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Low vitamin D status may increase risk of death from pneumonia

Posted on: October 11, 2012   by  John Cannell, MD

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Pneumonia, particularly community-acquired pneumonia or CAP (pneumonia acquired outside the hospital) is a common illness in all parts of the world. It is a major cause of death among all age groups. In children, the majority of deaths occur in the newborn period, with over two million worldwide deaths a year. In fact, the WHO estimates that one in three newborn infant deaths is from pneumonia.

Death rates decreases with age until late adulthood; elderly individuals are particularly at risk for CAP and death. More cases of community-acquired pneumonia occur during winter months. It occurs more commonly in Blacks than Caucasians. Individuals with underlying chronic illnesses are at increased risk for CAP.

Dr Leong Leow and colleagues of the University of Otago in New Zealand wanted to know if death rates from CAP were related to vitamin D levels. So they measured 25(OH)D levels in 112 patients with CAP.

Leow L, Simpson T, Cursons R, Karalus N, Hancox RJ. Vitamin D, innate immunity and outcomes in community acquired pneumonia. Respirology. 2011 May;16(4):611-6.

The authors compared two groups, those with levels less than 12 ng/ml and those with levels above 20 ng/ml. They found those with the lowest levels were 12 times more likely to die! However, the numbers were small; 5 of 17 patients with levels below 12 ng/ml died, compared to 2 of 63 with levels above 20 ng/ml. The highest level was 56 ng/ml and that patient got CAP, reminding us that vitamin D reduces the risk, but does not eliminate it. Also, we don’t know if he was one of the two with higher levels who died?

Eighteen patients were taking vitamin D orally, and they had a mean level of almost 30 ng/ml. The authors did not note if any of these 18 patients died or what the levels were in the two patients with higher levels who died. We do know that 94 patients were not taking vitamin D, so they got what they had from the sun.

My lungs are glad I have natural levels of vitamin D.

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