Serum vitamin D concentration in children with pneumonia and acute respiratory infections, risk factors for its low level.

INTRODUCTION: While there is extensive literature discussing the link between various respiratory infections and risk factors that contribute to low vitamin D levels, there is still no consensus on this relationship. The aim of this study was to test whether low vitamin D levels are associated with pneumonia and acute respiratory infections (ARI) and to identify risk factors for low vitamin D levels in children with these conditions. METHODOLOGY: The study was conducted at the Muratsan Hospital in Yerevan from February to December 2017. It included 140 randomly selected children aged 1 to 5 years, half of whom had pneumonia and the other half had ARI. Based on serum vitamin D levels, the children were further divided into groups with low (52 patients with pneumonia and 38 patients with ARI) and normal vitamin D levels (18 patients with pneumonia and 32 patients with ARI). Factors such as feeding, age, gender, and mother's education were included as indicators of risk for low vitamin D. RESULTS: The difference between the mean values of vitamin D in groups of children with pneumonia and ARI was statistically significant (p < 0.05). Feeding was positively, and age was negatively associated with the level of vitamin D (p < 0.05). CONCLUSIONS: We found that children with pneumonia had a lower vitamin D level. We also found that poor nutrition and the age of the child (1 to 5 years) were risk factors for low vitamin D levels with respiratory infections.

Liver involvement in the process of acute respiratory infections in pediatric patients.

INTRODUCTION: We aimed to investigate the prevalence of liver involvement in pediatric patients with ARI using both routine tests of hepatic panel, and ornithine carbamoyltransferase (OCT) to identify the most sensitive indicators of early hepatic injury. METHODOLOGY: A prospective cohort study of 84 armenian children with ARI was conducted to evaluate the associated liver involvement. The diagnostic variables of interest were the signs of clinical disease severity, and enzymatic profile of the patients. RESULTS: Serum levels of OCT were increased in 94% of patients versus routine tests of hepatic panel (AST in 41.7%, ALT in 15.5%, etc). Variance analysis by severity groups showed the serum levels of OCT (p < 0.001), ammonia (p < 0.001), phospholipides (p = 0.05), glucose (p = 0.01), TNF-α (p = 0.01), IL-8 (p < 0.001), AST (p < 0.001), and ALP (p < 0.001) were associated with the severity of underlying disease. Moreover, regression analysis revealed the serum activity of OCT (p value < 0.001, OR = 1.27) and ammonia (p value 0.002, OR = 1.1) significantly predict the severity of the disease. CONCLUSIONS: Using more sensitive marker of liver damage can detect more cases of ARI with hepatic manifestations. For evaluation of the liver involvement we are suggesting the testing of serum OCT levels as a more sensitive and specific marker. Pediatric patients with ARI and with higher serum OCT levels have 27% more chance to experience increased disease severity, which can affect on liver state and prolong hospitalization time and cost.