Vitamin D status in children with COVID-19: does it affect the development of long COVID and its symptoms?

DOI record: { "DOI": "10.3389/fped.2025.1507169", "ISSN": [ "2296-2360" ], "URL": "http://dx.doi.org/10.3389/fped.2025.1507169", "abstract": "<jats:sec><jats:title>Introduction</jats:title><jats:p>Long COVID is characterized by diverse symptoms persisting after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Given the immunomodulatory and neuroprotective properties of vitamin D, understanding its role in long COVID symptoms is of growing interest. This study aimed to determine vitamin D status in children with COVID-19 and assess its impact on the clinical course of disease and long COVID development.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A prospective cohort study included hospitalized children with confirmed COVID-19, aged 1 month to 18 years, diagnosed between September 2022 and March 2024. Serum 25-hydroxyvitamin D (25(OH)D) concentrations were measured upon hospital admission, and follow-up was done to identify long COVID symptoms.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>In total, 162 hospitalized patients with COVID-19 were examined. Vitamin D deficiency was determined in 8.0%, insufficiency in 25.3%, and optimal levels in 66.7% of children with COVID-19. Vitamin D deficiency/insufficiency was observed in 73% of children over 6 years and 21.6% of children under 6 years of age. Comorbid conditions were 1.4 times more frequent in children with vitamin D insufficiency, with undernutrition and obesity playing the most significant roles (<jats:italic>p</jats:italic> = 0.0023, <jats:italic>p</jats:italic> = 0.0245, respectively). Serum 25(OH)D concentration depends on COVID-19 severity (<jats:italic>p</jats:italic> = 0.0405) and children with vitamin D deficiency/insufficiency had a longer hospital stay (4 vs. 3 days, <jats:italic>p</jats:italic> = 0.0197). The vitamin D status affected the median levels of neutrophils, lymphocytes, their ratio, prothrombin time, fibrinogen levels, and the frequency of increased immunoglobulins M and E levels. Among 134 children who agreed to follow up, 56 (41.8%) experienced long COVID symptoms, while 78 (58.2%) recovered fully. Long COVID was frequently observed in children with vitamin D deficiency/insufficiency (<jats:italic>p</jats:italic> = 0.0331). The odds of developing long COVID were 2.2 times higher (<jats:italic>p</jats:italic> = 0.0346) in children with vitamin D deficiency/insufficiency compared to those with optimal levels. Children with vitamin D deficiency/insufficiency more often exhibited neurological (80% vs. 41.9%, <jats:italic>p</jats:italic> = 0.0040) and musculoskeletal symptoms (16% vs. 0%, <jats:italic>p</jats:italic> = 0.0208).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The 25(OH)D concentrations in children with COVID-19 depended on their age. Comorbid conditions affect the vitamin D status in children with COVID-19. Vitamin D influenced the COVID-19 severity and duration of hospitalization. There was an increased risk of developing long COVID in children with vitamin D deficiency/insufficiency, and its impact on the development of neurological symptoms associated with long COVID was established.</jats:p></jats:sec>", "alternative-id": [ "10.3389/fped.2025.1507169" ], "author": [ { "affiliation": [], "family": "Perestiuk", "given": "Vita", "sequence": "first" }, { "affiliation": [], "family": "Kosovska", "given": "Tetyana", "sequence": "additional" }, { "affiliation": [], "family": "Dyvoniak", "given": "Olha", "sequence": "additional" }, { "affiliation": [], "family": "Volianska", "given": "Liubov", "sequence": "additional" }, { "affiliation": [], "family": "Boyarchuk", "given": "Oksana", "sequence": "additional" } ], "container-title": "Frontiers in Pediatrics", "container-title-short": "Front. Pediatr.", "content-domain": { "crossmark-restriction": true, "domain": [ "frontiersin.org" ] }, "created": { "date-parts": [ [ 2025, 2, 19 ] ], "date-time": "2025-02-19T12:46:51Z", "timestamp": 1739969211000 }, "deposited": { "date-parts": [ [ 2025, 2, 19 ] ], "date-time": "2025-02-19T12:46:56Z", "timestamp": 1739969216000 }, "indexed": { "date-parts": [ [ 2025, 2, 19 ] ], "date-time": "2025-02-19T13:10:31Z", "timestamp": 1739970631011, "version": "3.37.3" }, "is-referenced-by-count": 0, "issued": { "date-parts": [ [ 2025, 2, 14 ] ] }, "license": [ { "URL": "https://creativecommons.org/licenses/by/4.0/", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2025, 2, 14 ] ], "date-time": "2025-02-14T00:00:00Z", "timestamp": 1739491200000 } } ], "link": [ { "URL": "https://www.frontiersin.org/articles/10.3389/fped.2025.1507169/full", "content-type": "unspecified", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "1965", 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