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

• Published in: The Journal of infectious diseases Vol. 226; no. 6; pp. 958 - 966
• Main Authors: Ferolla, F Martin, Yfran, E Walter, Ballerini, M Gabriela, Caratozzolo, Ana, Toledano, Analía, Giordano, Ana C, Acosta, Patricio L, Cassinelli, Hamilton, Bergada, Ignacio, Ropelato, M Gabriela, Contrini, María M, López, Eduardo L
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 21.09.2022
• Subjects: 25-Hydroxyvitamin D; Immunomodulation; Infants; Infections; Respiratory function; Respiratory syncytial virus; Risk factors; Sexually transmitted diseases; STD; Vitamin D; severity; 25-hydroxyvitamin D; intensive care; acute respiratory infection; respiratory syncytial virus; bronchiolitis
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/jiac033

Abstract 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. Results of this prospective cohort study showed that previously healthy infants with vitamin D deficiency have an increased risk of developing respiratory syncytial virus life-threatening disease, and that vitamin D supplementation significantly prevents a deficient state.