The Effects of Vitamin D Supplementation on Respiratory Infections in Children under 6 Years Old: A Systematic Review
Larisa Mihaela Marusca,
Gowry Reddy,
Mihaela Blaj,
Reshmanth Prathipati,
Ovidiu Rosca,
Felix Bratosin,
Iulia Bogdan,
Razvan Mihai Horhat,
Gabriela-Florentina Tapos,
Daniela-Teodora Marti,
Monica Susan,
Raja Akshay Pingilati,
Florin George Horhat,
Mavrea Adelina
Affiliations
Larisa Mihaela Marusca
Laboratory Medicine, “Louis Turcanu” Emergency Hospital for Children, Doctor Iosif Nemoianu Street, 300011 Timisoara, Romania
Gowry Reddy
New York Medical College at St. Mary’s and St. Clare’s Hospital, Denville, NJ 07834, USA
Mihaela Blaj
Department of Anesthesiology and Intensive Care, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, 700115 Iasi, Romania
Reshmanth Prathipati
Santiram Medical College General Hospital, Nandyala 518001, India
Ovidiu Rosca
Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
Felix Bratosin
Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
Iulia Bogdan
Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
Razvan Mihai Horhat
Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
Gabriela-Florentina Tapos
Department of Emergency Medicine, Arad County Emergency Clinical Hospital, Calea Victoriei, 310037 Arad, Romania
Daniela-Teodora Marti
Department of Biology and Life Sciences, Faculty of Medicine, “Vasile Goldis” Western University of Arad, Revolutiei Square 94, 310025 Arad, Romania
Monica Susan
Department of Internal Medicine, Discipline of Medical Semiology I, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
Raja Akshay Pingilati
Malla Reddy Institute of Medical Sciences, Suraram Main Road 138, Hyderabad 500055, India
Florin George Horhat
Multidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
Mavrea Adelina
Department of Internal Medicine I, Cardiology Clinic, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
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 p-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.
