Study On The Relationship Between The Level Of Serum 25-Hydroxyvitamin D And The Severity Of Community-Acquired Pneumonia In Infants Aged 1～36 Months

Objective: To prospectively observe the level of serum 25-hydroxyvitamin D(VD)and the incidence of VD deficiency in mild community-acquired pneumonia(CAP)group and severe CAP group from 1 to 36 months,and comparing the days of hospitalization,treatment and the incidence of respiratory tract infection within 3 months after discharge in different VD level groups,to explore the relationship between serum VD level and the severity of infant CAP,so as to provide basis for the prevention and treatment of severe CAP by VD.Methods: A total of 230 CAP children aged 1～36 months were collected from the Respiratory Department of Shenzhen Children’s Hospita from December 2019 to December 2020.According to the criteria for the diagnosis and treatment of community-acquired pneumonia in children(2019 edition),the children were divided into severe CAP group(n=81)and mild CAP group(n=149).The level of venous serum VD was detected at admission,and the degree of serum VD deficiency in the two groups was calculated.According to the criteria of VD level in the recommendations for the prevention and treatment of micronutrient deficiency in children,the children were divided into two groups: VD unsuitable group(including VD deficiency,deficiency and severe deficiency,n=27)and VD suitable group(n=203).The days of hospitalization,treatment and the incidence of respiratory tract infection within 3 months after discharge in different VD level groups were compared.Results: The level of serum VD in severe CAP group was lower than that in mild CAP group(33.73 ±13.59ng/ml vs 37.59 ±13.20ng/ml,P<0.05).And the rate of VD deficiency in severe CAP group was significantly higher than that in mild CAP group(12.3% vs 4.7%,P<0.05).The hospitalization days[4(3,5)d vs 6(3,7)d],oxygen therapy(22.2% vs 51.9%)and ECG monitoring ratio(5.4% vs 25.9%)in the VD suitable group were significantly lower than those in the VD unsuitable group(P < 0.05).During the follow-up for 3 months after discharge,respiratory tract infection occurred again in 10cases(37.0%)in the VD unsuitable group and 47 cases(23.2%)in the VD suitable group,but the difference was not statistically significant(χ2 = 2.464,P>0.05).Conclusion: The level of serum VD in infants is related to the severity of CAP.The lower the serum VD level of infants,the longer the hospital stay,and the more likely they are to need oxygen therapy and ECG monitoring.However,the risk of recurrent respiratory tract infection in the future cannot be evaluated by the level of serum VD.