Is vitamin D deficiency a risk factor for COVID‐19 in children?
Kamil Yılmaz, Velat Şen
Pediatric Pulmonology, doi:10.1002/ppul.25106
Objective: Coronavirus disease 2019 (COVID-19) is a global health problem that can result in serious complications. The aim of this study was to investigate the prevalence and clinical importance of vitamin D deficiency in children with COVID-19. Material and Methods: This study includes 40 patients who were diagnosed to have COVID-19 and hospitalized with the real-time reverse transcription polymerase chain reaction method, 45 healthy matched control subjects with vitamin D levels. The age of admission, clinical and laboratory data, and 25-hydroxycholecalciferol (25-OHD) levels were recorded. Those with vitamin D levels which are below 20 ng/ml were determined as Group 1 and those with ≥20 ng/ml as Group 2. Results: Patients with COVID-19 had significantly lower vitamin D levels 13.14 μg/L (4.19-69.28) than did the controls 34.81 (3.8-77.42) μg/L (p < .001). Patients with COVID-19 also had significantly lower serum phosphorus (4.09 ± 0.73 vs. 5.06 ± 0.93 vs. (U/L) (p < .001)) values compared with the controls. The symptom of fever was significantly higher in COVID-19 patients who had deficient and insufficient vitamin D levels than in patients who had sufficient vitamin D levels (p = .038). There was a negative correlation found between fever symptom and vitamin D level (r = −0.358, p = .023). Conclusion: This is the first to evaluate vitamin D levels and its relationship with clinical findings in pediatric patients with COVID-19. Our results suggest that vitamin D values may be associated with the occurrence and management of the COVID-19 disease by modulating the immunological mechanism to the virus in the pediatric population.
CONFLICT OF INTERESTS The author declares that there are no conflict of interests.
AUTHOR CONTRIBUTIONS Kamil Yılmaz and Velat Şen wrote the manuscript. All authors read and approved the final manuscript.
ORCID
Kamil Yılmaz https://orcid.org/0000-0001-5137-0501
References
Aglipay, Birken, Parkin, Effect of high-dose vs standard-dose wintertime vitamin d supplementation on viral upper respiratory tract infections in young healthy children, JAMA
Alipio, Vitamin D supplementation could possibly improve clinical outcomes of patients infected with coronavirus
Baqui, Black, Arifeen, Causes of childhood deaths in Bangladesh: results of a nationwide verbal autopsy study, Bull World Health Organ
Bombardini, Picano, Angiotensin-converting enzyme 2 as the molecular bridge between epidemiologic and clinical features of COVID-19, Can J Cardiol
Caccialanza, Laviano, Lobascio, Early nutritional supplementation in non-critically ill patients hospitalized for the 2019 novel coronavirus disease (COVID-19): rationale and feasibility of a shared pragmatic protocol, Nutrition
Dalvi, Ramraje, Patil, Hegde, Yeram, Study of IL-6 and vitamin D3 in patients of pulmonary tuberculosis, Indian J Tuberc
Daneshkhah, Eshein, Subramanian, The role of vitamin D in suppressing cytokine storm in COVID-19 patients and associated mortality
Grant, Lahore, Mcdonnell, Evidence that vitamin D supplementation could reduce risk of influenza and COVID-19 infections and deaths, Nutrients
Greiller, Martineau, Modulation of the immune response to respiratory viruses by vitamin D, Nutrients
Hansdottir, Monick, Vitamin D effects on lung immunity and respiratory diseases, Vitam Horm
Hoffmann, Kleine-Weber, Schroeder, SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor, Cell
Hughes, Norton, Vitamin D and respiratory health, Clin Experiment Immunol
Ilie, Stefanescu, Smith, The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality, Aging Clinical and Experimental Research
Lau, Vitamin D insufficiency is prevalent in severe COVID-19
Li, Cheng, Guo, Association between serum 25-hydroxyvitamin D concentration and pulmonary infection in children, Medicine
Livingston, Bucher, Coronavirus disease 2019 (COVID-19) in Italy, JAMA
Lu, Zhang, Ma, Link between community-acquired pneumonia and vitamin D levels in older patients, Zeitschrift für Gerontologie und Geriatrie
Manion, Hullsiek, Wilson, Vitamin D deficiency is associated with IL-6 levels and monocyte activation in HIV-infected persons, PLOS One
Marik, Kory, Varon, Does vitamin D status impact mortality from SARS-CoV-2 infection? Medicine in drug discovery
Martineau, Jolliffe, Hooper, Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data, BMJ
Mccartney, Byrne, Optimisation of vitamin D status for enhanced immuno-protection against COVID-19, Ir Med J
Misra, Agarwal, Gasparyan, Zimba, Rheumatologists' perspective on coronavirus disease 19 (COVID-19) and potential therapeutic targets, Clin Rheumatol
Poudel-Tandukar, Poudel, Jimba, Kobayashi, Johnson et al., Serum 25-hydroxyvitamin d levels and C-reactive protein in persons with human immunodeficiency virus infection, AIDS Res Hum Retroviruses
Raharusun, Priambada, Budiarti, Patterns of COVID-19 mortality and vitamin D: an Indonesian study
Rehan, Torday, Peleg, 1α, 25-Dihydroxy-3-epi-vitamin D3, a natural metabolite of 1α, 25-dihydroxy vitamin D3: production and biological activity studies in pulmonary alveolar type II cells, Mol Gen Metab
Shen, Yang, Wang, Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: experts' consensus statement, World J Pediatr
Stagi, Rigante, Lepri, Cerinic, Falcini, Severe vitamin D deficiency in patients with Kawasaki disease: a potential role in the risk to develop heart vascular abnormalities?, Clin Rheumatol
Stephanie, Ryan, Michelle, Lucya, Coronavirus disease 2019 in children -United States, February 12, Morb Mortal Wkly Rep
Wrapp, Wang, Corbett, Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation, Science
Xu, Yang, Chen, Luo, Zhang et al., Vitamin D alleviates lipopolysaccharide-induced acute lung injury via regulation of the renin-angiotensin system, Mol Med Rep
Yeşiltepe-Mutlu, Aksu, Bereket, Hatun, Vitamin D status across age groups in Turkey: results of 108742 samples from a private laboratory, J Clin Res Pediatr Endocrinol
Yuanyuan, Xi, Hu Yabin, Xin, Fan et al., Epidemiology of COVID-19 Among Children in China, Pediatrics
Zhang, The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19)-China, Chinese J Epidemiol
Zhou, Du, Huang, Wang, Shi et al., Preventive effects of vitamin D on seasonal influenza A in infants: a multicenter, randomized, open, controlled clinical trial, Pediatr Infect Dis J
Zhou, Fu, Zheng, Pathogenic T cells and inflammatory monocytes incite inflammatory storm in severe COVID-19 patients, Natl Sci Rev
Zhou, Luo, Qin, The association between vitamin D deficiency and community-acquired pneumonia: A meta-analysis of observational studies, Medicine
