Clinical Manifestations of Pediatric Pneumonia Aged 3 Months to 12 years; Evaluation of Effect of Vitamin A

Heydarian, Farhad; Amini, Sara; Ansarinejad, Tahereh

doi:10.22038/jpp.2025.90197.5585

Clinical Manifestations of Pediatric Pneumonia Aged 3 Months to 12 years; Evaluation of Effect of Vitamin A

Document Type : original article

Authors

Farhad Heydarian ¹

Sara Amini ²

Tahereh Ansarinejad ²

¹ Department of Pediatrics, Dr. Sheikh hospital, Mashhad university of Medical Science, Mashhad, Iran.

² Department of Pediatrics, Mashhad University of Medical Science, Mashhad, Iran.

10.22038/jpp.2025.90197.5585

Abstract

Background: The effect of vitamin A on clinical manifestations of pediatric pneumonia was evaluated.
Method: In this randomized double-blinded clinical trial, ninety children between 3 months and 12 years of age with pneumonia admitted to Qaem and Dr. Sheikh Hospital children's ward were assessed. They were randomly divided into two groups: one receiving vitamin A (or retinol) and the other receiving a placebo. Clinical features such as tachypnea, fever, cough, rales, wheezing, and intercostal retraction were recorded and compared between the groups every 12 hours for 120 hours. The significance level was set at less than 0.05.
Results: Of the participants, 42 patients (46.7%) were female and 48 (53.3%) were male. The mean age of all children was 18.37±9.23 months. There were no significant differences between the groups in terms of age and sex (P-values > 0.05). In the group receiving vitamin A, fever was significantly reduced after 60 hours, (P-values < 0.05) and cough was significantly reduced at 24 hours (P-value: 0.025) and 36 hours (P-value: 0.049). However, vitamin A had no effects on other clinical manifestations of pediatric pneumonia (all P-values > 0.05).
Conclusion: The prescription of vitamin A was effective in reducing fever and cough in pediatric pneumonia.

Keywords

Pediatric

Pneumonia

Retinol

Vitamin A

Souza JM, Lins LS, Meireles JM, Dantas MS, Torquato IM. Incidence of Pneumonia in Children in the City of João Pessoa/PB from 2000 to 2008. Revista do unipê. 2010;14(2):147-50.
Chowdhury S, Mishu AA, Rahman MM, Zayed NM. An analysis of factors for acute respiratory infections (ARI) in children under five of age in Bangladesh: a study on DHS, 2014. J Midwifery, Women Heal Gynaecol Nurs. 2020 Mar;2(2):26-32.
Krishnan A, Kumar R, Broor S, Gopal G, Saha S, Amarchand R, et al. Epidemiology of viral acute lower respiratory infections in a community-based cohort of rural north Indian children. Journal of global health. 2019 May 12;9(1):010433.
Amorim PG, Morcillo AM, Tresoldi AT, Fraga AD, Pereira RM, Baracat EC. Factors associated with complications of community-acquired pneumonia in preschool children. Jornal Brasileiro de Pneumologia. 2012;38:614-21.
Caldart RV, Marrero L, Basta PC, Orellana JD. Fatores associados à pneumonia em crianças Yanomami internadas por condições sensíveis à atenção primária na região norte do Brasil. Ciência & Saúde Coletiva. 2016 May;21(5):1597-606.
Masarweh K, Gur M, Toukan Y, Bar‐Yoseph R, Kassis I, Gut G, et al. Factors associated with complicated pneumonia in children. Pediatric Pulmonology. 2021 Aug;56(8):2700-6.
Imdad A, Mayo-Wilson E, Haykal MR, Regan A, Sidhu J, Smith A, et al. Vitamin A supplementation for preventing morbidity and mortality in children from six months to five years of age. Cochrane database of systematic reviews. 2022(3).
Stevens GA, Bennett JE, Hennocq Q, Lu Y, De-Regil LM, Rogers L, et al. Trends and mortality effects of vitamin A deficiency in children in 138 low-income and middle-income countries between 1991 and 2013: a pooled analysis of population-based surveys. The Lancet Global Health. 2015 Sep 1;3(9):e528-36.
Wirth JP, Petry N, Tanumihardjo SA, Rogers LM, McLean E, Greig A, et al. Vitamin A supplementation programs and country-level evidence of vitamin A deficiency. Nutrients. 2017 Feb 24;9(3):190.
Abdelkader A, Wahba AA, El-Tonsy M, Zewail AA, Eldin MS. Recurrent respiratory infections and vitamin A levels: a link? It is cross-sectional. Medicine. 2022 Aug 19;101(33):e30108.
Wang X, Li X, Jin C, Bai X, Qi X, Wang J, et al. Association between serum vitamin A levels and recurrent respiratory tract infections in children. Frontiers in pediatrics. 2021 Dec 24;9:756217.
Milani GP, Alberti I, Abodi M, Lakoumentas J, Konstantinou GN, Papadopoulos NG, et al. A systematic review and meta‐analysis on nutritional and dietary interventions for the treatment of acute respiratory infection in pediatric patients: An EAACI taskforce. Allergy. 2024 Jul;79(7):1687-707.
Hu N, Li QB, Zou SY. Effect of vitamin A as an adjuvant therapy for pneumonia in children: a Meta analysis. Zhongguo Dang dai er ke za zhi= Chinese Journal of Contemporary Pediatrics. 2018 Feb 1;20(2):146-53.
Gombart AF, Pierre A, Maggini S. A review of micronutrients and the immune system–working in harmony to reduce the risk of infection. Nutrients. 2020 Jan 16;12(1):236.
Hume-Nixon M, Graham H, Russell F, Mulholland K, Gwee A, ARI Review group. Review of the role of additional treatments including oseltamivir, oral steroids, macrolides, and vitamin supplementation for children with severe pneumonia in low-and middle-income countries. Journal of Global Health. 2022 Aug 22;12:10005.
Marquez HA, Cardoso WV. Vitamin A-retinoid signaling in pulmonary development and disease. Molecular and Cellular Pediatrics. 2016 Aug 1;3(1):28.
Timoneda J, Rodríguez-Fernández L, Zaragozá R, Marín MP, Cabezuelo MT, Torres L, et al. Vitamin A deficiency and the lung. Nutrients. 2018 Aug 21;10(9):1132.
Mendes AD, De Souza AM, Nunes AD, Jerez-Roig J, Barbosa IR. Frequency of vitamin a deficiency in children hospitalized for Pneumonia: An integrative review. Public Health Reviews. 2022 Dec 13;43:1604500.
Tian Y, Tian Q, Wu Y, Peng X, Chen Y, Li Q, et al. Vitamin A supplement after neonatal Streptococcus pneumoniae pneumonia inhibits the progression of experimental asthma by altering CD4+ T cell subsets. Scientific reports. 2020 Mar 6;10(1):4214.
Atta A, Aftab A, Shafqat A, Yousuf MH, Ahmed A, Pirzada H, et al. Investigating the Efficacy of Zinc and Vitamin A in Treating Pediatric Community-Acquired Pneumonia. Cureus. 2024 Jan 13;16(1).
Mathew JL. Vitamin A supplementation for prophylaxis or therapy in childhood pneumonia: A systematic review of randomized controlled trials. Indian Pediatr. 2010 Mar 1;47(3):255-61.