Respiratory infection, children and Vitamin D - many studies

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26+ VitaminDWiki Infant-Child pages with RESPIRATORY OR RTI in title

This list is automatically updated

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Fewer ARTIs and recover 5X faster after a single dose of 120,000 IU of Vitamin D (age 3) – RCT Oct 2024

The Role of Vitamin D Supplementation in the Prevention of Acute Respiratory Infections: A Double-Blind Randomized Controlled Trial
Res. J. Pharm., 18: 13-17, doi: 10.36478/ makrjp.2024.3.13.17
1Megha R. Raju and 2R.V. Mookambika
2 Dept of General Medicine, Sree Mookambika Institute of Medical Sciences, Kanyakumari, Tamil Nadu, India

Fewer ARTI episodes

5X more likely to be <4 days

We calculate the serum levels of 25 hydroxyvitamin D (25(OH)D) in patients who have been admitted to a rural hospital's paediatric ward due to acute respiratory tract infections (ARTI). We also determine the serum 25 hydroxyvitamin D [25(OH)D] levels in these patients in order to investigate the relationship between vitamin D insufficiency and respiratory tract infections. The patients were randomized into two groups (Groups A and B ) using a computer-generated sequence:

• Group A (Vitamin D 120,000 IU with standard treatment., n=165) and
• Group B (placebo with standard treatment., n=153).

The pharmacologist, who was not involved in the study, dispensed the identical containers (Abbott Healthcare Pvt. Ltd., India) containing Vitamin D and placebo to assigned random groups. Data regarding demographics, clinical history of patients, socioeconomic status of parents, clinical presentations and medication details were recorded in a predesigned pro forma. Out of 318 (n=165 in Group A and n=153 in Group B ) patients, 200 (62.8%) were males and 118 (37.1%) were females with mean age and mean weight of 36±17.7 versus 37.2±16.4 months and 13.2±4.5 versus 12.5±4.1 kg, respectively and no significant difference was found (P>0.05) between them.
Majority (77., 26.2%) of the patients were in the age group of 11-20 months. Furthermore, a trend of gradual decrease in the number of ARTI patients was observed with the progression of age till 40 months of age.
We draw the conclusion that vitamin D insufficiency and respiratory tract infections are related based on the findings of this study. Measuring the levels of vitamin D before beginning any supplementation is advised, as only a small number of patients had dangerous amounts of the vitamin. As a result, vitamin D treatment may not be recommended in every instance of ARTI.
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RTI Meta-analysis failed to look at any Vitamin D dosing >2,000 IU - July 2023

A meta-analysis of the association between vitamin D supplementation and the risk of acute respiratory tract infection in the healthy pediatric group
Front Nutr. 2023 Jun 20;10:1188958. doi: 10.3389/fnut.2023.1188958. eCollection 2023.

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Acute respiratory infections decreased a small amount when a small amount of vitamin D was added – meta-analysis March 2020

Vitamin D supplementation to prevent acute respiratory infections: a systematic review and meta-analysis of aggregate data from randomised controlled trials
Lancet Diabetes and Endocrinology March 30, 2021DOI:https://doi.org/10.1016/S2213-8587(21)00051-6
David A Jolliffe, PhD, Prof Carlos A Camargo Jr, MD, John D Sluyter, PhD, Mary Aglipay, Msc, Prof John F Aloia, MD, Davaasambuu Ganmaa, PhD

Background
A 2017 meta-analysis of data from 25 randomised controlled trials (RCTs) of vitamin D supplementation for the prevention of acute respiratory infections (ARIs) revealed a protective effect of this intervention. We aimed to examine the link between vitamin D supplementation and prevention of ARIs in an updated meta-analysis.

Methods
For this systematic review and meta-analysis, we searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and the ClinicalTrials.gov registry for studies listed from database inception to May 1, 2020. Double-blind RCTs of vitamin D3, vitamin D2, or 25-hydroxyvitamin D (25[OH]D) supplementation for any duration, with a placebo or low-dose vitamin D control, were eligible if they had been approved by a research ethics committee, and if ARI incidence was collected prospectively and prespecified as an efficacy outcome. Studies reporting results of long-term follow-up of primary RCTs were excluded. Aggregated study-level data, stratified by baseline 25(OH)D concentration and age, were obtained from study authors. Using the proportion of participants in each trial who had one or more ARIs, we did a random-effects meta-analysis to obtain pooled odds ratios (ORs) and 95% CIs to estimate the effect of vitamin D supplementation on the risk of having one or more ARIs (primary outcome) compared with placebo. Subgroup analyses were done to estimate whether the effects of vitamin D supplementation on the risk of ARI varied according to baseline 25(OH)D concentration (<25 nmol/L vs 25·0–49·9 nmol/L vs 50·0–74·9 nmol/L vs >75·0 nmol/L), vitamin D dose (daily equivalent of <400 international units [IU] vs 400–1000 IU vs 1001–2000 IU vs >2000 IU), dosing frequency (daily vs weekly vs once per month to once every 3 months), trial duration (≤12 months vs >12 months), age at enrolment (<1·00 years vs 1·00–15·99 years vs 16·00–64·99 years vs ≥65·00 years), and presence versus absence of airway disease (ie, asthma only, COPD only, or unrestricted). Risk of bias was assessed with the Cochrane Collaboration Risk of Bias Tool. The study was registered with PROSPERO, CRD42020190633.

Findings
We identified 1528 articles, of which 46 RCTs (75 541 participants) were eligible. Data for the primary outcome were obtained for 48 488 (98·1%) of 49 419 participants (aged 0–95 years) in 43 studies. A significantly lower proportion of participants in the vitamin D supplementation group had one or more ARIs (14 332 [61·3%] of 23 364 participants) than in the placebo group (14 217 [62·3%] of 22 802 participants), with an OR of 0·92 (95% CI 0·86–0·99; 37 studies; I2=35·6%, pheterogeneity=0·018). No significant effect of vitamin D supplementation on the risk of having one or more ARIs was observed for any of the subgroups defined by baseline 25(OH)D concentration. However, protective effects of supplementation were observed in trials in which vitamin D was given in a daily dosing regimen (OR 0·78 [95% CI 0·65–0·94]; 19 studies; I2=53·5%, pheterogeneity=0·003), at daily dose equivalents of 400–1000 IU (0·70 [0·55–0·89]; ten studies; I2=31·2%, pheterogeneity=0·16), for a duration of 12 months or less (0·82 [0·72–0·93]; 29 studies; I2=38·1%, pheterogeneity=0·021), and to participants aged 1·00–15·99 years at enrolment (0·71 [0·57–0·90]; 15 studies; I2=46·0%, pheterogeneity=0·027). No significant interaction between allocation to the vitamin D supplementation group versus the placebo group and dose, dose frequency, study duration, or age was observed. In addition, no significant difference in the proportion of participants who had at least one serious adverse event in the vitamin supplementation group compared with the placebo group was observed (0·97 [0·86–1·07]; 36 studies; I2=0·0%, pheterogeneity=0·99). Risk of bias within individual studies was assessed as being low for all but three trials.

Interpretation
Despite evidence of significant heterogeneity across trials, vitamin D supplementation was safe and overall reduced the risk of ARI compared with placebo, although the risk reduction was small. Protection was associated with administration of daily doses of 400–1000 IU for up to 12 months, and age at enrolment of 1·00–15·99 years. The relevance of these findings to COVID-19 is not known and requires further investigation.
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