Marusca Larisa Mihaela, Reddy Gowry, Blaj Mihaela, Prathipati Reshmanth, Rosca Ovidiu, Bratosin Felix, Bogdan Iulia, Horhat Razvan Mihai, Tapos Gabriela-Florentina, Marti Daniela-Teodora, Susan Monica, Pingilati Raja Akshay, Horhat Florin George, Adelina Mavrea
Laboratory Medicine, "Louis Turcanu" Emergency Hospital for Children, Doctor Iosif Nemoianu Street, 300011 Timisoara, Romania.
Doctoral School, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania.
Diseases. 2023 Aug 8;11(3):104. doi: 10.3390/diseases11030104.
Childhood respiratory tract infections (RTIs) pose a significant health burden, especially in children under six years old. The main objective of this systematic review was to assess the effectiveness of vitamin D supplementation in the prevention of RTI in this population while also exploring potential effect modifiers such as age, baseline vitamin D status, and type of respiratory infection. A systematic review of the literature published up to February 2023 was conducted according to PRISMA guidelines, searching PubMed, Web of Science, Cochrane, and Scopus databases. Eight studies met the inclusion criteria, which investigated the association between vitamin D supplementation and respiratory infections in children between zero and five years old. The included studies were conducted between 2012 and 2021, encompassing a total of 2189 children from five randomized trials, two case-control studies, and one prospective cohort study. The relationship between vitamin D supplementation and the prevention of childhood RTI was not consistently observed across all included studies. Pooled results demonstrated varied effects of vitamin D supplementation on respiratory infection incidence, severity, and symptoms. Three studies reported statistically significant associations between low vitamin D levels and respiratory infections (OR = 4.90, OR = 6.97), while one study found that children who received vitamin D supplementation of 800 UI/day for 3 months during the cold season had fewer episodes of respiratory symptoms (RR = 0.55) and recovered more quickly from acute RTI. Lastly, according to one study, vitamin D intake < 80 IU/kg/day was significantly associated with the risk of acquiring pneumonia (OR 7.9) but not bronchiolitis. The remaining five studies found no statistically significant differences in infection rates or severity (-value > 0.050). The available evidence on the effectiveness of vitamin D supplementation for preventing and treating respiratory infections in children under six years old is limited, with only a few favorable effects being reported. In some cases, a dose of 80 UI/kg/day was found to provide significant protection for acute respiratory infections, although in the major trials the only benefit was a quicker recovery and fewer respiratory symptoms, with no impact on incidence and severity of respiratory infections. Nevertheless, the study protocol, the supplementation dose, and duration of supplementation had significant variations between studies, leading to inconclusive findings.
儿童呼吸道感染（RTIs）造成了重大的健康负担，尤其是在六岁以下儿童中。本系统评价的主要目的是评估补充维生素D在预防该人群RTIs方面的有效性，同时探讨潜在的效应修饰因素，如年龄、基线维生素D状态和呼吸道感染类型。根据PRISMA指南，对截至2023年2月发表的文献进行了系统评价，检索了PubMed、科学网、Cochrane和Scopus数据库。八项研究符合纳入标准，这些研究调查了补充维生素D与0至5岁儿童呼吸道感染之间的关联。纳入的研究在2012年至2021年期间进行，共涉及来自五项随机试验、两项病例对照研究和一项前瞻性队列研究的2189名儿童。在所有纳入研究中，补充维生素D与预防儿童RTIs之间的关系并不一致。汇总结果表明，补充维生素D对呼吸道感染发病率、严重程度和症状有不同的影响。三项研究报告低维生素D水平与呼吸道感染之间存在统计学显著关联（OR = 4.90，OR = 6.97），而一项研究发现，在寒冷季节接受每日800国际单位维生素D补充剂三个月的儿童呼吸道症状发作较少（RR = 0.55），并且从急性RTIs中恢复得更快。最后，根据一项研究，维生素D摄入量<80国际单位/千克/天与患肺炎的风险显著相关（OR 7.9），但与细支气管炎无关。其余五项研究发现感染率或严重程度无统计学显著差异（P值>0.050）。关于补充维生素D预防和治疗六岁以下儿童呼吸道感染有效性的现有证据有限，仅有少数有利影响被报道。在某些情况下，发现每日80国际单位/千克的剂量可为急性呼吸道感染提供显著保护，尽管在主要试验中唯一的益处是恢复更快和呼吸道症状更少，对呼吸道感染的发病率和严重程度没有影响。然而，研究方案、补充剂量和补充持续时间在各研究之间存在显著差异，导致结果不确定。
