{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T23:52:59Z","timestamp":1792194779591,"version":"4.4.0"},"reference-count":51,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T00:00:00Z","timestamp":1691452800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Childhood respiratory tract infections (RTIs) pose a significant health burden, especially in children under six years old. The main objective of this systematic review was to assess the effectiveness of vitamin D supplementation in the prevention of RTI in this population while also exploring potential effect modifiers such as age, baseline vitamin D status, and type of respiratory infection. A systematic review of the literature published up to February 2023 was conducted according to PRISMA guidelines, searching PubMed, Web of Science, Cochrane, and Scopus databases. Eight studies met the inclusion criteria, which investigated the association between vitamin D supplementation and respiratory infections in children between zero and five years old. The included studies were conducted between 2012 and 2021, encompassing a total of 2189 children from five randomized trials, two case-control studies, and one prospective cohort study. The relationship between vitamin D supplementation and the prevention of childhood RTI was not consistently observed across all included studies. Pooled results demonstrated varied effects of vitamin D supplementation on respiratory infection incidence, severity, and symptoms. Three studies reported statistically significant associations between low vitamin D levels and respiratory infections (OR = 4.90, OR = 6.97), while one study found that children who received vitamin D supplementation of 800 UI\/day for 3 months during the cold season had fewer episodes of respiratory symptoms (RR = 0.55) and recovered more quickly from acute RTI. Lastly, according to one study, vitamin D intake &lt; 80 IU\/kg\/day was significantly associated with the risk of acquiring pneumonia (OR 7.9) but not bronchiolitis. The remaining five studies found no statistically significant differences in infection rates or severity (p-value &gt; 0.050). The available evidence on the effectiveness of vitamin D supplementation for preventing and treating respiratory infections in children under six years old is limited, with only a few favorable effects being reported. In some cases, a dose of 80 UI\/kg\/day was found to provide significant protection for acute respiratory infections, although in the major trials the only benefit was a quicker recovery and fewer respiratory symptoms, with no impact on incidence and severity of respiratory infections. Nevertheless, the study protocol, the supplementation dose, and duration of supplementation had significant variations between studies, leading to inconclusive findings.<\/jats:p>","DOI":"10.3390\/diseases11030104","type":"journal-article","created":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T12:26:39Z","timestamp":1691497599000},"page":"104","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["The Effects of Vitamin D Supplementation on Respiratory Infections in Children under 6 Years Old: A Systematic Review"],"prefix":"10.3390","volume":"11","author":[{"given":"Larisa Mihaela","family":"Marusca","sequence":"first","affiliation":[{"name":"Laboratory Medicine, \u201cLouis Turcanu\u201d Emergency Hospital for Children, Doctor Iosif Nemoianu Street, 300011 Timisoara, Romania"},{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gowry","family":"Reddy","sequence":"additional","affiliation":[{"name":"New York Medical College at St. Mary\u2019s and St. Clare\u2019s Hospital, Denville, NJ 07834, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihaela","family":"Blaj","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Faculty of Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, University Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1099-5816","authenticated-orcid":false,"given":"Reshmanth","family":"Prathipati","sequence":"additional","affiliation":[{"name":"Santiram Medical College General Hospital, Nandyala 518001, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ovidiu","family":"Rosca","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4711-4315","authenticated-orcid":false,"given":"Felix","family":"Bratosin","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"},{"name":"Department of Infectious Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iulia","family":"Bogdan","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"},{"name":"Department of Infectious Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Razvan Mihai","family":"Horhat","sequence":"additional","affiliation":[{"name":"Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela-Florentina","family":"Tapos","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Arad County Emergency Clinical Hospital, Calea Victoriei, 310037 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela-Teodora","family":"Marti","sequence":"additional","affiliation":[{"name":"Department of Biology and Life Sciences, Faculty of Medicine, \u201cVasile Goldis\u201d Western University of Arad, Revolutiei Square 94, 310025 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Susan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Discipline of Medical Semiology I, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0743-1594","authenticated-orcid":false,"given":"Raja Akshay","family":"Pingilati","sequence":"additional","affiliation":[{"name":"Malla Reddy Institute of Medical Sciences, Suraram Main Road 138, Hyderabad 500055, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6133-0204","authenticated-orcid":false,"given":"Florin George","family":"Horhat","sequence":"additional","affiliation":[{"name":"Multidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4032-0899","authenticated-orcid":false,"given":"Mavrea","family":"Adelina","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Cardiology Clinic, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"17","DOI":"10.31729\/jnma.6889","article-title":"Acute Respiratory Infections among Under-five Children Admitted in a Tertiary Hospital of Nepal: A Descriptive Cross-sectional Study","volume":"60","author":"Bhurtel","year":"2022","journal-title":"J. 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