Acute Respiratory Infections in children admitted to the hospital were 2X worse if low Vitamin D

Prevalence of Vitamin D Deficiency and its Association with Disease Severity in Children Hospitalized with Acute Respiratory Infections - 2025

Curr Health Sci J, vol. 51, no. 4, 2025 DOI 10.12865/CHSJ.51.04.07

Background: Vitamin D deficiency (VDD) is highly prevalent in pediatric patients, and it has been implicated in the pathogenesis and clinical severity of acute respiratory infections (ARI). Objectives: To evaluate the prevalence of VDD and its association with ARI disease severity and clinical outcomes in hospitalized pediatric patients.

Methods: A 4-year prospective case-control study, conducted between 2021 and 2024, in two Romanian pediatric hospitals, included 400 inpatients, aged 0-18 years, admitted for ARI. Patients were stratified into cases with a low level of vitamin D (n=200) and controls with a normal vitamin D (n=200). Clinical severity of ARI, inflammatory biomarkers, presence of fever, need for supplemental oxygen, and length of hospital stay were recorded and analyzed in both cases and controls.

Results: Low serum vitamin D levels were significantly associated with

• severe ARI (26.5% vs. 5.5%),
• fever at admission (61.0% vs. 32.0%), and
• increased requirement for oxygen therapy (69.5% vs. 21.0%).

Cases also exhibited

• higher C-reactive protein levels (3.50 vs. 1.64mg/L),
• higher clinical severity scores (3.77 vs. 1.62), and
• longer hospital length of stay (4.68 vs. 2.89 days).

Conclusions: Vitamin D deficiency was strongly associated with increased disease severity and adverse clinical outcomes in pediatric inpatients with ARI.

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