Evaluating the relation between serum vitamin d level, viral infection and severity of exacerbations in children with recurrent wheezing attacks

Purpose: The aim of this study was to evaluate the relation between vitamin D level and virus infection and severity of exacerbation in children with recurrent wheezing attacks. Materials and methods: 52 patients between 12-60 months age, with recurrent three or more wheezing attacks per year and 54 healthy children with similar age and gender distribution involved in this study. For children with wheezing attacks, sociodemographic data, environmental conditions, severity of wheezing exacerbations, the treatments performed during attacks and for the control group sociodemographic information and environmental conditions were recorded. In both patient and control groups for 25(OH)D3, Calcium, Phosphor, Alkaline phosphatase and parathormone levels, 2cc blood samples in biochemistry blood tubes were acquired and analyzed in biochemistry laboratory. Nasopharyngeal virus swab samples also were acquired and analyzed with PCR technique. For statistical analysis chi-squared, t test, Mann Whitney U and Kolmogorov-Smirnov tests and for evaluation of the correlation between variables Spearman correlation test were utilized. The values of p<0,05 were accepted as statistically significant. Results: In the patient group 17 (%32,7) were female, 35 (%67,3) were male and M/F rate was 1/2. In control group 27 (%50) were female, 27 (%50) were male and M/F rate was 1/1. For the patient group, being breastfed for 6 months or less, history of cesarean section, tobacco exposure, humid home environment, family history of allergic disease were statistically significantly higher comparing with the control group. In the patient group mean D vitamin level was 20,20±8,01 ng/ml, whereas 27,09±8,78 ng/ml in the control group. There was no statistically significant difference regarding vitamin D levels during the wheezing attacks, between the patients evaluated inpatient or outpatient or treated with oxygen and steroid or not.Serum vitamin D levels in the patient group were lower comparing to the control group and it was statistically significant. Among the patients, in 38 (%73) virus detected. Rhinovirus (%63,2) and respiratory syncytial virus (%23,7) were the most frequently detected two viruses. There was no statistically significant difference between virus detection in viral panel and vitamin D levels. Conclusion: In comparison of wheezing patients and control group, it was detected that cigarette exposure, being breastfed for less than 6 months, humid home environment, history of cesarean section, family history of allergic disease and vitamin D deficiency might be risk factors for recurrent wheezing. Having detected low vitamin D serum levels and deficiency in children with recurrent wheezing, vitamin supplementation in case of detection of vitamin D deficiency or low serum levels in these patients might be efficient in decreasing wheezing exacerbations. We believe that further prospective randomized controlled studies are required. Keywords: Recurrent wheezing, D vitamin, Virus