Burn patients with higher levels of Vitamin D do better in 6 ways - meta-analysis Dec 2025

Vitamin D Deficiency and Clinical Outcomes in Adult Burn Patients: A Systematic Review and Meta-Analysis

Cureus. 2025 Dec 13;17(12):e99123. doi: 10.7759/cureus.99123

Daniel Madarshahian 1,✉, Anjana Kaur 2, Jvalant Parekh 3, Yvonne Wilson 2

Vitamin D deficiency is highly prevalent among burn patients and may impair immune function, inflammation control, and wound healing. To clarify its clinical impact, we conducted a systematic review and meta-analysis of observational studies evaluating outcomes stratified by baseline vitamin D status in adult burn patients. Six endpoints were analyzed:

wound infection or cellulitis,
bacteremia or septicemia,
intensive care unit (ICU) admission,
mechanical ventilation,
ICU length of stay (LOS), and
total hospital LOS.

Random-effects models generated pooled odds ratios (ORs) and weighted mean differences (WMDs) with 95% CI. Five studies comprising 1,814 patients met the inclusion criteria. Vitamin D sufficiency was associated with significantly reduced odds of bacteremia or septicemia (OR 0.21; 95% CI 0.10-0.43; p<0.0001) and shorter ICU (WMD -5.5 days; p=0.04) and hospital LOS (WMD -5.7 days; p=0.003). A borderline reduction in mechanical ventilation was also observed (OR 0.55; p=0.05), whereas ICU admission and wound infection outcomes showed non-significant trends favoring sufficiency. Heterogeneity varied across outcomes, with the bacteremia analysis demonstrating no heterogeneity (I²=0%). Vitamin D deficiency appears associated with increased systemic infection risk and prolonged hospitalization following burn injury, supporting further prospective trials to evaluate vitamin D supplementation in burn care.

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Burns less severe if the person has higher level of Vitamin D

Perplexity AI Dec 2025 Research confirms that higher levels of Vitamin D are strongly associated with less severe clinical outcomes following a burn injury. While having high Vitamin D levels does not physically prevent the initial thermal damage (burn depth) from a heat source, it significantly reduces the severity of the recovery process, complications, and scarring.

For sunburns specifically, there is evidence that high-dose Vitamin D can directly reduce the acute severity of skin inflammation and redness.

1. Thermal Burns (Heat/Fire): Impact on Recovery Severity

For traumatic burns, "severity" is often measured by how the body recovers rather than just the initial injury depth. Research indicates a strong protective association between Vitamin D sufficiency and milder clinical courses.

Faster Wound Healing: Patients with sufficient Vitamin D levels heal significantly faster. Deficiency prolongs wound healing time (WHT) across all burn types (flame, electrical, and scald).[1][2]
Reduced Infection Risk: Vitamin D activates the production of cathelicidin, an antimicrobial peptide that helps preventing infection. Deficient patients have significantly higher rates of infection and sepsis, which are leading causes of increased burn severity and mortality.[3][4]
Shorter Hospital Stays: Multiple studies show a direct correlation between low Vitamin D and longer stays in both the hospital and Intensive Care Unit (ICU).[5][6][3]
Less Chronic Pain: A study of burn survivors found that those with lower Vitamin D levels at the time of injury (peritraumatic) experienced greater chronic pain severity in the year following the burn.[7]

The "Vicious Cycle" of Deficiency: Research identifies a bidirectional relationship. Severe burns cause a massive, rapid drop in Vitamin D levels (due to loss of skin synthesis area and hypermetabolic response). This induced deficiency then impairs healing, creating a "vicious cycle" that worsens the overall severity of the condition.[8]

2. Sunburn (UV Radiation): Impact on Acute Severity

For burns caused by UV radiation (sunburn), Vitamin D appears to have a direct anti-inflammatory effect that reduces the visible severity of the burn.

Reduced Inflammation: A randomized double-blind trial found that participants who took high doses of Vitamin D (50,000–200,000 IU) one hour after a sunburn experienced significantly less redness, swelling, and inflammation compared to placebo.[9][10]
Skin Repair Activation: The study showed that Vitamin D activated arginase-1, an anti-inflammatory enzyme that promotes tissue repair, effectively making the sunburn "less severe" at a genetic and cellular level.[10][11]

3. Mechanisms of Action

Vitamin D makes burns "less severe" through three primary biological mechanisms:

Mechanism	Effect on Burn Severity
Antimicrobial Defense	Increases production of cathelicidin and defensins, natural antibiotics that kill bacteria and prevent wound infection [1][12].
Barrier Regulation	Regulates keratinocyte proliferation and lipid organization, helping to rebuild the skin barrier faster and reducing fluid loss [12][13].
Inflammation Control	Suppresses pro-inflammatory cytokines (like TNF-α) and boosts anti-inflammatory enzymes, preventing the excessive inflammation that leads to scarring and pain [9][10].

Summary Table: Vitamin D & Burn Severity

Burn Type	Does High Vit D Reduce Initial Damage?	Does High Vit D Reduce Recovery Severity?	Key Finding
Thermal Burn	Unlikely (Heat damage is physical)	Yes (Strong Evidence)	Faster healing, fewer infections, less scarring, and reduced mortality risk.
Sunburn (UV)	Yes (Biochemical protection)	Yes (Strong Evidence)	High doses post-exposure reduce redness, swelling, and skin cell death.

Recommendation based on findings

Since Vitamin D levels drop rapidly after a burn injury, maintaining optimal levels beforehand acts as a safety buffer. However, immediate supplementation following a burn (under medical supervision) has been shown to improve outcomes and break the cycle of deficiency-impaired healing.[8]

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