Vitamin D Status in South Korean Military Personnel with Acute Eosinophilic Pneumonia: A Pilot Study

Association of Vitamin D Status with the Severity and Mortality of Community-Acquired Pneumonia in Iran during 2016-2017: A Prospective Cohort Study

BACKGROUND

Community-acquired pneumonia (CAP) is a common disease considered as a major public health problem. It causes considerable morbidity and mortality despite antibiotic treatments. Hospital admission of CAP patients is a significant financial burden and many efforts are ongoing to decrease hospital stay durations. Vitamin D deficiency is associated with increased risk of respiratory infections. This study was designed to determine the association of vitamin D status with hospitalized CAP patient mortality and disease severity.

METHODS

This prospective cohort study examined 180 CAP patients admitted to a teaching Hospital in Tehran, Iran during 2016-2017. Their demographic and anthropometric characteristics were recorded. The disease severity was evaluated based on CURB-65. Vitamin D status was determined by measuring by serum 25-hydroxylated vitamin D (25(OH)D) with ELISA. The patients were followed for 30 days to evaluate their vitality.

RESULTS

One hundred and eighty pneumonia patients, including 104 males and 84 females, were recruited from respiratory disease, infectious disease, emergency, and ICU wards. Nearly 18% of the patients were current smokers. The CAP severity, evaluated by CURB-65, was determined to be non-severe in 74.4% of the patients. Patients were classified as vitamin D sufficient, insufficient, or deficient. Thirty percent of the patients were vitamin D sufficient, 18% were insufficient, and 52% were deficient. Thirty-day mortality was 40% (72 cases). Mortality was greater in males than in females (47.1% vs. 30.3%, p=0.03). The disease was significantly less severe in the patients who survived than in those who did not. The vitamin D status differed between males and females (p=0.027). The vitamin D status was lower in the more severe cases than in the less (p=0.036), and vitamin D deficiency was more prevalent in patients who died than in those who lived. Vitamin D concentration was negatively correlated with hospital stay duration. The 25(OH)D concentration was significantly greater in patients who survived than in those who did not (p<0.001).

CONCLUSION

Pneumonia severity and mortality risk were greater and hospital stays longer in vitamin D-deficient patients than in those with higher vitamin D status.

Age-Related Vitamin D Deficiency Is Associated with the Immune Response in Children with Community-Acquired Pneumonia

To investigate vitamin D status in children with community-acquired pneumonia (CAP) and explore the association between vitamin D deficiency and the immune response in CAP children, 77 children with CAP were retrospectively analyzed. The baseline characteristics of patients were obtained from medical records. Based on the blood samples collected during diagnosis of CAP, the routine blood examination results and proportions of lymphocyte subsets were assessed. There were 71.4% (55/77) of patients with vitamin D deficiency among CAP children. The serum 25(OH)D level significantly decreased with age. Patients with vitamin D deficiency had a significantly higher neutrophil percentage, but significantly lower lymphocyte percentage and count as well as proportion of CD19 positive lymphocytes (CD19+). Spearman's rho test further confirmed these positive correlations and negative correlations. Moreover, significant associations of vitamin D deficiency with age and the above immune markers were also confirmed by univariate logistic regression analysis. However, only age entered the backward stepwise regression model in multivariate analysis. Vitamin D status in CAP children was negatively associated with age. Age-related vitamin D deficiency may affect the immune response in children with CAP.

Association of Serum Vitamin D Levels with Bacterial Load in Pulmonary Tuberculosis Patients

Background

Vitamin D is known to have diverse effects on various systems in the body. There is evidence to suggest that a link exists between the serum vitamin D status and tuberculosis. The present study was designed to assess the alterations in serum 25-hydroxyvitamin D levels in newly diagnosed sputum acid fast bacilli (AFB) positive pulmonary tuberculosis patients and to study the association, if any, between serum vitamin D levels and different levels of sputum smear positivity.

Methods

Serum 25-hydroxyvitamin D levels were estimated in 65 sputum AFB positive pulmonary tuberculosis patients and 65 age and gender-matched healthy controls.

Results

The levels of serum 25 hydroxy-vitamin D in tuberculosis patients were not statistically different from the levels of serum 25 hydroxy-vitamin D in healthy controls. However, among patients with pulmonary tuberculosis, there was a significant negative correlation between the levels of serum 25 hydroxy-vitamin D and levels of sputum positivity.

Conclusion

Serum vitamin D levels negatively correlates with bacterial load in patients with active pulmonary tuberculosis.