Effects of Vitamin D in the Prevention of Acute Viral Bronchiolitis: Systematic Review

Angélica Maria Barba Rueda, Edgar Enrique Sarria-Icaza, Marcelo Comerlato Scotta, Leonardo Araújo Pinto, Ângela de Moura, Rafaela Becker, Matheus Dorigatti Soldatelli, Matias Epifanio, Eduardo Mundstock, Rita Mattiello


Aims: Published evidence suggests that Vitamin D supplementation may have a protective effect on infectious disease of the lower respiratory tract. The objective of this review was to critically appraise the effects of vitamin D intake in the prevention of acute viral bronchiolitis in children.

Methods: We searched the databases MEDLINE, EMBASE, Web of Science, LILACS, and Cochrane Central Register of Controlled Trials, until December 2014. Keywords: "Vitamin D" OR cholecalciferol OR ergocalciferol AND "bronchiolitis, viral" OR bronchiolitides, viral OR "bronchiolitides viral". Eligibility Criteria: We included studies evaluating the effect of vitamin D intake in the prevention of acute viral bronchiolitis in young children. Studies with less than two weeks of intervention and review articles were excluded.

Results: The search identified 241 articles; twenty were selected for full reading but only two were included in the systematic review, comprising 296 children. No study measured serum vitamin D. One of them was a clinical trial, where the number of episodes of acute viral bronchiolitis was significantly lower in children supplemented with vitamin D (Group I: mean: 0.6 ± 0.7 Group II: mean: 1.4 ± 0.9; p = 0.001). The other, a case-control study, did not find a significant relationship between the occurrence of  acute viral bronchiolitis cases and the intake of vitamin D (OR 1.7 95% CI 0.7 to 4.0).

Conclusions: Current scientific evidence is insufficient to prove clinical benefits of vitamin D in preventing  acute viral bronchiolitis.


Vitamin D, Bronchiolitis.

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Lozano JM. Bronchiolitis. Clinical evidence. 2007;2007. Epub 2007/01/01.

Antunes H, Rodrigues H, Silva N, Ferreira C, Carvalho F, Ramalho H, et al. Etiology of bronchiolitis in a hospitalized pediatric population: prospective multicenter study. Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology. 2010;48(2):134-6. Epub 2010/04/07.

Smyth RL, Openshaw PJ. Bronchiolitis. Lancet. 2006;368(9532):312-22. Epub 2006/07/25.

Hughes DA, Norton R. Vitamin D and respiratory health. Clinical and experimental immunology. 2009;158(1):20-5. Epub 2009/09/10.

Kotagal UR, Robbins JM, Kini NM, Schoettker PJ, Atherton HD, Kirschbaum MS. Impact of a bronchiolitis guideline: a multisite demonstration project. Chest. 2002;121(6):1789-97. Epub 2002/06/18.

Holick MF. Vitamin D deficiency. The New England journal of medicine. 2007;357(3):266-81. Epub 2007/07/20.

Shawn L. Ralston ASL, H. Cody Meissner, Brian K. Alverson, Jill E,Baley, Anne M. Gadomski, David W. Johnson, Michael J. Light, Nizar F. Maraqa, Eneida A. Mendonca, Kieran J. Phelan, Joseph J. Zorc, Danette Stanko-Lopp, Mark,A. Brown, Ian Nathanson, Elizabeth Rosenblum, Stephen Sayles III and Sinsi Hernandez-Cancio. Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis. Pediatrics 2014;134;e1474; originally published online October 27, 2014;. 2014.

Li-Ng M, Aloia JF, Pollack S, Cunha BA, Mikhail M, Yeh J, et al. A randomized controlled trial of vitamin D3 supplementation for the prevention of symptomatic upper respiratory tract infections. Epidemiology and infection. 2009;137(10):1396-404. Epub 2009/03/20.

Roth DE. Bones and beyond: an update on the role of vitamin D in child and adolescent health in Canada. Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme. 2007;32(4):770-7. Epub 2007/07/12.

