VITAMIN D STATUS AND ITS CORRELATION WITH COMMUNITY ACQUIRED PNEUMONIA SEVERITY IN CHILDREN

Аннотация

To elucidate the role of vitamin D status on the outcome of pneumonia, we estimated the associations between vitamin D status and pneumonia severity in children. Material and Methods. A hospital based cross-sectional study was conducted in two hospitals. 97 children with community acquired pneumonia (CAP) aged 5-17 years were included in 3 research groups divided according vitamin D status. Vitamin D3 deficiency was defined as a level of serum vitamin D<20ng/ml. The history of the child’s illness and the results from the physical examination and laboratory/instrumental data were recorded in a standardized form. Oxygen saturation (SpO2), weight, and height were measured. Indicators of the severity of pneumonia for analysis were presence or absence of danger signs, hypoxemia, prolonged hospitalization, and ICU admission, consolidation on chest X-ray, high inflammatory markers. Statistics. Data analysis was performed using SPSS 18.0 (SPSS Inc., Chicago, IL, USA). The nonparametric tests were used to compare groups (Kruskal–Wallis and Mann–Whitney). Statistical significance was taken as p<0.05. Results. Children with 25(OH)D <20ng/ml had an increased risk for treatment failure and a longer duration compared with patients with levels ≥ 30ng/ml (p<0.001). Hypoxemia and respiratory distress syndrome were more common in vitamin D3 deficient patients (p<0.05). The leukocytosis was in positive correlation with vitamin D3 deficiency, but CRP level was not associated with the vitamin D3 status. Pneumonia cases with 25(OH)D level 20-30ng/ml to compare with vitamin D3 level > 30ng/ml cases did not show any significant differences in severity. Conclusion. Vitamin D deficiency (level < 20ng/ml) was associated with severity of CAP in children. There is not yet achieved any consensus about this question and the data from ongoing clinical trials are needed for better elucidation of this matter.