Vitamin D and morbidity in children with Multisystem inflammatory syndrome related to Covid-19. (September 2022)

• Record Type: Journal Article
• Authors: Torpoco Rivera, Diana; Misra, Amrit; Sanil, Yamuna; Sabzghabaei, Natalie; Safa, Raya; Garcia, Richard U.
• Is Part Of: Progress in pediatric cardiology. Volume 66(2022)
• Publication Date: 2022-09
• Subjects: Vitamin D -- Covid-19 infection -- Severe disease -- Cardiac involvement; Pediatric cardiology -- Periodicals; Cardiovascular Diseases -- Periodicals; Infant; Child; Cardiologie pédiatrique -- Périodiques; 618.9212005
• DOI: 10.1016/j.ppedcard.2022.101507
• Languages: English
• ISSNs: 1058-9813

Abstract

Abstract: Background: Multisystem inflammatory syndrome (MIS-C) is a clinical presentation reported in children related to Coronavirus-19 infection who present with a toxic shock like syndrome. Vitamin D deficiency has been postulated to play a role with severity of coronavirus infection in adult patients and other viral respiratory infections. Objective: This study aims to investigate if severe vitamin D deficiency was associated with increased disease severity and cardiac involvement in MIS-C. Methods: This is a retrospective and single center study. We included hospitalized patients less than 18 years of age with diagnosis of MIS-C between March and July 2020. Severe vitamin D deficiency was defined as 25-OH vitamin D level < 10 ng/ml within 48 h of admission. The composite outcome severe disease included patients requiring inotropes, mechanical ventilation, and extracorporeal membrane oxygenation. Results: Of the 31 patients with MIS-C, 45% were male and 58% were African American. The median age was 8 (1–13) years. Ten patients had severe vitamin D deficiency with a mean level of 7.2 ng/ml. Ninety percent of patients with severe vitamin D deficiency had severe disease (P < 0.001). Patients with severe vitamin D deficiency had an increased risk of cardiac involvement (P < 0.001). Conclusions: We describe a potential association between severe vitamin D deficiency and severe disease in children presenting with MIS-C. Severe vitamin D deficiency predisposes patients for cardiovascular involvement and may play a critical role in the host immune response to COVID-19 infection. Future prospective studies at the basic science and clinical level should be pursued to better delineate this association. Highlights: Multisystem Inflammatory Syndrome in Children (MIS-C) has been related to a late presentation of Covid-19 infection. Previous studies in critically ill children have shown an association between severe disease and vitamin D deficiency. We report a possible association between severe vitamin D deficiency and severe disease in children with MIS-C. Severe vitamin D deficiency was associated with cardiac involvement, prolonged ICU, and hospital length of stay.