Phuong Vo1, Claire Koppel2, Janice A Espinola3, Jonathan M Mansbach4, Juan C Celedón5, Kohei Hasegawa3, Megan Bair-Merritt6, Carlos A Camargo3. 1. Department of Pediatrics, Boston Medical Center, Boston, MA. Electronic address: phuong.vo@bmc.org. 2. Leiden University Medical Center, Leiden University, Leiden, The Netherlands. 3. Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA. 4. Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA. 5. Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA. 6. Department of Pediatrics, Boston Medical Center, Boston, MA.
Abstract
OBJECTIVE: To investigate the association between circulating 25-hydroxyvitamin D [25(OH)D] status at admission and disease severity among infants hospitalized for bronchiolitis and to determine whether the association differs by the form of 25(OH)D-total, bioavailable or free 25(OH)D. STUDY DESIGN: We conducted a 17-center prospective cohort study of 1016 US infants <12 months old hospitalized with bronchiolitis. Vitamin D status was defined by total 25(OH)D levels, and by calculated levels of bioavailable and free 25(OH)D. Bronchiolitis severity was defined by requirement for intensive care and hospital length-of-stay (LOS). Logistic and Poisson regression were used for unadjusted and multivariable analyses. RESULTS: The median age of hospitalized infants was 3.2 months (IQR 1.6-6.0). The median total 25(OH)D was 26.5 ng/mL (IQR 18.0-33.1); 298 (29%) infants had total 25(OH)D <20 ng/mL. In multivariable models, infants with total 25(OH)D <20 ng/mL had higher risk of requiring intensive care (aOR 1.72, 95% CI 1.12-2.64) and longer LOS (adjusted rate ratio 1.39, 95% CI 1.17-1.65) compared with infants with total 25(OH)D ≥30 ng/mL. Infants with the lowest tertile of bioavailable 25(OH)D, compared with those with the highest tertile, had longer LOS (adjusted rate ratio 1.32, 95% CI 1.07-1.62); admission to the intensive care unit was not statistically significant in the adjusted model (aOR 1.39, 95% CI 0.96-2.64). Free 25(OH)D level was not associated with severity of bronchiolitis in either unadjusted or adjusted models. CONCLUSION: In a large, multicenter cohort of US infants hospitalized for bronchiolitis, infants with total 25(OH)D <20 ng/mL had increased risk of intensive care and longer hospital LOS.
OBJECTIVE: To investigate the association between circulating 25-hydroxyvitamin D [25(OH)D] status at admission and disease severity among infants hospitalized for bronchiolitis and to determine whether the association differs by the form of 25(OH)D-total, bioavailable or free 25(OH)D. STUDY DESIGN: We conducted a 17-center prospective cohort study of 1016 US infants <12 months old hospitalized with bronchiolitis. Vitamin D status was defined by total 25(OH)D levels, and by calculated levels of bioavailable and free 25(OH)D. Bronchiolitis severity was defined by requirement for intensive care and hospital length-of-stay (LOS). Logistic and Poisson regression were used for unadjusted and multivariable analyses. RESULTS: The median age of hospitalized infants was 3.2 months (IQR 1.6-6.0). The median total 25(OH)D was 26.5 ng/mL (IQR 18.0-33.1); 298 (29%) infants had total 25(OH)D <20 ng/mL. In multivariable models, infants with total 25(OH)D <20 ng/mL had higher risk of requiring intensive care (aOR 1.72, 95% CI 1.12-2.64) and longer LOS (adjusted rate ratio 1.39, 95% CI 1.17-1.65) compared with infants with total 25(OH)D ≥30 ng/mL. Infants with the lowest tertile of bioavailable 25(OH)D, compared with those with the highest tertile, had longer LOS (adjusted rate ratio 1.32, 95% CI 1.07-1.62); admission to the intensive care unit was not statistically significant in the adjusted model (aOR 1.39, 95% CI 0.96-2.64). Free 25(OH)D level was not associated with severity of bronchiolitis in either unadjusted or adjusted models. CONCLUSION: In a large, multicenter cohort of US infants hospitalized for bronchiolitis, infants with total 25(OH)D <20 ng/mL had increased risk of intensive care and longer hospital LOS.
Authors: Mohammed Al-Jarallah; Rajesh Rajan; Raja Dashti; Ahmad Al Saber; Jiazhu Pan; Kobalava D Zhanna; Hassan Abdelnaby; Wael Aboelhassan; Farah Almutairi; Mohammed Abdullah; Naser Alotaibi; Mohammad Al Saleh; Noor Al Nasrallah; Bader Al-Bader; Haya Malhas; Maryam Ramadhan; Mahdy Hamza; Peter A Brady; Ibrahim Al-Zakwani; Moudhi Alroomi Journal: J Med Virol Date: 2021-06-20 Impact factor: 20.693
Authors: George Griffin; Martin Hewison; Julian Hopkin; Rose Kenny; Richard Quinton; Jonathan Rhodes; Sreedhar Subramanian; David Thickett Journal: R Soc Open Sci Date: 2020-12-01 Impact factor: 2.963
Authors: Kelsea M Drall; Catherine J Field; Andrea M Haqq; Russell J de Souza; Hein M Tun; Nadia P Morales-Lizcano; Theodore B Konya; David S Guttman; Meghan B Azad; Allan B Becker; Diana L Lefebvre; Piush J Mandhane; Theo J Moraes; Malcolm R Sears; Stuart E Turvey; Padmaja Subbarao; James A Scott; Anita L Kozyrskyj Journal: Gut Microbes Date: 2020-11-09