus) for studies from 2012-2025.
- Employed multilevel random-effects meta-analysis and logit-transformed proportions to model multisystem involvement.
Main Results:
- Analyzed 25 studies with 147 patients; a mean of 2.29 organ systems were affected per patient.
- Musculoskeletal involvement was most frequent; neurological manifestations were less common.
- Cases clustered in pediatric patients with neurodevelopmental disorders, restrictive diets, complex medical conditions, and psychosocial vulnerability.
Conclusions:
- Scurvy persists in HICs as an under-recognized condition in vulnerable populations.
- Contemporary scurvy often presents with multisystem manifestations; concomitant deficiencies are possible.
- Highlights the need for comprehensive nutritional assessment and screening in high-risk groups to prevent diagnostic delays.
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