The impact of vitamin A supplementation given during a pneumonia episode on the subsequent morbidity of children. Respiratory infections reduce the growth response to vitamin A supplementation in a randomized controlled trial. Vitamin D supplementation for severe pneumonia — A randomized controlled trial The clinical effects of vitamin C supplementation in elderly hospitalised patients with acute respiratory infections. Vitamin A supplementation and severity of pneumonia in children admitted to the hospital in Dar es Salaam, Tanzania. Randomised, double blind, placebo controlled clinical trial of efficacy of vitamin A treatment in non-measles childhood pneumonia Vitamin C and acute illness in Navajo school children. Effect on the incidence of pneumonia of vitamin D supplementation by quarterly bolus dose to infants in Kabul: a randomised controlled superiority trial Effects of vitamin D supplementation to children diagnosed with pneumonia in Kabul: a randomised controlled trial. Effect of routine zinc supplementation on pneumonia in children aged 6 months to 3 years: randomised controlled trial in an urban slum High dose vitamin A supplementation in the course of pneumonia in Vietnamese children Vitamin C and upper respiratory illness in Navaho children: preliminary observations (1974). Adverse effects of high-dose vitamin A supplements in children hospitalized with pneumonia. Zinc combined with vitamin A reduces upper respiratory tract infection morbidity in a randomised trial in preschool children in Indonesia. Vitamin A supplementation in children with recurrent respiratory infections. Vitamin D3 supplementation in patients with chronic obstructive pulmonary disease (ViDiCO): a multicentre, double-blind, randomised controlled trial. Vitamin C supplementation reduces the incidence of postrace symptoms of upper-respiratory-tract infection in ultramarathon runners.
OBJECTIVE To evaluate the impact of large-dose vitamin A supplementation given to infants > 6 months old ( 200000 IU ) and to preschool children aged 1 - 4 years ( 400000 IU ) during a pneumonia episode , on their subsequent morbidity and severe morbidity . METHOD In a r and omized , double-blind , placebo controlled trial , the children were followed-up with 2-weekly visits at home for 16 weeks , with the first visit 2 weeks after treatment for pneumonia was initiated . The field workers asked about the presence of morbidity on the day of the visit and in the previous two weeks and about the occurrence and number of clinic attendances and hospital admissions since the last visit . They also measured the patients respiratory rate and temperature and assessed the children for the presence of cyanosis , chest indrawing and wheezing . RESULTS Except for the prevalence of diet refusal which was higher in the vitamin A group , no differences between the study groups were observed , either in the prevalence of morbidity or in the incidence of clinic attendances and hospital admissions . CONCLUSION No evidence was found for a beneficial effect of vitamin A given during acute pneumonia on the subsequent morbidity and severe morbidity of children in a population with marginal vitamin A deficiency BACKGROUND Studies on the effect of vitamin A supplementation on growth have yielded various results . It is possible that such growth is dependent on the burden of infectious diseases in the population . METHODS We analysed data from a r and omized , double-masked , placebo-controled trial to examine the role of respiratory infections and diarrhoea in modifying the growth response to vitamin A supplementation . A single high dose of vitamin A or placebo was given every 4 months to 1405 children aged 6 - 48 months , and 4430 child treatment cycles were used in this analysis . RESULTS Vitamin A supplementation modestly improved linear but not ponderal growth of children who experienced little respiratory infection and especially of those who had vitamin A intake below the normative requirement ( < 400 RE/day ) . Children who received vitamin A and were free of respiratory infection grew 0.22 cm/4 months ( 95 % CI : 0.08 , 0.37 ) more in height than the placebo group , but those with > or = 21.5 % of days of respiratory infection did not show a significant growth response to vitamin A supplementation . Children who experienced no respiratory infection and had vitamin A intake < 400 RE/day benefited most , gaining 0.31 cm/4 months ( 95 % CI : 0.10 , 0.52 ) more in height compared to the placebo group . Diarrhoea was associated with poorer growth , but did not significantly modify the effect of  vitamin A supplementation  on growth . CONCLUSIONS Vitamin A supplementation improves the linear growth of children who have a low intake of vitamin A but this impact is muted with increasing levels of respiratory infections Objective To determine the role of