Respiratory viral infection (RSV) and low vitamin D - many studies

Vitamin D Life pages with RSV in title (7 as of Nov 2022)

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RSV 11.8 X more likely to be life-threatenings if low Vitamin D – Feb 2022
RSV Symptoms

See also Vitamin D Life

• Vitamin D can inhibit enveloped virus (e.g. Corona, Herpes, Zoster, Epstein, Hepatitis, RSV) – March 2011
• Croup (due to viruses) has surged with Omicron - March 2022
• Overview Colds and flu and Vitamin D
• Influenza prevented by 40 ng levels or treated with vitamin D hammer (50,000 IU) – June 2015
• Number of people to treat to prevent 1 case of flu: Vitamin D 4, Vaccination 40 – Feb 2017
• Vitamin D improves a child’s immune system – can now be claimed in Europe – Sept 2016

Flu and RSV can probably be treated in adults by 50,000 IU and in children by 20,000 IU

For the most benefit, the Vitamin D should be given within hours of getting symptoms.

RSV vaccine mostly useless and costs $600, Absolute Risk Reduction = 0.26% - May 2023

Approved by US Federal Regulators (FDA?) July 2023

RSV 11.8 X more likely to be life-threatening if low Vitamin D – Feb 2022

Serum Vitamin D Levels and Life-Threatening Respiratory Syncytial Virus Infection in Previously Healthy Infants
J Infect Dis. 2022 Feb 1;jiac033. doi: 10.1093/infdis/jiac033 $28 PDF
F Martin Ferolla 1, E Walter Yfran 1, M Gabriela Ballerini 2 3, Ana Caratozzolo 1, Analía Toledano 1, Ana C Giordano 1, Patricio L Acosta 1 2, Hamilton Cassinelli 2 3, Ignacio Bergada 2 3, M Gabriela Ropelato 2 3, María M Contrini 1, Eduardo L López 1, GUTI

Background: 25-hydroxyvitamin D (VD) effects on lung function and immune-modulation might affect RSV infection outcomes. We aimed to assess serum VD levels on admission and their association to life-RSV 11X more likely to be life threatening disease (LTD)
in previously healthy infants hospitalized with RSV.

Methods: Prospective cohort study conducted during 2017-2019. Previously healthy infants <12 months, hospitalized with a first episode of RSV infection, were enrolled. LTD was defined by the need of intensive care and ventilatory support. Serum VD levels <20 ng/ml were categorized as deficient, and between 20-29.9 ng/ml as insufficient.

Results: 125 patients were studied, 73 (58%) were male. The median age was 4 months (interquartile range [IQR]) 2-6). Twenty-two patients developed LTD. No differences were seen in viral load of cases with LTD compared to those with better outcome (P=.94).
Patients with LTD had significantly lower VD levels: median 18.4 ng/ml (IQR 15.1-26.9 ng/ml) versus 31.7 ng/ml (IQR 23.6-42.0 ng/ml), P<.001; 59% of all infants with LTD had VD levels <20 ng/ml, compared with a frequency of 12% in those with better outcome. Multivariable regression analysis confirmed VD deficiency as a risk factor for LTD (OR 11.83, 95%CI 3.89-35.9, P<.001).

Conclusions: These findings provide additional evidence for the development of preventive strategies.

Seasonal variations of respiratory viruses detected from children with respiratory tract infections in Riyadh, Saudi Arabia - 2018

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Respiratory Syncytial Virus Infection and Bronchiolitis

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(RSV) accounts worldwide for more than 60% of acute respiratory infections in children and more than 80% in infants younger than 1 year and at the peak of viral season.

RSV is also a problem for SENIORS in the winter Oct 2017

URL

• Most people contract the virus by age 2 and get it repeatedly throughout life.
• For healthy people, RSV feels like a cold.
  • Its symptoms can be indistinguishable from the flu, except for the fact that RSV is less likely than the flu to cause fever.

RSV is also known as Human orthopneumovirus - Wikipedia

• " It is a major cause of lower respiratory tract infections and hospital visits during infancy and childhood."
• "In temperate climates there is an annual epidemic during the winter months; in tropical climates, infection is most common during the rainy season."
• "In the United States, 60% of infants are infected during their first HRSV season,[2] and nearly all children will have been infected with the virus by 2–3 years of age"
• RSV is an enveloped virus, similar to Coronavirus
  • Vitamin D can inhibit enveloped virus (e.g. Corona, Herpes, Zoster, Epstein, Hepatitis, RSV) – March 2011
  • Some enveloped virus are 1.2 X more likely if have a poor Vitamin D Receptor -Aug 2018
  • Risk of enveloped virus infection is increased 50 percent if poor Vitamin D Receptor - meta-analysis Dec 2018

Serum 25-hydroxy Vitamin D Levels in Japanese Infants Younger Than 3-months Old With Respiratory Syncytial Virus Infection - July 2020

Jpn J Infect Dis. 2020 Jun 30. doi: 10.7883/yoken.JJID.2019.541
Hisashi Kawashima 1, Masahiro Kimura 1, Shinichiro Morichi 1, Shigeo Nishimata 1, Gaku Yamanaka 1, Yasuyo Kashiwagi 1
 Download the PDF from Vitamin D Life

Low levels of blood vitamin D have been reported in children who have frequent respiratory tract infections. We measured serum concentrations of 25-hydroxy (OH) vitamin D in Japanese infants less than 3-months old infected with respiratory syncytial virus (RSV). Serum levels of 25-OH vitamin D of the 10 infants, excluding those with underlying diseases, were between less than 4 to 29.8 ng/mL. In 8 out of 10 subjects (80.0%), serum 25-OH vitamin D levels were less than 20 ng/mL. There was no statistically significant association between levels of 25-OH vitamin D and age, duration of admission, respiratory severity score, white blood cell count, blood gas levels, and NT-proBNP levels. Levels of serum 25-OH vitamin D in children who required hospitalization owing to RSV infection were low, indicating deficiency. These results suggested that vitamin D deficiency affects the susceptibility to RSV infection, but not the severity of the RSV respiratory infection.

