An investigation of vitamin D nutritional status in children after outbreak of coronavirus disease 2019 / 中国当代儿科杂志

OBJECTIVES@#To investigate vitamin D nutritional status in children after outbreak of coronavirus disease 2019 (COVID-19), as well as the effect of strict epidemic prevention and control measures for the COVID-19 epidemic on vitamin D nutritional status in children.@*METHODS@#A total of 7 460 children who underwent routine physical examinations from February to August, 2020 and had normal results were retrospectively enrolled as the observation group, and 10 102 children who underwent routine physical examinations from February to August, 2019 (no epidemic of COVID-19) and had normal results were enrolled as the control group. The serum level of 25-hydroxy vitamin D [25(OH)D] was compared between the two groups. The children in the observation and control groups who underwent physical examinations in March and April were selected as the epidemic prevention subgroup (@*RESULTS@#The observation group had a lower serum level of 25(OH)D than the control group in March and April (@*CONCLUSIONS@#Strict prevention and control measures for the COVID-19 epidemic may lead to a significant reduction in vitamin D level in children, especially school-aged and adolescent children. It is recommended to timely monitor vitamin D level in children, take vitamin D supplements, and increase the time of outdoor sunshine as far as possible under the premise of adherence to epidemic prevention regulations.

Dynamic change in vitamin D level in infants/toddlers with severe pneumonia and a correlation analysis / 中国当代儿科杂志

OBJECTIVE@#To study the correlation of dynamic change in serum 25-hydroxy vitamin D [25(OH)D] level with the disease severity and related laboratory markers in infants/toddlers with severe pneumonia.@*METHODS@#A total of 132 infants/toddlers with severe pneumonia who were hospitalized between March 2017 and March 2018 were enrolled as the severe pneumonia group. According to the disease severity on admission and after one week of treatment, they were further divided into non-critical group (41 children on admission and 78 after one week of treatment), critical group (59 children on admission and 35 after one week of treatment), and extremely critical group (32 children on admission and 19 after one week of treatment). A total of 142 infants/toddlers who underwent physical examination during the same period of time were enrolled as the healthy control group. The serum levels of 25(OH)D, procalcitonin (PCT), and N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured on admission and after one week of treatment for the severe pneumonia group, and the serum level of 25(OH)D was measured on admission for the healthy control group. According to the 25(OH)D level after one week of treatment, the children with severe pneumonia were divided into increased vitamin D (VD) group with 81 children and reduced VD group with 51 children, and a comparative analysis and a correlation analysis were performed.@*RESULTS@#The severe pneumonia group had a significantly lower mean 25(OH)D level than the healthy control group (P<0.05), and all the three subgroups of different severities had significantly lower 25(OH)D level than the healthy control group (P<0.05). On admission and after one week of treatment, the non-critical group had a significantly higher 25(OH)D level than the critical and extremely critical groups (P<0.01), and the critical group had a significantly higher 25(OH)D level than the extremely critical group (P<0.05). The extremely critical and critical groups had significantly higher serum levels of PCT and NT-proBNP than the non-critical group on admission and after one week of treatment (P<0.05). After one week of treatment, compared with the reduced VD group, the increased VD group had a significantly less serious condition. At discharge, the increased VD group had a significantly better outcome compared with the reduced VD group (P<0.01). In the children with severe pneumonia, the change value of serum 25(OH)D level after treatment was negatively correlated with the change values of PCT and NT-proBNP (r=-0.597 and -0.404 respectively; P<0.01).@*CONCLUSIONS@#The change in VD level is correlated with the severity of severe pneumonia in infants/toddlers and can be used as an index for disease monitoring. VD supplementation may help with disease recovery.

Risk factors for coronary artery lesions secondary to Kawasaki disease in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To explore the risk factors for coronary artery lesions (CAL) secondary to Kawasaki disease (KD) in children.</p><p><b>METHODS</b>The medical data of 895 children with KD were retrospectively reviewed. The patients were classified into two groups according to the presence of CAL: CAL (n=284) and control (n=611). The clinical and laboratory indices were compared between the two groups. The risk factors for the development of CAL in children with KD were identified by multiple logistic regression analysis.</p><p><b>RESULTS</b>Male gender (OR=1.712), occurrence of non-CAL complications (OR=2.028), atypical KD (OR=3.655), intravenous immunoglobulin (IVIG) resistance (OR=2.912), more than 5 days of fever duration before IVIG treatment (OR=1.350), and increased serum procalcitonin (PCT) level (OR=1.068) were the independent risk factors for the development of CAL in children with KD (P<0.05), whereas increased serum albumin (Alb) level was a protective factor (OR=0.931, P<0.05). The areas under the receiver operating characteristic curve of serum PCT and ALB for prediction of the development of CAL in children with KD were 0.631 and 0.558, respectively.</p><p><b>CONCLUSIONS</b>Male gender, atypical KD, occurrence of other non-CAL complications, long duration of fever and IVIG resistance are associated with an increased risk for CAL in children with KD. Serum PCT and ALB have little value in the prediction of CAL in children with KD.</p>