oral vitamin D supplementation for resolution of severe pneumonia in under-five children . Design R and omized , double blind , placebo-controlled trial . Setting In patients from a tertiary care hospital . Participants Two hundred children [ mean ( SD ) age : 13.9 ( 11.7 ) months ; boys : 120 ] between 2 months to 5 years with severe pneumonia . Pneumonia was diagnosed in the presence of fever , cough , tachypnea ( as per WHO cut-offs ) and crepitations . Children with pneumonia and chest indrawing or at least one of the danger sign ( inability to feed , lethargy , cyanosis ) were diagnosed as having severe pneumonia . The two groups were comparable for baseline characteristics including age , anthropometry , socio-demographic profile , and clinical and laboratory parameters . InterventionOral vitamin D ( 1000 IU for < 1 year and 2000 IU for > 1 year ) ( n=100 ) or placebo ( lactose ) ( n=100 ) once a day for 5 days , from enrolment . Both the groups received antibiotics as per the Indian Academy of Pediatrics guidelines , and supportive care ( oxygen , intravenous fluids and monitoring ) . Outcome variables Primary : time to resolution of severe pneumonia . Secondary : duration of hospitalization and time to resolution of tachypnea , chest retractions and inability to feed . Results Median duration ( SE , 95 % CI ) of resolution of severe pneumonia was similar in the two groups [ vitamin D : 72 ( 3.7 , 64.7–79.3 ) hours ; placebo : 64 ( 4.5 , 55.2–72.8 ) hours ] . Duration of hospitalization and time to resolution of tachypnea , chest retractions , and inability to feed were also comparable between the two groups . ConclusionS hort-term supplementation with oral vitamin D ( 1000–2000 IU per day for 5 days ) has no beneficial effect on resolution of severe pneumonia in under-five children . Further studies need to be conducted with higher dose of Vitamin D or longer duration of supplementation to corroborate these findings A r and omised double-blind trial involving vitamin C/placebo supplementation was conducted on 57 elderly patients admitted to hospital with acute respiratory infections ( bronchitis and bronchopneumonia ) . Patients were assessed clinical ly and biochemically on admission and again at 2 and 4 weeks after admission having received either 200 mg vitamin C per day , or placebo . This relatively modest oral dose led to a significant increase in plasma and white cell vitamin C concentration even in the presence of acute respiratory infection . Using a clinical scoring system based on major symptoms of the respiratory condition , patients supplemented with the vitamin fared significantly better than those on placebo . This was particularly the case for those commencing the trial most severely ill , many of whom had very low plasma and white cell vitamin C concentrations on admission . Various mechanisms by which vitamin C could assist this type of patient are discussed Vitamin A deficiency and acute lower respiratory tract infections coexist as important public health problems in many developing countries . We carried out a r and omized , double-blind , placebo-controlled trial to examine whether large doses of vitamin A given to Tanzanian children who are admitted to the hospital with nonmeasles pneumonia would reduce the severity of respiratory disease .  Six hundred eighty-seven children were r and omly assigned to receive either placebo or vitamin A [ 200 000 IU ( 60 mg retinol equivalents ) for children > 1 y of age and 100000 IU ( 30 mg retinol equivalents ) for infants ] on the day of admission and another dose on the following day . Of the 346 children in the vitamin A group , 13 died in the hospital , compared with 8 of 341 children in the placebo group ; the relative mortality was 1.63 ( 95 % CI : 0.67 , 3.97 ; P = 0.28 ) . The mean number of days of hospitalization was the same in both groups ( 4.2 d ) . There were no differences between the vitamin A and placebo groups in the duration of hospital stay when examined within categories of children stratified by age , sex , breast-feeding status , nutritional status at baseline , or quartile of dietary vitamin A intake in the 4 mo before admission to the hospital . There were also no differences in the mean number of days of fever , rapid respiratory rate , or hypoxia , whether these endpoints were examined in the total number of subjects or in a subset with more severe clinical conditions at baseline . Large doses of vitamin A had no protective effect on the course of pneumonia in hospitalized Tanzanian children Abstract Objective : To evaluate the impact on clinical recovery and severity of the addition of large doses of vitamin A to the st and ard treatment for childhood pneumonia . Design : A r and omised , double blind , placebo controlled trial . Setting : Study children were recruited at a public hospital in Recife , north east Brazil , an area of marginal vitamin A deficiency . Subjects : 472 children aged 6 to 59 months with clinical diagnosis of pneumonia . Interventions : 200 000 IU ( infants ) or 400 000 IU ( 1 - 4 year olds ) of vitamin A in oil or similar capsules of placebo divided into two daily oral doses , in addition to the st and ard treatment . Main outcome measures : Duration of the episode and incidence of adverse outcomes . Results : The groups were similar with respect to overall duration of pneumonia and incidence of adverse outcomes . Children who received vitamin A , however , were less likely to have fever by day 3 ( P=0.008 ) and were 29 % less likely to fail to respond to the first line antibiotic ( P=0.054 ) . Conclusion : There was little evidence for an effect of vitamin A treatment on the immediate outcome of the pneumonia episode . Key messages Pneumonia is a leading cause of childhood mortality in developing countries Vitamin A supplementation has no impact on mortality from pneumonia even though it reduces overall mortality Treatment of measles pneumonia with vitamin A reduces case fatality and severity of disease This study showed that vitamin A treatment has no impact on the recovery from non-measles pneumonia , despite some suggestion that severely affected patients may benefit The addition of vitamin A for treatment protocol s for childhood pneumonia is not recommended for clinical cure , although it maybe a useful contact to improve vitamin A To evaluate earlier observations , including our own , showing usefulness of vitamin C for managing the common cold , we performed a double-blind trial of vitamin C versus placebo in 868 children . There was no difference in number becoming ill ( 133 versus 129 ) , number of episodes ( 166 versus 159 ) or mean illness duration ( 5.5 versus 5.8 days ) between the groups . Children receiving vitamin C  had fewer throat cultures yielding beta-hemolytic streptococcus ( six versus 13 , P less than 0.10 ) , but no difference in overall complicated illness rate ( 24 versus 25 ) . Plasma ascorbic acid levels were higher in the vitamin group 24 to 26 hours after supplementation ( 1.28 versus 1.04 mg per 100 ml , P less than 0.01 ) . Children with high plasma ascorbic acid concentrations had longer mean illness ( 6.8 versus 4.0 days , P less than 0.05 ) than those with low levels . Vitamin C does not seem to be an effective prophylactic or therapeutic agent for upper respiratory illness Summary Background Vitamin D has a role in regulating immune function , and its deficiency is a suggested risk factor for childhood pneumonia . Our aim was to assess whether oral supplementation of vitamin D3 ( cholecalciferol ) will reduce the incidence and severity of pneumonia in a high-risk infant population . Methods We did a r and omised placebo-controlled trial to compare oral 100 000 IU ( 2·5 mg ) vitamin D3 with placebo given to children aged 1–11 months in Kabul , Afghanistan . R and omisation was by use of a computer-generated list . Vitamin D or placebo was given by fieldworkers once every 3 months for 18 months . Children presenting at the study hospital with signs of pneumonia had their diagnosis confirmed radiographically . Our primary outcome was the first or only episode of radiologically confirmed pneumonia . Our analysis was by intention to treat . This study is registered with Clinical Trials.gov , number NCT00548379 . Findings 1524 children were assigned to receive vitamin D3 and 1522 placebo .  There was no significant difference between the incidence of first or only pneumonia between the vitamin D ( 0·145 per child per year , 95 % CI 0·129–0·164 ) and the placebo group ( 0.137 , 0·121–0·155 ) ; the incidence rate ratio was 1·06 ( 95 % CI 0·89–1·27 ) . From 652 children during five separate periods of testing serum calcifediol , only one child in each of two testing periods had results greater than 375 nmol/L in the intervention group — a toxic level . Interpretations Quarterly bolus doses of oral vitamin D3 supplementation to infants are not an effective intervention to reduce the incidence of pneumonia in infants in this setting . Funding Wellcome Trust and British Council OBJECTIVES To determine whether ( i ) supplementation of oral 100,000 iu of vitamin D(3 ) ( cholecalciferol ) along with antibiotics will reduce the duration of illness in children with pneumonia ; ( ii ) supplementation will reduce the risk of repeat episodes . METHODS Double-blind individually r and omised placebo-controlled trial in an inner-city hospital in Kabul , of 453 children aged 1 - 36 months , diagnosed with non-severe or severe pneumonia at the outpatient clinic . Children with rickets , other concurrent severe diseases , very severe pneumonia or wheeze , were excluded . Children were given vitamin D(3 ) or placebo drops additional to routine pneumonia treatment . RESULTS Two hundred and twenty-four children received vitamin D(3 ; ) and 229 received placebo .  