Zinc Deficiency and the Severity of Pneumonia in Vietnamese Children: A Hospital-Based Study

Background Pneumonia is a critical global health concern that often results in severe complications and fatalities, especially among young children. Zinc plays a crucial role in immune function and maintaining respiratory epithelial integrity. Despite its importance, data on the prevalence of zinc deficiency and its impact on pneumonia severity in Vietnamese children are limited. Objectives This study aimed to investigate the prevalence of zinc deficiency and its association with pneumonia severity in Vietnamese children under five years old. The findings could significantly contribute to our understanding of the role of zinc in pneumonia severity, guiding future public health interventions, nutritional policies, and clinical practices to prevent zinc deficiency and reduce pneumonia morbidity and mortality in children. Methods An analytical cross-sectional study was conducted at a major pediatric center in Southwestern Vietnam from December 2022 to February 2024, involving 222 children aged 2 to 59 months diagnosed with pneumonia. Clinical assessments and laboratory measurements, including serum zinc levels, were performed. Statistical analyses were conducted to compare clinical characteristics and outcomes between zinc-deficient and non-deficient groups. Multivariable logistic regression was used to assess the association between zinc deficiency and pneumonia severity, with statistical significance set at p<0.05. Results The prevalence of zinc deficiency among children with pneumonia was 74.3%. Zinc-deficient children showed a significantly higher proportion of severe pneumonia (57.6% vs. 8.8%, p<0.001), as well as a higher proportion of high fever, poor feeding, vomiting, and respiratory distress compared to non-deficient children (p<0.001). Multivariable logistic regression identified zinc deficiency as an independent predictor of severe pneumonia (aOR=13.1, 95% CI: 4.7-36.8, p<0.001). Conclusion Zinc deficiency was prevalent among Vietnamese children with pneumonia and was associated with an increased risk of severe pneumonia.

Efficacy of Zinc as Adjuvant Therapy in the Treatment of Severe Pneumonia in Hospitalized Children: A Randomized Clinical Trial

Background: Pneumonia remains one of the leading causes of childhood mortality and morbidity in developing countries. Studies showed that zinc supplementation can prevent pneumonia, but its therapeutic effectiveness has not been determined definitively. Objectives: This study evaluated the effect of zinc supplementation as adjuvant treatment on children with severe pneumonia admitted to 17th Shahrivar Training Hospital in Rasht, Iran. Methods: In this double-blind placebo-controlled clinical trial, 120 children aged two to 60 months hospitalized for pneumonia were randomly divided into 2 groups of size 60 each. The first group received zinc sulfate (20 mg daily for children twelve months of age or older and 10 mg daily for children younger than 12 months), and the second group received a placebo for seven days. All patients received standard antibiotic treatment for pneumonia. The children were daily evaluated, and recovery time for fever and tachypnea (as primary outcomes) and duration of hospitalization and mortality rate (as secondary outcomes) were compared between the two groups. Results: The mean age of patients was 14.1 months ± 13.9. The youngest and oldest patients were aged 2 and 60 months, respectively. No significant difference in age and sex distribution was found between the two groups. The zinc receiving group experienced a considerably shorter time of fever (2.1 days vs. 2.84 days, P < 0.05) and tachypnea (1.75 days versus 2.1 days, P = 0.011). There was no significant difference in the duration of admission between the two groups (P = 0.728), and no cases of death occurred in either group. Conclusions: This study showed that adjuvant treatment with zinc in children aged 2 to 60 months with severe pneumonia accelerates recovery from pneumonia. Further studies are needed to investigate the effects of administering zinc as adjunctive therapy for pneumonia in other age groups.