Efficacy of vitamin D supplementation for children with acute bronchiolitis: A randomized controlled trial

doi:10.5409/wjcp.v15.i1.114465

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World Journal of Clinical Pediatrics

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Randomized Controlled Trial

©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.

World J Clin Pediatr. Mar 9, 2026; 15(1): 114465
Published online Mar 9, 2026. doi: 10.5409/wjcp.v15.i1.114465

Efficacy of vitamin D supplementation for children with acute bronchiolitis: A randomized controlled trial

Elsayed Abdelkreem, Yostena Safwat Labeeb, Mostafa Ashry Mohamed

Elsayed Abdelkreem, Yostena Safwat Labeeb, Mostafa Ashry Mohamed, Department of Pediatrics, Faculty of Medicine, Sohag University, Nasser City 82524, Sohag, Egypt

Elsayed Abdelkreem, Department of Clinical Sciences, Al Rayan National College of Medicine, Al Madinah Al Munawarah 41411, Saudi Arabia

Author contributions: Abdelkreem E conceived and designed the study, shared in methodology, interpreted data, and wrote manuscript draft; Labeeb YS shared in study methodology, data analysis, and manuscript editing; Mohamed MA designed the study, shared in methodology, and revised the manuscript; all authors have read and approved the final manuscript.

Institutional review board statement: This study was approved by the Research Ethics Committee of Faculty of Medicine, Sohag University (Approval No. Soh-Med-23-03-11MS; dated March 8, 2023).

Clinical trial registration statement: This study has been registered at https://clinicaltrials.gov/study/NCT05795933 (ID: NCT05795933).

Informed consent statement: Parents or legally authorized representatives of all participating children provided written informed consent prior to study enrollment.

Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.

CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.

Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.

Corresponding author: Elsayed Abdelkreem, MD, PhD, Assistant Professor, Department of Pediatrics, Faculty of Medicine, Sohag University, Sohag University Street, Nasser City 82524, Sohag, Egypt. d.elsayedmohammed@med.sohag.edu.eg

Received: September 22, 2025
Revised: October 20, 2025
Accepted: December 3, 2025
Published online: March 9, 2026
Processing time: 167 Days and 22.6 Hours

Abstract

BACKGROUND

Previous studies have suggested an association between vitamin D deficiency and bronchiolitis, but the therapeutic benefits of vitamin D supplementation remain uncertain.

AIM

To investigate the efficacy of vitamin D supplementation for hospitalized children with acute bronchiolitis.

METHODS

This two-arm randomized controlled trial included 146 children aged 3-24 months who were hospitalized with bronchiolitis at an Egyptian tertiary care center. Participants were equally randomized to receive a single intramuscular dose of 200000 IU (study group) or a daily oral dose of 400 IU (comparison group) of vitamin D₃. The primary outcome was the time to hospital discharge. Secondary outcomes included time to oxygen weaning, discontinuation of intravenous fluids, and discharge readiness as well as serum 25-hydroxyvitamin D [25(OH)D] levels on day 3 post-randomization. Both the study and comparison groups were compared in the whole cohort (primary analysis) and within the subgroup of participants with baseline serum 25(OH)D levels < 30 ng/mL (prespecified subgroup analysis).

RESULTS

In the overall analysis, the study and comparison groups showed no significant differences in median time to discharge (130 hours vs 140 hours, P = 0.149) or in secondary outcomes, except for a higher serum 25(OH)D level in the study group (51 ± 12.8 vs 32 ± 13.2 ng/mL, P < 0.001). However, among the subgroup of participants with baseline serum 25(OH)D levels < 30 ng/mL, the study group demonstrated significantly shorter median times to hospital discharge (120 hours vs 170 hours, P < 0.001), oxygen weaning (56 hours vs 79 hours, P = 0.012), discontinuation of intravenous fluids (55 hours vs 73 hours, P = 0.017), and discharge readiness (118 hours vs 165 hours, P = 0.001) as well as a greater increase in serum 25(OH)D levels (40 ± 6.6 ng/mL vs 20 ± 6.1 ng/mL, P < 0.001) than the comparison group.

CONCLUSION

Vitamin D supplementation may improve clinical outcomes in hospitalized children with bronchiolitis who have vitamin D deficiency or insufficiency, supporting a test-and-treat approach.

Keywords: Bronchiolitis; Cholecalciferol; Length of hospital stay; Respiratory tract infections; Vitamin D deficiency

Core Tip: Vitamin D deficiency has been linked to bronchiolitis, yet the therapeutic benefit of supplementation remains uncertain. In this randomized controlled trial, a single intramuscular dose of 200000 IU vitamin D₃ significantly shortened hospital stay and reduced oxygen and intravenous fluid requirements in children with bronchiolitis who were vitamin D deficient, but not in those with sufficient levels. These results suggest that targeted supplementation may improve outcomes in deficient children, supporting a test-and-treat strategy.