Objective: To determine the benefit of oral vitamin A. supplementation
for acute respiratory syncytial virus (RSV) infection. Design: An obs
ervational study of vitamin A and retinol binding protein (REP) levels
in RSV-infected in patients and two control groups; and a randomized,
controlled trial of vitamin A supplementation for RSV-infected inpati
ents. Setting: Two tertiary care, urban teaching hospitals. Participan
ts: Thirty-two RSV-infected inpatients (aged 2 to 58 months), 35 hospi
talized children without respiratory infections (aged 2 to 19 months),
and 39 healthy outpatient controls (aged 2 to 67 months). Interventio
ns: The RSV-infected group was randomized to receive a single dose of
100 000 IU oral vitamin A or placebo. Main Outcome Measures: Serum vit
amin A and REP levels of all participants and clinical indicators of s
everity such as days of hospitalization, oxygen use, intensive care, i
ntubation, and a daily severity score. Results: Mean vitamin A and REP
levels were lower in RSV-infected children than in healthy controls (
P<.05). Among RSV-infected children, those admitted to the intensive c
are unit had lower mean vitamin A (P=.03) and REP levels (P=.04) than
those not in intensive care. Among children hospitalized without respi
ratory infection, those admitted to the intensive care unit had lower
mean vitamin A levels (P=.02) than those not in intensive care. In the
RSV-infected children, no significant difference was seen between the
vitamin A group (n=21) and the placebo group (n=11) in improvement in
severity score, mean days of hospitalization, intensive care, or rece
ipt of supplemental oxygen. Conclusions: Serum vitamin A and REP level
s were low in children hospitalized with RSV infection and were lower
in children admitted to the intensive care unit. Hospitalized control
patients in intensive care also had lower levels than those treated on
the ward. We observed no benefit from oral vitamin A supplementation
for children hospitalized with RSV infection.