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Vitamin D Levels and Cardiopulmonary Status in Infants With Acute Bronchiolitis

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Abstract

Background

To assess association of vitamin D deficiency with cardiac and pulmonary status in infants with acute bronchiolitis.

Methods

Infants hospitalized with acute bronchiolitis were enrolled and classified as those with serum 25-hydroxyvitamin D (25-OHD) below or equal and above 20 ng/mL. The primary outcomes were cardiopulmonary involvement defined by elevation of NT-ProBNP, alteration of echocardiography parameters and respiratory support requirements. The secondary outcomes were the need for PICU admission and duration of hospitalization.

Results

92 (50 males) infants with median (IQR) age of 1 (0.5–3) month were included with median (IQR) serum 25-OHD level 27.4 (11.4–40.3) ng/mL. 43 (47%) patients had serum 25-OHD level below 20 ng/mL with left ventricle dysfunction (P=0.008), right ventricle dysfunction (P=0.008) and pulmonary hypertension (P=0.007) on echocardiography more commonly than those with serum 25-OHD >20 ng/mL. The median (IQR) serum NT-ProBNP levels were higher in those with low 25-OHD levels than normal 25-OHD levels [2232.2 (461.4–4313.3) and 830.4 (312.7–2579.5)], respectively (P=0.003). Low 25-OHD levels were associated with increased risk for PICU admission (OR 3.9 (95% CI 1.5–10.1); P=0.004), higher rates of non-invasive ventilation (P=0.048) and mechanical ventilation (P=0.005) and longer duration of hospitalization (P=0.015).

Conclusion

Low serum vitamin D level was associated with clinical severity and impaired cardiac and pulmonary status in infants with acute bronchiolitis.

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References

  1. Ralston SL, Lieberthal AS, Meissner HC, et al. Clinical Practice Guideline: The Diagnosis, Management, and Pre-vention of Bronchiolitis. Pediatricss. 2014;134:e1474–502.

    Article  Google Scholar 

  2. Vo P, Koppel C, Espinola JA, et al. Vitamin D status at the time of hospitalization for bronchiolitis and Its association with disease severity. J Pediatr. 2018;203:416–22.e1.

    Article  CAS  Google Scholar 

  3. McNally JD, Amrein K. Vitamin D deficiency in pediatric critical care. J Pediatr Inten Care. 2016;5:142–53.

    Article  Google Scholar 

  4. Michos ED, Selvin E, Misialek JR, et al. 25-Hydroxyvitamin D levels and markers of subclinical myocardial damage and wall stress: The atherosclerosis risk in communities study. J Am Heart Assoc. 2016;5:e003575.

    Article  Google Scholar 

  5. Callejo M, Mondejar-Parreño G, Esquivel-Ruiz S, et al. Total, bioavailable, and free vitamin D levels and their prognostic value in pulmonary arterial hypertension. J Clin Med. 2020;9:448.

    Article  CAS  Google Scholar 

  6. Rodriguez-Gonzalez M, Perez-Reviriego AA, Castellano-Martinez A, et al. Left ventricular dysfunction and plasmatic NT-ProBNP are associated with adverse evolution in respiratory syncytial virus bronchiolitis. Diagnostics (Basel). 2019;9:85.

    Article  CAS  Google Scholar 

  7. Rodriguez-Gonzalez M, Benavente-Fernandez I, Castellano-Martinez A, et al. NT-proBNP plasma levels as biomarkers for pulmonary hypertension in healthy infants with respiratory syncytial virus infection. Biomark Med. 2019;13:605–18.

    Article  CAS  Google Scholar 

  8. Balaguer M, Alejandre C, Vila D, et al. Bronchiolitis score of Sant Joan de Déu: BROSJOD Score, validation and usefulness. Pediatr Pulmonol. 2017;52:533–9.

    Article  Google Scholar 

  9. Rodriguez-Gonzalez M, Perez-Reviriego AA, Castellano-Martinez A, et al. The assessment of myocardial strain by cardiac imaging in healthy infants with acute bronchiolitis: A systematic review and meta-analysis. Diagnostics (Basel). 2020;10:382.

    Article  Google Scholar 

  10. Mona Abd El-Gelel M, Khalid Mahmoud Z. Impact of acute bronchiolitis on cardiac functions and serum microrna-11 and 499. Am J Infect Dis. 2016;12:11–9.

    Article  Google Scholar 

  11. Passeri E, Rigolini R, Costa E, et al. Serum NT-proBNP levels are not related to vitamin D status in young patients with congenital heart defects. Dis Markers. 2016;2016:3970284.

    Article  CAS  Google Scholar 

  12. Rodriguez-Gonzalez M, Estepa-Pedregosa L, Estalella-Mendoza A, et al. Early elevated NT-proBNP but not Troponin I is associated with severe bronchiolitis in infants. Clin Chim Acta. 2021.

  13. Ozer PK, Emet S, Karaayvaz EB, Elitok A, et al. Silent myocardial dysfunction in vitamin D deficiency. Arch Med Sci Atheroscler Dis. 2020;5:e153–e162.

    Article  Google Scholar 

  14. Skaaby T, Thuesen BH, Linneberg A. Vitamin D, cardiovascular disease and risk factors. Adv Exp Med Biol. 2017;996:221–30.

    Article  CAS  Google Scholar 

  15. Atamañuk AN, Litewka DF, Baratta SJ, et al. Vitamin D deficiency among patients with pulmonary hypertension. BMC Pulm Med. 2019;19:258.

    Article  Google Scholar 

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Authors and Affiliations

  1. Pediatric Intensive Care Unit, Puerta del Mar University Hospital, Cádiz, Spain

    Ana Estalella-Mendoza, Jose Carlos Flores-González, Lorena Estepa-Pedregosa & Patricia Rodríguez-Campoy

  2. Pediatric Nephrology Division, Puerta del Mar University Hospital, Cádiz, Spain

    Ana Castellano-Martínez

  3. Pediatric Cardiology Division, Puerta del Mar University Hospital, Cádiz, Spain

    Moisés Rodríguez-González

  4. Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, Cádiz, Spain

    Ana Estalella-Mendoza, Ana Castellano-Martínez, Jose Carlos Flores-González, Lorena Estepa-Pedregosa, Patricia Rodríguez-Campoy & Moisés Rodríguez-González

Authors
  1. Ana Estalella-Mendoza
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  2. Ana Castellano-Martínez
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  3. Jose Carlos Flores-González
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  4. Lorena Estepa-Pedregosa
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  5. Patricia Rodríguez-Campoy
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  6. Moisés Rodríguez-González
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Contributions

EM, CM, RG: conceptualized and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript; EP,RC,RG,FG: collected data and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Ana Castellano-Martínez.

Ethics declarations

IRB, Puerta del Mar Univesity Hospital; No. 82.18, dated Oct 26, 2018.

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Competing interest

None stated.

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Estalella-Mendoza, A., Castellano-Martínez, A., Flores-González, J.C. et al. Vitamin D Levels and Cardiopulmonary Status in Infants With Acute Bronchiolitis. Indian Pediatr 59, 384–387 (2022). https://doi.org/10.1007/s13312-022-2519-0

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  • DOI: https://doi.org/10.1007/s13312-022-2519-0

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