VITAMIN D SUPPLEMENTATION FOR THE PREVENTION OF RESPIRATORY INFECTIONS IN CHILDHOOD: A SYSTEMATIC REVIEW AND META-ANALYSIS
- 1Centro Universitario UNINOVAFAPI (Afya Teresina), Teresina, Piaui, Brazil
Abstract
BackgroundVitamin D modulates innate and adaptive immunity and has been investigated for preventing pediatric respiratory infections.
ObjectiveTo assess the effects of vitamin D supplementation on respiratory tract infections (RTIs), including upper RTIs, lower RTIs/recurrent pneumonia, and hospitalization/clinical severity in children and adolescents.
MethodsSystematic review and random-effects meta-analysis of 16 publications, of which 13 contributed to quantitative synthesis. Twenty-four effect estimates were pooled, eight per outcome. The odds ratio (OR) was analyzed on its natural logarithmic scale (logOR), using restricted maximum likelihood (REML) estimation and Knapp-Hartung (KH) adjusted inference. Where necessary, risk ratios (RRs), hazard ratios (HRs), and incidence rate ratios (IRRs) were approximated on the logOR scale.
ResultsFor respiratory infection/upper RTI, pooled logOR was -0.284 (KH-adjusted 95% confidence interval [CI]: -0.678 to 0.110; OR 0.753; p = 0.132; I2 = 97.2%). For lower RTI/recurrent pneumonia, logOR was -0.445 (95% CI: -0.987 to 0.097; OR 0.641; p = 0.093; I2 = 89.5%). For hospitalization/clinical severity, logOR was -0.609 (95% CI: -1.134 to -0.083; OR 0.544; p = 0.029; I2 = 78.3%).
ConclusionsPooled estimates favored supplementation in direction for all three groups, although confidence intervals included the null for the first two. Heterogeneity was substantial, and the results are limited by approximations among effect measures, clinically diverse endpoints, and potentially correlated effects from individual studies.
Related
- No convergence in three decades: national trajectories of episode-fatality ratios for childhood lower respiratory infections in 204 countries, 1990-2023
- Global burden of respiratory infections and tuberculosis and risk factors, 1990-2021: a systematic analysis of the Global Burden of Disease Study 2021.
- Diversifying deaths: the shifting spectrum of childhood respiratory infectious mortality, 1990-2023: a systematic analysis of the Global Burden of Disease Study 2023
- Ambient air pollution and risk of respiratory tract infections in low- and middle-income countries: a systematic review and meta-analysis
- Cardiac Complications of Infections Due to Respiratory Syncytial Virus and Human Metapneumovirus: A Systematic Review and Pooled Analysis of Clinical Features.
BibTeX
@misc{sousa2026vitamin,
title = {{VITAMIN D SUPPLEMENTATION FOR THE PREVENTION OF RESPIRATORY INFECTIONS IN CHILDHOOD: A SYSTEMATIC REVIEW AND META-ANALYSIS}},
author = {H. K. P. Sousa and T. d. S. Siqueira and M. A. M. d. C. Oliveira and E. R. B. d. Carvalho and A. J. H. Cavalcante and J. B. T. d. Silva and P. L. V. Viana and G. S. Fidencio and V. C. S. Costa and L. M. L. B. Arnaud and A. P. V. Matos and J. M. R. Barbosa},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.11.26365254},
url = {https://www.medrxiv.org/content/10.64898/2026.10.11.26365254v1},
note = {CC BY-NC},
}
RIS
TY - UNPB
TI - VITAMIN D SUPPLEMENTATION FOR THE PREVENTION OF RESPIRATORY INFECTIONS IN CHILDHOOD: A SYSTEMATIC REVIEW AND META-ANALYSIS
AU - H. K. P. Sousa
AU - T. d. S. Siqueira
AU - M. A. M. d. C. Oliveira
AU - E. R. B. d. Carvalho
AU - A. J. H. Cavalcante
AU - J. B. T. d. Silva
AU - P. L. V. Viana
AU - G. S. Fidencio
AU - V. C. S. Costa
AU - L. M. L. B. Arnaud
AU - A. P. V. Matos
AU - J. M. R. Barbosa
PY - 2026
DA - 2026/10/11
PB - medRxiv
DO - 10.64898/2026.10.11.26365254
UR - https://www.medrxiv.org/content/10.64898/2026.10.11.26365254v1
AB - BackgroundVitamin D modulates innate and adaptive immunity and has been investigated for preventing pediatric respiratory infections. ObjectiveTo assess the effects of vitamin D supplementation on respiratory tract infections (RTIs), including upper RTIs, lower RTIs/recurrent pneumonia, and hospitalization/clinical severity in children and adolescents. MethodsSystematic review and random-effects meta-analysis of 16 publications, of which 13 contributed to quantitative synthesis. Twenty-four effect estimates were pooled, eight per outcome. The odds ratio (OR) was analyzed on its natural logarithmic scale (logOR), using restricted maximum likelihood (REML) estimation and Knapp-Hartung (KH) adjusted inference. Where necessary, risk ratios (RRs), hazard ratios (HRs), and incidence rate ratios (IRRs) were approximated on the logOR scale. ResultsFor respiratory infection/upper RTI, pooled logOR was -0.284 (KH-adjusted 95% confidence interval [CI]: -0.678 to 0.110; OR 0.753; p = 0.132; I2 = 97.2%). For lower RTI/recurrent pneumonia, logOR was -0.445 (95% CI: -0.987 to 0.097; OR 0.641; p = 0.093; I2 = 89.5%). For hospitalization/clinical severity, logOR was -0.609 (95% CI: -1.134 to -0.083; OR 0.544; p = 0.029; I2 = 78.3%). ConclusionsPooled estimates favored supplementation in direction for all three groups, although confidence intervals included the null for the first two. Heterogeneity was substantial, and the results are limited by approximations among effect measures, clinically diverse endpoints, and potentially correlated effects from individual studies.
ER -