{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T15:53:20Z","timestamp":1787932400126,"version":"build-2784847793"},"reference-count":68,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,14]],"date-time":"2025-02-14T00:00:00Z","timestamp":1739491200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"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>\u2009=\u20090.0023, <jats:italic>p<\/jats:italic>\u2009=\u20090.0245, respectively). Serum 25(OH)D concentration depends on COVID-19 severity (<jats:italic>p<\/jats:italic>\u2009=\u20090.0405) and children with vitamin D deficiency\/insufficiency had a longer hospital stay (4 vs. 3 days, <jats:italic>p<\/jats:italic>\u2009=\u20090.0197). 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>\u2009=\u20090.0331). The odds of developing long COVID were 2.2 times higher (<jats:italic>p<\/jats:italic>\u2009=\u20090.0346) 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>\u2009=\u20090.0040) and musculoskeletal symptoms (16% vs. 0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.0208).<\/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>","DOI":"10.3389\/fped.2025.1507169","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T12:46:51Z","timestamp":1739969211000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Vitamin D status in children with COVID-19: does it affect the development of long COVID and its 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