Jartti T, Ruuskanen O, Mansbach JM, Vuorinen T, Camargo CA, Jr. Low serum 25-hydroxyvitamin D levels are associated with increased risk of viral coinfections in wheezing children. The Journal of allergy and clinical immunology. 2010;126(5):1074-6, 6 e1-4. Epub 2010/11/06.

Borges MC, Martini LA, Rogero MM. Current perspectives on vitamin D, immune system, and chronic diseases. Nutrition. 2011;27(4):399-404. Epub 2010/10/26.

Baeke F, Takiishi T, Korf H, Gysemans C, Mathieu C. Vitamin D: modulator of the immune system. Current opinion in pharmacology. 2010;10(4):482-96. Epub 2010/04/30.

Luong KV, Nguyen LT. Beneficial role of vitamin D3 in the prevention of certain respiratory diseases. Therapeutic advances in respiratory disease. 2013;7(6):327-50. Epub 2013/09/24.

Wagner CL, Greer FR. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics. 2008;122(5):1142-52. Epub 2008/11/04.

McNally JD, Sampson M, Matheson LA, Hutton B, Little J. Vitamin D receptor (VDR) polymorphisms and severe RSV bronchiolitis: A systematic review and meta-analysis. Pediatric pulmonology. 2013. Epub 2013/09/11.

Bergman P, Lindh AU, Bjorkhem-Bergman L, Lindh JD. Vitamin D and Respiratory Tract Infections: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PloS one. 2013;8(6):e65835. Epub 2013/07/11.

Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Journal of clinical epidemiology. 2009;62(10):1006-12. Epub 2009/07/28.

Leis KS, McNally JD, Montgomery MR, Sankaran K, Karunanayake C, Rosenberg AM. [Vitamin D intake in young children with acute lower respiratory infection]. Zhongguo Dang Dai Er Ke Za Zhi. 2012;14(1):1-6. Epub 2012/02/01.

El-Mazary, Abdel-Maaboud M, MM Mm, Nasef KA. Vitamin D supplementation and risk of infections in fullterm infants: Correlations with the maternal serum vitamin D. Egypt J Pediatr Allergy immunol. 2012;10(2):87-94.

Yamshchikov AV, Desai NS, Blumberg HM, Ziegler TR, Tangpricha V. Vitamin D for treatment and prevention of infectious diseases: a systematic review of randomized controlled trials. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2009;15(5):438-49. Epub 2009/06/06.

Bergman P, Norlin AC, Hansen S, Rekha RS, Agerberth B, Bjorkhem-Bergman L, et al. Vitamin D3 supplementation in patients with frequent respiratory tract infections: a randomised and double-blind intervention study. BMJ open. 2012;2(6). Epub 2012/12/18.

Belderbos ME, Houben ML, Wilbrink B, Lentjes E, Bloemen EM, Kimpen JL, et al. Cord blood vitamin D deficiency is associated with respiratory syncytial virus bronchiolitis. Pediatrics. 2011;127(6):e1513-20. Epub 2011/05/11.

Jolliffe DA, Griffiths CJ, Martineau AR. Vitamin D in the prevention of acute respiratory infection: systematic review of clinical studies. The Journal of steroid biochemistry and molecular biology. 2013;136:321-9. Epub 2012/12/12.

Manaseki-Holland S, Qader G, Isaq Masher M, Bruce J, Zulf Mughal M, Chandramohan D, et al. Effects of vitamin D supplementation to children diagnosed with pneumonia in Kabul: a randomised controlled trial. Tropical medicine & international health : TM & IH. 2010;15(10):1148-55. Epub 2010/08/21.

Martineau AR. Bolus-dose vitamin D and prevention of childhood pneumonia. Lancet. 2012;379(9824):1373-5. Epub 2012/04/13.

DOI: http://dx.doi.org/10.15448/1980-6108.2015.2.20313

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