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.
Digital Object Identifier (DOI)
This research study was funded by Centers for Disease Control and Prevention (CDC), grant number CDC Cooperative # 5U01CI000628-05. icore/unrestricted support.
Chowdhury, Fahmida; Shahid, Abu Sadat Mohammad Sayeem Bin; Tabassum, Mosharrat; Parvin, Irin; Ghosh, Probir Kumar; Hossain, Mohammad Iqbal; Alam, Nur Haque; Faruque, A. S. G.; Huq, Sayeeda; Shahrin, Lubaba; Homaira, Nusrat; Hassan, Zakiul; Akhtar, Zubair; Mah-E-Muneer, S.; Fuchs, George J. III; Ahmed, Tahmeed; and Chisti, Mohammod Jobayer, "Vitamin D Supplementation among Bangladeshi Children under-Five Years of Age Hospitalised for Severe Pneumonia: A Randomised Placebo Controlled Trial" (2021). Pediatrics Faculty Publications. 311.
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