A meta-analysis of the association between vitamin D supplementation and the risk of acute respiratory tract infection in the healthy pediatric group

Abstract

No previous meta-analysis had explored the association between vitamin D supplementation in healthy pediatrics and the risk of acute respiratory tract infections (ARTIs). Thus, we meta-analyzed the current evidence in this regard to provide sufficient knowledge about this risk-benefit ratio for vitamin D supplementation in this specific age group. We searched seven databases for randomized controlled trials (RCTs) that investigated the effect of vitamin D supplementation and ARTIs risk on a healthy pediatric population (0–18 years old). Meta-analysis was performed through R software. We included eight RCTs after the screening of 326 records according to our eligibility criteria. There were comparable infection rates between Vitamin D and placebo groups (OR = 0.98, 95% CI = 0.90–1.08, P-value = 0.62), with no significant heterogeneity among the included studies (I2 = 32%; P-value = 0.22). Moreover, there was no significant difference between the two vitamin D regimens (OR = 0.85, 95% CI = 0.64–1.12, P-value = 0.32), with no considerable heterogeneity among the included studies (I2 = 37%; P-value = 0.21). However, there was a significant reduction in Influenza A rates in the high-dose vitamin D group compared to the low dose one (OR = 0.39, 95% CI = 0.26–0.59, P-value < 0.001), with no heterogeneity among the included studies (I2 = 0%; P-value = 0.72). Only two studies of 8,972 patients reported different side effects, with overall acceptable safety profile. Regardless of the dosing regimen used or the type of infection, in the healthy pediatric group, there is no evident benefit of using vitamin D to prevent or reduce the ARTI rates.

Vitamin D supplementation for prevention of acute respiratory infections in older adults: A systematic review and meta-analysis

“…Recently, a review by Cho and colleagues showed that vitamin D supplementation has no clinical effect in the prevention of ARIs in the main analysis and subgroup analysis of high-quality studies [12], which was consistent with our study. Some reviews also explored the association between vitamin D supplementation in children and the risk of ARIs [13,14,43,44], all of them indicated…”

“…that vitamin D supplementation provided no benefit in preventing ARIs. However, two of these reviews showed high-dose vitamin D might reduce the incidence of influenza in children [13,14]. Another review also suggested that the most effective approach to optimizing and sustaining serum (25(OH)D) concentration throughout the year is by administering a significant bolus dose, followed by monthly or bi-monthly maintenance doses [45].…”

“…While some meta-analyses of the association between vitamin D supplementation and the risk of ARIs in the pediatric populations have been published [13,14], the efficacy of vitamin D supplementation in preventing ARIs in older adults remains uncertain and has not been thoroughly reviewed to the best of our knowledge. The number of older adults and adults with age-related chronic diseases is projected to more than double between 2019 and 2050 [15].…”

Exploring the Preventive Potential of Vitamin D against Respiratory Infections in Preschool-Age Children: A Cross-Sectional Study

“…Vitamin D‘s potential to enhance innate and adaptive immune responses suggests a promising adjunctive strategy to reduce the incidence and severity of respiratory infections in this vulnerable population [ 15 , 16 , 17 ]. In this context, several large studies and meta-analyses observed the safety and overall protective role of vitamin D supplements and higher 25(OH)D levels against respiratory infections [ 18 , 19 ].…”

Optimal vitamin D supplement dosage for improving insulin resistance in children and adolescents with overweight/obesity: a systematic review and network meta-analysis

“…In addition, many studies have also demonstrated the safety profile of vitamin D supplementation in different populations, even at high-dose daily vitamin D supplementation [ 15 ]. A monthly intake of 300,000 IU of vitamin D3 by hemodialysis patients aged 18 and above for 9 months [ 16 ] and a meta-analysis have demonstrated the safety of pediatric patients aged 0–18 years taking 400 IU/d of vitamin D [ 17 ]. Nevertheless, the dosage levels of vitamin D supplementation vary in clinical practice, and consensus on their comparative efficacy has not been reported yet, making decision-making very difficult.…”