Vitamin D status in children with mild, moderate, or severe confirmed COVID-19: systematic-review and meta-analysis

BackgroundVitamin D acts as a pro-hormone with a wide range of beneficial effects. It is reported that vitamin D deficiency is a risk factor for COVID-19 severity in children. In the present study, we decided to assess 25 hydroxy (OH) vitamin D status in children with mild, moderate, or severe confi...

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Main Authors: Tahoora Mousavi, Mahmood Moosazadeh
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1436633/full
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author Tahoora Mousavi
Mahmood Moosazadeh
author_facet Tahoora Mousavi
Mahmood Moosazadeh
author_sort Tahoora Mousavi
collection DOAJ
description BackgroundVitamin D acts as a pro-hormone with a wide range of beneficial effects. It is reported that vitamin D deficiency is a risk factor for COVID-19 severity in children. In the present study, we decided to assess 25 hydroxy (OH) vitamin D status in children with mild, moderate, or severe confirmed COVID-19 and also compare them with those of a healthy control group using existing data.MethodsRelevant studies were extracted using online international databases including Scopus, Science Direct, PubMed, Web of Science, ProQuest, and Google Scholar search engine between Jan 2019 and 2024. The quality of all papers is determined by the NOS checklist. Heterogeneity between the results of primary studies was evaluated with the I-square index. Egger's test, funnel plot, and sensitivity analysis were applied. The statistical analysis was done using Stata version 17.ResultsIn 12 documents, the status of vitamin D was examined between case and control groups. By combining the results of these studies using random effect model, the standardized mean difference (SMD) vitamin D level in the COVID-19 children compared to the control group was estimated to be −0.88 (98% CI: −1.24, −0.51), which was statistically significant. In the present study, the odd ratio of vitamin D deficiency and vitamin D disorder (insufficiency and deficiency) in children with moderate COVID-19 compared to asymptomatic children with COVID-19 were estimated to be 3.58 (1.10, 11.63) and 2.52 (0.99, 6.41) respectively which was higher than in asymptomatic children with COVID-19. In addition, vitamin D deficiency and vitamin D disorder in children with moderate COVID-19 compared to the children with mild COVID-19 were estimated to be 2.12 (0.90, 4.98) and 1.82 (0.78, 4.22) respectively, which was higher than in children with mild COVID-19. Also, vitamin D deficiency and vitamin D disorder in children with mild COVID-19 compared to asymptomatic children with COVID-19 were estimated to be 2.02 (0.60, 6.78) and 1.64 (0.53, 5.07) respectively, which was higher than in asymptomatic children.ConclusionsCombining the results of these studies, the effect size of the relationship between vitamin D and COVID-19 in children is significant. During the COVID-19 pandemic (except for the Omicron peak), children were less affected by the severity of COVID-19. The standardized mean difference (SMD) vitamin D level in children with COVID-19 was significantly 0.88 units lower than the control group. Also, the odds ratio of moderate COVID-19 in children with vitamin D deficiency was significantly 3.58 times higher than in asymptomatic children with COVID-19.
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spelling doaj-art-9aaf6fe220df47a18e0032472f6d0e4a2025-08-20T01:50:23ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-05-011310.3389/fped.2025.14366331436633Vitamin D status in children with mild, moderate, or severe confirmed COVID-19: systematic-review and meta-analysisTahoora Mousavi0Mahmood Moosazadeh1Molecular and Cell Biology Research Center, Hemoglobinopathy Institute, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, IranGastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, IranBackgroundVitamin D acts as a pro-hormone with a wide range of beneficial effects. It is reported that vitamin D deficiency is a risk factor for COVID-19 severity in children. In the present study, we decided to assess 25 hydroxy (OH) vitamin D status in children with mild, moderate, or severe confirmed COVID-19 and also compare them with those of a healthy control group using existing data.MethodsRelevant studies were extracted using online international databases including Scopus, Science Direct, PubMed, Web of Science, ProQuest, and Google Scholar search engine between Jan 2019 and 2024. The quality of all papers is determined by the NOS checklist. Heterogeneity between the results of primary studies was evaluated with the I-square index. Egger's test, funnel plot, and sensitivity analysis were applied. The statistical analysis was done using Stata version 17.ResultsIn 12 documents, the status of vitamin D was examined between case and control groups. By combining the results of these studies using random effect model, the standardized mean difference (SMD) vitamin D level in the COVID-19 children compared to the control group was estimated to be −0.88 (98% CI: −1.24, −0.51), which was statistically significant. In the present study, the odd ratio of vitamin D deficiency and vitamin D disorder (insufficiency and deficiency) in children with moderate COVID-19 compared to asymptomatic children with COVID-19 were estimated to be 3.58 (1.10, 11.63) and 2.52 (0.99, 6.41) respectively which was higher than in asymptomatic children with COVID-19. In addition, vitamin D deficiency and vitamin D disorder in children with moderate COVID-19 compared to the children with mild COVID-19 were estimated to be 2.12 (0.90, 4.98) and 1.82 (0.78, 4.22) respectively, which was higher than in children with mild COVID-19. Also, vitamin D deficiency and vitamin D disorder in children with mild COVID-19 compared to asymptomatic children with COVID-19 were estimated to be 2.02 (0.60, 6.78) and 1.64 (0.53, 5.07) respectively, which was higher than in asymptomatic children.ConclusionsCombining the results of these studies, the effect size of the relationship between vitamin D and COVID-19 in children is significant. During the COVID-19 pandemic (except for the Omicron peak), children were less affected by the severity of COVID-19. The standardized mean difference (SMD) vitamin D level in children with COVID-19 was significantly 0.88 units lower than the control group. Also, the odds ratio of moderate COVID-19 in children with vitamin D deficiency was significantly 3.58 times higher than in asymptomatic children with COVID-19.https://www.frontiersin.org/articles/10.3389/fped.2025.1436633/fullvitamin DchildrenCOVID-19SARS coV-2pneumonia
spellingShingle Tahoora Mousavi
Mahmood Moosazadeh
Vitamin D status in children with mild, moderate, or severe confirmed COVID-19: systematic-review and meta-analysis
Frontiers in Pediatrics
vitamin D
children
COVID-19
SARS coV-2
pneumonia
title Vitamin D status in children with mild, moderate, or severe confirmed COVID-19: systematic-review and meta-analysis
title_full Vitamin D status in children with mild, moderate, or severe confirmed COVID-19: systematic-review and meta-analysis
title_fullStr Vitamin D status in children with mild, moderate, or severe confirmed COVID-19: systematic-review and meta-analysis
title_full_unstemmed Vitamin D status in children with mild, moderate, or severe confirmed COVID-19: systematic-review and meta-analysis
title_short Vitamin D status in children with mild, moderate, or severe confirmed COVID-19: systematic-review and meta-analysis
title_sort vitamin d status in children with mild moderate or severe confirmed covid 19 systematic review and meta analysis
topic vitamin D
children
COVID-19
SARS coV-2
pneumonia
url https://www.frontiersin.org/articles/10.3389/fped.2025.1436633/full
work_keys_str_mv AT tahooramousavi vitamindstatusinchildrenwithmildmoderateorsevereconfirmedcovid19systematicreviewandmetaanalysis
AT mahmoodmoosazadeh vitamindstatusinchildrenwithmildmoderateorsevereconfirmedcovid19systematicreviewandmetaanalysis