There was no significant difference in the mean number of days to recovery between the vitamin D(3 ) ( 4.74 days ; SD 2.22 ) and placebo arms ( 4.98 days ; SD 2.89 ; P = 0.17 ) . The risk of a repeat episode of pneumonia within 90 days of supplementation was lower in the intervention ( 92/204 ; 45 % ) than the placebo group [ 122/211 ; ( 58 % ; relative risk 0.78 ; 95 % CI 0.64 , 0.94 ; P = 0.01 ] . Children in the vitamin D(3 ) group survived longer without experiencing a repeat episode ( 72 days vs. 59 days ; HR 0.71 ; 95 % CI 0.53 - 0.95 ; P = 0.02 ) . CONCLUSION A single high-dose oral vitamin D(3 ) supplementation to young children along with antibiotic treatment for pneumonia could reduce the occurrence of repeat episodes of pneumonia Abstract Objectives : To evaluate the effect of daily zinc supplementation  in children on the incidence of acute lower respiratory tract infections and pneumonia . Design : Double masked , r and omised placebo controlled trial . Setting : A slum community in New Delhi , India . Participants : 2482 children aged 6 to 30 months . Interventions : Daily elemental zinc , 10 mg to infants and 20 mg to older children or placebo for four months . Both groups received single massive dose of vitamin A ( 100 000 IU for infants and 200 000 IU for older children ) at enrolment . Main outcome measures : All households were visited weekly . Any children with cough and lower chest indrawing or respiratory rate 5 breaths per minute less than the World Health Organization criteria for fast breathing were brought to study physicians . Results : At four months the mean plasma zinc concentration was higher in the zinc group ( 19.8 ( SD 10.1 ) v 9.3 ( 2.1 ) μmol/l , P<0.001 ) . The proportion of children who had acute lower respiratory tract infection during follow up was no different in the two groups ( absolute risk reduction −0.2 % , 95 % confidence interval −3.9 % to 3.6 % ) . Zinc supplementation result ed in a lower incidence of pneumonia  than placebo ( absolute risk reduction 2.5 % , 95 % confidence interval 0.4 % to 4.6 % ) . After correction for multiple episodes in the same child by generalised estimating equations analysis the odds ratio was 0.74 , 95 % confidence interval 0.56 to 0.99 . Conclusions : Zinc supplementation substantially reduced the incidence of pneumonia in children who had received vitamin We carried out a r and omized , placebo‐controlled , double‐blinded trial to evaluate the effect on morbidity of high dose oral vitamin A , given on hospital admission to 592 children aged 1–59 months with moderate and severe pneumonia . Severely underweight children were not included , but 45 % were moderately underweight . The vitamin A and placebo groups were comparable in baseline characteristics . Four patients died . Among all of the surviving children , no differences were found regarding mean time for normalization of fever , respiratory rate and time of hospitalization . Stratification for moderate malnutrition , degree of pneumonia , age and sex revealed moderately malnourished vitamin A‐supplemented children to have a shorter time of hospitalization ( p= 0 . 04 ) , due to an effect in females aged > 12 months ( p= 0 . 02 ) and females with very severe pneumonia ( p= 0 . 048 ) . This study indicates that , in developing countries like Vietnam , supplementation with vitamin A in children with pneumonia could shorten the recovery rate in the ones that are undernourished , especially females > 1 y old In a large double-blind study among Navaho school children , we evaluated the effects of vitamin C in 1- and 2-gram daily doses on acute respiratory illness during a 14-week period . ' We found no evidence of significant prophylaxis , but our findings did suggest a modest therapeutic benefit in that children taking vitamin Chad from 28 % to 34 % fewer days of morbidity caused by respiratory episodes than those taking placebo . Likewise , in classroom surveillance , younger children on vitamin C had 26 % fewer symptom-days of cough and nasal discharge recorded . These observations were consistent with other recent trials using 1 gram daily ( 4 grams during illness ) in Canadian adults L ' and 250 - 500 milligrams daily in Irish schoolchildren.3 The clinical significance of this modest therapeutic result in minor , selflimited illness was , in itself , question able . However , further study was indicated to determine : ( a ) if use of vitamin C could prevent complications of the common cold in children , such as superinfections or otitis media ; ( b ) if certain symptoms or symptom complexes responded specifically to vitamin C therapy ; and ( c ) if indeed , as our data had suggested , l higher blood ascorbic acid levels were correlated with fewer days