Vitamin A deficiency is associated with severe Mycoplasma pneumoniae pneumonia in children

Background: Children with vitamin A, D, and E deficiency are susceptible to respiratory infections. However, the correlations between the levels with Mycoplasma pneumoniae pneumonia (MPP) and patient MPP occurrence is still unclear. This study aims to measure and compare the serum levels in severe (sMPP) and non-severe MPP (nsMPP) and to investigate the correlations between their levels and the occurrence of MPP.

Methods: A total of 122 children were enrolled, including 52 sMPP and 70 nsMPP aged 0-15 years old in 2015-2018. The serum levels of vitamins A, D, and E were measured and compared, and two-category logistic regression was used for correlation analysis of vitamins A, D, and E levels with nsMPP and sMPP.

Results: The age was older (7.12 vs. 4.01 y, P=0.002) in the sMPP samples than that in the nsMPP samples. Vitamin A deficiency was present in both the nsMPP and sMPP samples; its level was significantly lower (0.15±0.06 vs. 0.19±0.07, P=0.0193) in the sMPP serum than that in the nsMPP serum. Vitamins E and D in the sMPP samples were significantly lower (vitamin E 7.43±1.55 vs. 8.22±2.22, P=0.0104; vitamin D 23.08±11.0 vs. 32.07±19.2, P=0.0007) than that in the nsMPP group; both sMPP and nsMPP did not show a deficiency of vitamins E and D. Logistic regression analysis revealed that vitamin A deficiency was significantly (OR 0.001, 95% CI: 0.001-0.334, P=0.009) associated with sMPP, and vitamin A supplementation could reduce the incidence of sMPP. In ≥6 y sMPP, the incidence of vitamin A deficiency was 62.5%, while <6 y, 85%, showing a significant difference. Vitamin A level in <6 y sMPP was significantly lower than that in ≥6 y sMPP.

Conclusions: Vitamin A deficiency is associated with sMPP and more likely present in the younger sMPP samples. Therefore, it is important to watch and supplement vitamin A in M. pneumoniae infection patients.