4.5X more Oxygen for Viral Respiratory Illness in Infants if low vitamin D - 2017

Inverse Correlation between 25-OH Vitamin D Levels and Severity of Viral Respiratory Illness in Infants
Journal of Infectious Diseases and Epidemiology 2017, 3:030 DOI: 10.23937/2474-3658/1510030
Mary Fairchok1,3'4*, Christina Schofield1, Wei-Ju Chen2,4, Mary Pugh3,4, Hugh Bigg1, John C Arnold5 and Eugene VMillar2,4*

Background: 25-OH vitamin D levels above 30 ng/mL activate HCAP-18, which impacts the immune response to respiratory viruses. While emerging data suggests a link between low levels of 25-OH vitamin D and an increased incidence of respiratory infections, the relationship between these levels and severity of infection is unknown. We hypothesized that infants with insufficient 25-OH vitamin D levels would have more severe viral respiratory infections.

Methods: Healthy infants admitted with fever and cough or congestion were prospectively enrolled and 25-OH vitamin D levels were measured. Presumptive bacterial infections were excluded. Nasopharyngeal specimens were collected for determination of viral etiology by Polymerase chain reaction (PCR). Demographics and severity markers were recorded. Levels were categorized as sufficient (> 30 ng/ mL), or insufficient (< 30 ng/mL).

Results: We enrolled 90 subjects. 25-OH vitamin D was < 30 ng/mL in 66%. Respiratory syncytial virus (RSV) was the most common virus. On multivariable analysis, breastfeeding was the only risk factor found to be associated with insufficiency. Administration of antibiotics and intravenous fluid, and PICU admission were not significantly different in infants with insufficient levels. However, infants with insufficient vitamin D had increased durations of both

• hospitalization (1.4 days, 95% Confidence interval (CI) = 1.0-1.9 days) and
• oxygen use (2.2 days, 95% CI = 1.4-3.5 days), and used a
• higher level of oxygen supplementation (odds ratio = 4.58, 95% CI = 1.58-13.23).

Conclusions: Infants with 25-OH vitamin D insufficiency had more severe viral respiratory illnesses. Breastfeeding was associated with insufficiency. Vitamin D supplementation during pregnancy might be a strategy to reduce risk and severity of respiratory illness in infants.
 Download the PDF from Vitamin D Life

Web - 9 studies

• What is the role of vitamin D supplementation in respiratory syncytial virus (RSV) infection prevention? Feb 2019
  • "neonates born with 25-OHD concentrations lower than 50 nmol/L had a 6-fold greater risk of RSV LRTI in the first year of life than neonates with 25-OHD concentrations of 75 nmol/L or less. "
• Vitamin D in respiratory viral infections: a key immune modulator? - Sep 2021 https://doi.org/10.1080/10408398.2021.1972407 FREE PDF
• Vitamin D Receptor polymorphisms and risk of enveloped virus infection: A meta-analysis = Dec 2018 https://doi.org/10.1016/j.gene.2018.08.017 FREE PDF
• Vitamin D receptor (VDR) polymorphisms and severe RSV bronchiolitis: A systematic review and meta-analysis - Sept 2013
  • https://doi.org/10.1002/ppul.22877 PDF from Sci-Hub via Vitamin D Life
• Back to basics: review on vitamin D and respiratory viral infections including COVID-19 = Oct 2020 https://doi.org/10.1080/20009666.2020.1811074 FREE PDF
• Serum Vitamin D Levels and Life-Threatening Respiratory Syncytial Virus Infection in Previously Healthy Infants Sept 2022, https://doi.org/10.1093/infdis/jiac033
• Effects of Maternal Vitamin D Supplementation During Pregnancy and Lactation on Infant Acute Respiratory Infections: Follow-up of a Randomized Trial in Bangladesh Sept 2021 Pages 901–909, https://doi.org/10.1093/jpids/piab032 FREE PDF
  • 28 000 IU per week was too little and given to too few mothers to be of statistical significance
• Cord blood vitamin D deficiency is associated with respiratory syncytial virus bronchiolitis - June 2011 doi: 10.1542/peds.2010-3054 FREE PDF
  • They found that babies with cord blood vitamin D levels below 20 ng/ml (50 nmol/L) were 6.2 times more likely to have an infection due to RSV compared to babies with cord blood levels greater than or equal to 30 ng/ml (75 nmol/L).
• Vitamin D-binding protein haplotype is associated with hospitalization for RSV bronchiolitis - Dec 2013 https://doi.org/10.1111/cea.12247 FREE PDF
  • "Between 75 000 and 125 000 U.S. infants are hospitalized for respiratory syncytial virus (RSV) bronchiolitis every year. Up to half will be diagnosed with asthma in later childhood. ( hint - poor gene does not stop with RSV treatment)
  • Increased risk onl y1.1 X

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