title: Role of Vitamin D in Hospitalized Children With Lower Tract Acute Respiratory Infections.
abstract: BACKGROUND
  Vitamin D is known to have modulatory actions in the immune system. Its influence on the severity of lower tract acute respiratory infections (LT-ARIs) is unclear.
  
  
  OBJECTIVE
  The aim of the present study was to evaluate the role of vitamin D on LT-ARI in paediatric patients.
  
  
  METHODS
  Children admitted to hospital with LT-ARI were prospectively recruited through the GENDRES network (March 2009-May 2013). The 25-hydroxyvitamin D (25-OHD) levels were measured by immunoassay. The severity of the illness was evaluated according to clinical scales, length of hospital stay, ventilatory requirements, and pediatric intensive care unit admission.
  
  
  RESULTS
  A total of 347 patients with a median (interquartile range) age of 8.4 (2.6-21.1) months were included. The mean (SD) 25-OHD levels in our series were 27.1 (11.3) ng/mL. In this study, a cutoff value of ≥30 ng/mL was considered optimal vitamin status. Patients with 25-OHD levels <20 ng/mL were at a higher risk of showing severe signs of respiratory difficulties (OR 5.065, 95% confidence interval 1.998-12.842; P = 0.001) than patients with normal values, and had a 117% higher risk of oxygen necessity and 217% higher risk of ventilatory requirement than those patients with normal values. An inverse correlation was found between 25-OHD levels and the severity in the evaluated scales. 25-OHD levels did not influence PICU admission rate or length of hospital stay.
  
  
  CONCLUSIONS
  25-OHD levels of children admitted because of a LT-ARI are <30 ng/mL. Lower levels of 25-OHD were found to be correlated with severity of the disease. The possible role of abnormal 25-OHD levels as a facilitator or consequence of the infection needs further evaluation.
authors.affiliation: *Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP), Hospital Clínico Universitario and Universidade de Santiago de Compostela (USC) †Translational Pediatrics and Infectious Diseases Section, Department of Pediatrics, Hospital Clínico Universitario de Santiago ‡Unidade de Xenética, Departamento de Anatomía Patolóxica e Ciencias Forenses, and Instituto de Ciencias Forenses, Grupo de Medicina Xenómica (GMX), Facultade de Medicina, Universidade de Santiago de Compostela, Galicia §Pediatric Emergency and Critical Care Division, Department of Pediatrics, Complejo Hospitalario de Jaén ||Unidad de Infectología Pediátrica, Hospital de Torrecárdenas, Almería ¶Instituto Hispalense de Pediatría, Seville, Andalucía, Spain.
authors.forename: Miriam
authors.initials: M
authors.lastname: Cebey-López
authors.forename: Jacobo
authors.initials: J
authors.lastname: Pardo-Seco
authors.forename: Alberto
authors.initials: A
authors.lastname: Gómez-Carballa
authors.forename: Nazareth
authors.initials: N
authors.lastname: Martinón-Torres
authors.forename: Irene
authors.initials: I
authors.lastname: Rivero-Calle
authors.forename: Antonio
authors.initials: A
authors.lastname: Justicia
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Redondo
authors.forename: José María
authors.initials: JM
authors.lastname: Martinón-Sánchez
authors.forename: María Del Carmen
authors.initials: Mdel C
authors.lastname: Martínez-Padilla
authors.forename: Francisco
authors.initials: F
authors.lastname: Giménez-Sánchez
authors.forename: Antonio
authors.initials: A
authors.lastname: Salas
authors.forename: Federico
authors.initials: F
authors.lastname: Martinón-Torres
mesh_terms: D000208:Acute Disease; D002648:Child; D002673:Child, Hospitalized; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012141:Respiratory Tract Infections / Q000097:blood*; D012720:Severity of Illness Index; D013030:Spain; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000150:complications / Q000453:epidemiology*
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D