of illness . A second investigation was design ed to confirm , if possible , and exp and our previous findings . The second trial was conducted in two Navaho boarding schools during January through May 1974 , using doses of 1 gram vitamin C daily versus placebo tablets . This report presents preliminary routine surveillance findings from the second study OBJECTIVE To test the hypothesis that high-dose vitamin A supplements will enhance recovery of children hospitalized for the treatment of community-acquired pneumonia . DESIGN We conducted a r and omized , double-blind , placebo-controlled clinical trial of high-dose vitamin A supplements among children 3 months to 10 years of age ( N = 95 ) admitted to hospital with community-acquired pneumonia in Lima , Peru . Children < /=1 year of age received 100 000 IU of water-miscible vitamin A on admission to the hospital and an additional 50 000 IU the next day . Children > 1 year of age received 200 000 IU on admission and 100 000 IU the next day . RESULTS Children receiving vitamin A ( n = 48 ) had lower blood oxygen saturation ( the mean difference on day 3 in hospital was 1.1 % ) , higher prevalence rates of retractions ( 37 % in the vitamin A group vs 15 % in the placebo group on day 3 ) , auscultatory evidence of consolidation ( 28 % in the vitamin A group vs 17 % in the placebo group on day 3 ) , and were more likely to require supplemental oxygen ( 21 % in the vitamin A group vs 8 % in the placebo group on day 3 ) than children in the placebo group ( n = 47 ) . Adjustment for baseline severity of disease and nutritional status did not alter the association of vitamin A with increased clinical severity , although the difference in blood oxygen saturation was no longer statistically significant . No differences were seen in duration of hospitalization or in chest x-ray changes 14 days after admission . No deaths occurred , and toxicity of vitamin A was not seen . CONCLUSIONS This study indicates that high-dose vitamin A supplements cause modest adverse effects in children recovering from pneumonia and should not be used therapeutically in such patients unless there is clinical evidence of vitamin A deficiency or concurrent measles infection Zn supplementation has shown inconsistent effects on  respiratory morbidity in young children in developing countries . Few studies have focused on upper respiratory tract infection ( URTI ) , a frequent cause of morbidity in this group , and potential benefit from Zn supplementation or factors that influence its efficacy . We investigated the effects of Zn supplementation on URTI before and after vitamin A supplementation . This r and omised double-blinded controlled Zn supplementation study was conducted on 826 children aged 2 - 5 years .  Placebo or Zn ( 10 mg/d ) was given in syrup daily for 4 months , with 200 000 IU vitamin A ( 60 mg retinol ) given to all children at 2 months . Health workers visited children every 3 d for compliance and morbidity information . We found that 84 % of children experienced URTI during the study . Zn supplementation reduced the percentage of days with URTI ( 12 % reduction ; P = 0·09 ) , with greater impact following vitamin A supplementation ( 20 % reduction ; P = 0·01 ) . Vitamin A supplementation was associated with a decreased number but an increased duration of URTI episodes . We conclude that Zn combined with vitamin A supplementation significantly reduced the percentage of days with URTI in a population of preschool Indonesian children with marginal nutritional status . The results suggest that vitamin A status modifies the efficacy of Zn supplementation  on URTI Vitamin A deficiency predisposes children to infection by suppression of humoral and cell-mediated immunity as well by changes in the respiratory epithelium . To evaluate the effect of vitamin A supplementation in children with recurrent respiratory infections a clinical trial was conducted . 61 children ( 37 boys and 24 girls ) aged 12 - 60 months with a history of recurrent respiratory infections were enrolled in the study with informed consent from the parents . All the included children were followed-up monthly in the outpatient clinic using a st and ard follow-up protocol . Parents were given a monthly calendar and were instructed to record the occurrence of any of the following symptoms daily : runny or blocked nose sore/scratchy throat dry cough chesty or moist cough wheezy breathing shortness of breath and fever . Overall the findings demonstrated that there was no difference between the groups even when the children were stratified by pre-supplementation vitamin A level or wheezing episodes . There was also no significant difference in the mean number of outpatient clinic visits for inter-current illnesses ( 2.1 + or- 2.4 vs. 1.34 + or- 1.4 p = 0.17 ) or in the mean weight gain between the two groups ( 0.6679 + or- 0.7385 = or- 0.78 kg p = 0.72 placebo vs. vitamin A. Based on the findings trials evaluating different dosages frequency of administration and formulations of vitamin A are required to delineate supplementation regimes which may result in sustained improvement in the retinol levels and thereby have a better clinical effect BACKGROUND Patients with chronic obstructive pulmonary disease ( COPD ) often have vitamin D deficiency , which is associated with increased susceptibility to upper respiratory infection-a major precipitant of exacerbation . Multicentre trials of vitamin D supplementation for prevention of exacerbation and upper respiratory infection in patients with COPD are lacking . We therefore investigated whether vitamin D3 ( colecalciferol ) supplementation would reduce the incidence of moderate or severe COPD exacerbations and upper respiratory infections . METHODS We did a r and omised , double-blind , placebo-controlled trial of vitamin D3 supplementation in adults with COPD in 60 general practice s and four Acute National Health Service Trust clinics in London , UK . Patients were allocated to receive six 2-monthly oral doses of 3 mg vitamin D3 or placebo over 1 year in a 1:1 ratio using computer-generated permuted block r and omisation . Participants and study staff were masked to treatment assignment . Co primary outcomes were time to first moderate or severe exacerbation and first upper respiratory infection . Analysis was by intention to treat . A prespecified subgroup analysis was done to assess whether effects of the intervention on the co primary outcomes were modified by baseline vitamin D status . This trial is registered with Clinical Trials.gov , number NCT00977873 . FINDINGS 240 patients were r and omly allocated to the vitamin D3 group ( n=122 ) and placebo group ( n=118 ) . Vitamin D3 compared with placebo did not affect time to first moderate or severe exacerbation ( adjusted hazard ratio 0·86 , 95 % CI 0·60 - 1·24 , p=0·42 ) or time to first upper respiratory infection ( 0·95 , 0·69 - 1·31 , p=0·75 ) . Prespecified subgroup analysis showed that vitamin D3 was protective against moderate or severe exacerbation in participants with baseline serum 25-hydroxyvitamin D concentrations of less than 50 nmol/L ( 0·57 , 0·35 - 0·92 , p=0·021 ) , but not in those with baseline 25-hydroxyvitamin D levels of at least 50 nmol/L ( 1·45 , 0·81 - 2·62 , p=0·21 ; p=0·021 for interaction between allocation and baseline serum 25-hydroxyvitamin D status ) . Baseline vitamin D status did not modify the effect of the intervention on risk of upper respiratory infection ( pinteraction=0·41 ) . INTERPRETATION Vitamin D3 supplementation protected against moderate or severe exacerbation , but not upper respiratory infection , in patients with COPD with baseline 25-hydroxyvitamin D levels of less than 50 nmol/L. Our findings suggest that correction of vitamin D deficiency in patients with COPD reduces the risk of moderate or severe exacerbation . FUNDING UK National Institute for Health Research This study determined whether daily supplementation with 600 mg vitamin C would reduce the incidence of symptoms of  upper-respiratory-tract ( URT ) infections after participation in a competitive ultramarathon race ( > 42 km ) . Ultramarathon runners with age-matched controls were r and omly divided into placebo and experimental ( vitamin C-supplemented ) groups . Symptoms of URT infections were monitored for 14 d after the race . Sixty-eight percent of the runners in the placebo group reported the development of symptoms of URT infection after the race ; this was significantly more ( P < 0.01 ) than that reported by the vitamin C-supplemented group ( 33 % ) . The duration and severity of symptoms of URT infections reported in the vitamin C-supplemented nonrunning control group was also significantly less than in the nonrunning control group receiving the placebo ( P < 0.05 ) . This study provides evidence that vitamin C supplementation may enhance resistance to the postrace URT infections that occur commonly in competitive ultramarathon runners and may reduce the severity of such infections in those who are sedentary
Due to the small number of included studies and very low quality of the existing evidence , we are uncertain of the effect of vitamin C supplementation for the prevention and treatment of pneumonia .
BACKGROUND According to the Global Burden of Disease Study 2015 , lower respiratory tract infection is the leading cause of infectious disease death , and the fifth most common cause of death overall .
Vitamin C has a role in modulating resistance to infectious agents , therefore vitamin C supplementation may be important in preventing and treating pneumonia .
OBJECTIVES To assess the impact of vitamin C supplementation to prevent and treat pneumonia in children and adults .