Serum Vitamin D Levels and Life-Threatening Respiratory Syncytial Virus Infection in Previously Healthy Infants.


Journal

The Journal of infectious diseases
ISSN: 1537-6613
Titre abrégé: J Infect Dis
Pays: United States
ID NLM: 0413675

Informations de publication

Date de publication:
21 09 2022
Historique:
received: 03 11 2021
accepted: 27 01 2022
pubmed: 3 2 2022
medline: 24 9 2022
entrez: 2 2 2022
Statut: ppublish

Résumé

25-hydroxyvitamin D (VD) effects on lung function and immune-modulation might affect respiratory syncytial virus (RSV) infection outcomes. We aimed to assess VD levels on admission and their association with life-threatening RSV disease (LTD). A prospective cohort study was conducted during 2017-2019. Previously healthy infants aged <12 months, hospitalized with a first episode of RSV infection, were enrolled. LTD was defined by need for intensive care and ventilatory support. Serum VD levels <20 ng/mL were categorized as deficient, and 20-29.9 ng/mL as insufficient. Of 125 patients studied, 73 (58%) were male. Median age was 4 months. Twenty-two patients developed LTD. No differences in viral load were seen between cases with LTD and controls (P = .94). Patients who developed LTD had significantly lower VD levels: median 18.4 ng/mL (IQR, 15.1-26.9 ng/mL) versus 31.7 ng/mL (IQR, 23.6-42.0 ng/mL), P < .001; 59% of infants with LTD had VD deficiency compared with 12% in those with better outcome. Multivariable regression analysis confirmed VD deficiency as a risk factor (odds ratio, 11.83; 95% confidence interval, 3.89-35.9; P < .001). These findings provide additional evidence for the development of strategies to prevent severe RSV infections.

Sections du résumé

BACKGROUND
25-hydroxyvitamin D (VD) effects on lung function and immune-modulation might affect respiratory syncytial virus (RSV) infection outcomes. We aimed to assess VD levels on admission and their association with life-threatening RSV disease (LTD).
METHODS
A prospective cohort study was conducted during 2017-2019. Previously healthy infants aged <12 months, hospitalized with a first episode of RSV infection, were enrolled. LTD was defined by need for intensive care and ventilatory support. Serum VD levels <20 ng/mL were categorized as deficient, and 20-29.9 ng/mL as insufficient.
RESULTS
Of 125 patients studied, 73 (58%) were male. Median age was 4 months. Twenty-two patients developed LTD. No differences in viral load were seen between cases with LTD and controls (P = .94). Patients who developed LTD had significantly lower VD levels: median 18.4 ng/mL (IQR, 15.1-26.9 ng/mL) versus 31.7 ng/mL (IQR, 23.6-42.0 ng/mL), P < .001; 59% of infants with LTD had VD deficiency compared with 12% in those with better outcome. Multivariable regression analysis confirmed VD deficiency as a risk factor (odds ratio, 11.83; 95% confidence interval, 3.89-35.9; P < .001).
CONCLUSIONS
These findings provide additional evidence for the development of strategies to prevent severe RSV infections.

Identifiants

pubmed: 35106574
pii: 6519589
doi: 10.1093/infdis/jiac033
doi:

Substances chimiques

Vitamin D 1406-16-2

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

958-966

Investigateurs

Pablo Neira (P)
Bárbara Carrizo (B)
Agustina Chiormi (A)
Gabriela Visingardi (G)
Florencia Feldman (F)
Mariana Reyero (M)
Laura Talarico (L)
Alejandra Retta (A)
Javier Matute (J)
Normando Mascardi (N)

Informations de copyright

© The Author(s) 2022. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Déclaration de conflit d'intérêts

Potential conflicts of interest . All authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Auteurs

F Martin Ferolla (FM)

Department of Medicine, Pediatric Infectious Diseases Program, Hospital de Niños Dr. Ricardo Gutiérrez, Universidad de Buenos Aires, Buenos Aires, Argentina.

E Walter Yfran (EW)

Department of Medicine, Pediatric Infectious Diseases Program, Hospital de Niños Dr. Ricardo Gutiérrez, Universidad de Buenos Aires, Buenos Aires, Argentina.

M Gabriela Ballerini (MG)

Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina.
Endocrinology Division, Hospital de Niños Dr. Ricardo Gutiérrez, Universidad de Buenos Aires, Buenos Aires, Argentina.

Ana Caratozzolo (A)

Department of Medicine, Pediatric Infectious Diseases Program, Hospital de Niños Dr. Ricardo Gutiérrez, Universidad de Buenos Aires, Buenos Aires, Argentina.

Analía Toledano (A)

Department of Medicine, Pediatric Infectious Diseases Program, Hospital de Niños Dr. Ricardo Gutiérrez, Universidad de Buenos Aires, Buenos Aires, Argentina.

Ana C Giordano (AC)

Department of Medicine, Pediatric Infectious Diseases Program, Hospital de Niños Dr. Ricardo Gutiérrez, Universidad de Buenos Aires, Buenos Aires, Argentina.

Patricio L Acosta (PL)

Department of Medicine, Pediatric Infectious Diseases Program, Hospital de Niños Dr. Ricardo Gutiérrez, Universidad de Buenos Aires, Buenos Aires, Argentina.
Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina.

Hamilton Cassinelli (H)

Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina.
Endocrinology Division, Hospital de Niños Dr. Ricardo Gutiérrez, Universidad de Buenos Aires, Buenos Aires, Argentina.

Ignacio Bergada (I)

Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina.
Endocrinology Division, Hospital de Niños Dr. Ricardo Gutiérrez, Universidad de Buenos Aires, Buenos Aires, Argentina.

M Gabriela Ropelato (MG)

Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina.
Endocrinology Division, Hospital de Niños Dr. Ricardo Gutiérrez, Universidad de Buenos Aires, Buenos Aires, Argentina.

María M Contrini (MM)

Department of Medicine, Pediatric Infectious Diseases Program, Hospital de Niños Dr. Ricardo Gutiérrez, Universidad de Buenos Aires, Buenos Aires, Argentina.

Eduardo L López (EL)

Department of Medicine, Pediatric Infectious Diseases Program, Hospital de Niños Dr. Ricardo Gutiérrez, Universidad de Buenos Aires, Buenos Aires, Argentina.

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