INTRODUCTION: Vitamin D is important for its immunomodulatory role and there is an independent association between vitamin D deficiency and pneumonia. We assessed the effect of vitamin D supplementation on the outcome in children hospitalized for severe pneumonia.

METHODS: This was a randomised, double blinded, placebo-controlled clinical trial in children aged >2–59 months with severe pneumonia attending Dhaka Hospital, icddr,b. Children received age-specific megadose of vitamin D3 (20,000IU: < 6 months, 50,000 IU: 6–12 months, 100,000 IU:13–59 months) or placebo on first day and 10,000 IU as maintenance dose for next 4 days or until discharge (if discharged earlier) along with standard therapy. This trial is registered at ClinicalTrials.gov, number NCT02185196.

FINDINGS: We enrolled 100 children in placebo group and 97 in vitamin D group. On admission, 50 (52%) and 49 (49%) of children in vitamin D and placebo groups, respectively were vitamin D deficient. Among children with a sufficient serum vitamin D level on admission, a lower trend for duration of resolution of severe pneumonia in hours [72(IQR:44-96)vs. 88(IQR:48-132);p = 0.07] and duration of hospital stay in days [4(IQR:3-5)vs.5(IQR:4-7);P = 0.09] was observed in vitamin D group compared to placebo. No beneficial effect was observed in vitamin D deficient group or irrespective of vitamin D status.

CONCLUSION: Age-specific mega dose of vitamin D followed by a maintenance dose shown to have no statistical difference between the two intervention groups, however there was a trend of reduction of time to recovery from pneumonia and overall duration of hospital stay in under-five children with a sufficient serum vitamin D level on hospital admission.

Document Type


Publication Date


Notes/Citation Information

Published in PLOS ONE, v. 16, issue 2, 0246460.

© 2021 Chowdhury et al.

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Digital Object Identifier (DOI)


Funding Information

This research study was funded by Centers for Disease Control and Prevention (CDC), grant number CDC Cooperative # 5U01CI000628-05. icore/unrestricted support.

journal.pone.0246460.s001.doc (219 kB)
S1 Checklist. CONSORT 2010 checklist of information to include when reporting a randomised trial*. https://doi.org/10.1371/journal.pone.0246460.s001

journal.pone.0246460.s002.docx (12 kB)
S1 Table. Multivariable adjusted hazard ratios for outcome median duration in hour by treatment groups. https://doi.org/10.1371/journal.pone.0246460.s002

journal.pone.0246460.s003.docx (7238 kB)
S1 File. Standard management guidelines for Dhaka Hospital. https://doi.org/10.1371/journal.pone.0246460.s003

journal.pone.0246460.s004.doc (8243 kB)
S2 File. Vitamin D protocol. https://doi.org/10.1371/journal.pone.0246460.s004

journal.pone.0246460.s005.dta (216 kB)
S3 File. Vitamin D Data set. https://doi.org/10.1371/journal.pone.0246460.s005

journal.pone.0246460.s006.do (12 kB)
S4 File. Vitamin D Do file. https://doi.org/10.1371/journal.pone.0246460.s006

Included in

Pediatrics Commons