Correlation between serum vitamin D levels with severity of community acquired Pneumonia in hospitalized patients over sixty years old in Indonesia
Keywords:
Vitamin D, Community Acquired Pneumonia, ElderlyAbstract
Background and aim: Old-aged persons commonly experience vitamin D deficiency due to many factors such as insufficient vitamin D intake, multiple medications, low sun exposure, and chronic kidney disease, thus increases susceptibility to infections. Community Acquired Pneumonia (CAP) is common in old-aged persons with a high morbidity rate. Its mortality rates can even reach 50-70% if accompanied by comorbidities. This study aimed to describe the correlation between CAP severity with serum vitamin D levels in hospitalized old-aged patients. Methods: This is an observational study with cross-sectional design, involving 82 hospitalized old-aged patients with diagnosis of CAP. Blood samples was collected in order to measure serum Vitamin D levels. Data normality was tested with Kolmogorov-Smirnov test, while Chi Square and Mann-Whitney test was utilized for statistical analysis. Statistical significance was described as p value < 0.05. Results: Average serum vitamin D levels were significantly lower in severe patients than in non-severe groups (p<0.05). The percentage of patients with vitamin D deficiency was also higher in the severe group compared to the non-severe group (p<0.05). Conclusions: There is a significant correlation between serum vitamin D levels and the severity of CAP in hospitalized old-aged patients.
References
Badan Pusat Statistik. Statistik Penduduk Lanjut Usia 2023.; 2021. https://sensus.bps.go.id/main/index/sp2020
Pinandita Faiz R. Undang-Undang Nomor 13 Tahun 1998 Tentang Kesejahteraan Lanjut Usia Dengan Draft Ruu Tentang Kesejahteraan Lanjut Usia Uu. Vol 43.; 1998.
Cacciatore F, Gaudiosi C, Mazzella F, et al. Pneumonia and hospitalizations in the elderly. Geriatr Care. 2017;3(1). doi:10.4081/gc.2017.6377
Pusparini P. Defisiensi Vitamin D Terhadap Penyakit. Indones J Clin Pathol Med Lab. 2018;21(1):1-4. doi:10.24293/ijcpml.v21i1.1265
Chong CP, Street PR. Pneumonia in the elderly: A review of the epidemiology, pathogenesis, microbiology, and clinical features. South Med J. 2008;101(11):1141-1145. doi:10.1097/SMJ.0b013e318181d5b5
Sari EF, Rumende CM, Harimurti K. Faktor–Faktor yang Berhubungan dengan Diagnosis Pneumonia pada Pasien Usia Lanjut. J Penyakit Dalam Indones. 2017;3(4):183. doi:10.7454/jpdi.v3i4.51
Metlay JP, Waterer GW, Long AC, et al. Diagnosis and treatment of adults with community-acquired pneumonia. Am J Respir Crit Care Med. 2019;200(7):E45-E67. doi:10.1164/rccm.201908-1581ST
Hewison M. Vitamin D and immune function: An overview. Proc Nutr Soc. 2012;71(1):50-61. doi:10.1017/S0029665111001650
Brance ML, Miljevic JN, Tizziani R, et al. Serum 25-hydroxyvitamin D levels in hospitalized adults with community-acquired pneumonia. Clin Respir J. 2018;12(7):2220-2227. doi:10.1111/crj.12792
Jovanovich AJ, Ginde AA, Holmen J, et al. Vitamin D level and risk of community-acquired pneumonia and sepsis. Nutrients. 2014;6(6):2196-2205. doi:10.3390/nu6062196
Kim HJ, Jang JG, Hong KS, Park JK, Choi EY. Relationship between serum vitamin D concentrations and clinical outcome of community-acquired pneumonia. Int J Tuberc Lung Dis. 2015;19(6):729-734. doi:10.5588/ijtld.14.0696
Pletz MW, Terkamp C, Schumacher U, et al. Vitamin D deficiency in community-acquired pneumonia: Low levels of 1,25(OH)2 D are associated with disease severity. Respir Res. 2014;15(1):1-8. doi:10.1186/1465-9921-15-53
Zhou YF, Luo BA, Qin LL, Shidoji Y. The association between Vitamin D deficiency and community-acquired pneumonia: A meta-analysis of observational studies. Med (United States). 2019;98(38):1-7. doi:10.1097/MD.0000000000017252
Slow S, Epton M, Storer M, et al. Effect of adjunctive single high-dose vitamin D3 on outcome of community-acquired pneumonia in hospitalised adults: The VIDCAPS randomised controlled trial. Sci Rep. 2018;8(1):1-9. doi:10.1038/s41598-018-32162-2
Jing R, Bin S, Po M, Xing F. Correlation between Serum Vitamin D Level and Severity of Community Acquired Pneumonia in Young Children. Chinese J Contemp Pediatr. 2013;15(7):519-521.
Liyanage G, Kaneshapillai A, Kanthasamy S. Serum Vitamin D Level and Risk of Community-Acquired Pneumonia: A Case-Control Study. Interdiscip Perspect Infect Dis. 2021;2021(Vdd):6-11. doi:10.1155/2021/2157337
Georgakopoulou VE, Mantzouranis K, Damaskos C, et al. Correlation Between Serum Levels of 25-Hydroxyvitamin D and Severity of Community-Acquired Pneumonia in Hospitalized Patients Assessed by Pneumonia Severity Index: An Observational Descriptive Study. Cureus. 2020;12(7):1-10. doi:10.7759/cureus.8947
Ginde AA, Mansbach JM, Camargo CA. Association between Serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med. 2009;169(4):384-390. doi:10.1001/archinternmed.2008.560
Schwalfenberg GK. A review of the critical role of vitamin D in the functioning of the immune system and the clinical implications of vitamin D deficiency. Mol Nutr Food Res. 2011;55(1):96-108. doi:10.1002/mnfr.201000174
Bartley J. Vitamin D : emerging roles in infection and immunity. 2010;8(12):1359-1369.
Bikle DD. Vitamin D and the immune system : role in protection against bacterial infection. 2008;25:25-29.
Routsias JG, Karagounis P, Parvulesku G, Legakis NJ, Tsakris A. In vitro bactericidal activity of human β-defensin 2 against nosocomial strains. Peptides. 2010;31(9):1654-1660. doi:10.1016/j.peptides.2010.06.010
Lu D, Zhang J, Ma C, et al. Link between community-acquired pneumonia and vitamin D levels in older patients. Z Gerontol Geriatr. 2018;51(4):435-439. doi:10.1007/s00391-017-1237-z
Lambert AA, Kirk GD, Astemborski J, et al. A cross sectional analysis of the role of the antimicrobial peptide cathelicidin in lung function impairment within the ALIVE cohort. PLoS One. 2014;9(4). doi:10.1371/journal.pone.0095099
Laird E, O’Halloran AM, Molloy AM, Healy M, Bourke N, Kenny RA. Vitamin D status & associations with inflammation in older adults. PLoS One. 2023;18(6 JUNE):1-12. doi:10.1371/journal.pone.0287169
Kuwabara A, Tsugawa N, Ao M, Ohta J, Tanaka K. Vitamin D deficiency as the risk of respiratory tract infections in the institutionalized elderly: A prospective 1-year cohort study. Clin Nutr ESPEN. 2020;40(xxxx):309-313. doi:10.1016/j.clnesp.2020.08.012
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Marwan Febrian, Agus Sudarso, MD, Muh. Ilyas, MD, Professor Syakib Bakri, Professor A. Makbul Aman, Arifin Seweng, MD
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
How to Cite
