VITAMIN-A AND RESPIRATORY SYNCYTIAL VIRUS-INFECTION - SERUM LEVELS AND SUPPLEMENTATION TRIAL

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.