Prevalence and clinical impact of Vitamin A Deficiency (VAD) in critically ill children with sepsis

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BACKGROUND: Data on vitamin A deficiency (VAD) among critically ill pediatric patients with sepsis and its impact remain limited. This study aimed to determine the prevalence of VAD in septic children and evaluate its association with clinical outcomes. METHODS: This prospective cohort included 180 children with sepsis admitted to the Pediatric Intensive Care Unit (PICU) of Benha University Hospital, and 40 healthy controls. Using ELISA, serum vitamin A (VA) levels were measured upon admission. Clinical parameters, including the Pediatric Risk of Mortality (PRISM) scores, sepsis progression, ventilation duration, PICU stay, and mortality were assessed. Multivariate regression evaluated the relationship between VAD and sepsis severity. RESULTS: VAD was significantly more prevalent among septic patients than controls (61.7% vs. 20%, P < 0.001). ROC analysis identified serum VA ≤ 21.4 µg/dl as a significant predictor of sepsis (AUC = 0.699, P < 0.001). While VAD was more frequent in non-survivors (71.4%), the association with mortality was not statistically significant. VAD was linked to higher PRISM scores, longer PICU stays, and greater sepsis severity. CONCLUSION: Our cohort found that VAD is more prevalent in pediatric sepsis patients compared to controls and correlated with higher PRISM scores, sepsis severity and prolonged stays in PICUs. Nevertheless, VAD did not demonstrate a statistically significant association with 28-days mortality. These findings highlight the necessity for additional large-scale research to determine if routine screening of VAD and potential supplementation could improve outcomes in these patients.

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