Vitamin D Status in Children: Romania’s National Vitamin D Screening Programme in Context of the COVID-19 Pandemic

• Published in: Medical sciences (Basel) Vol. 13; no. 3; p. 193
• Main Authors: Margan, Mădălin-Marius, Alexandru, Alexandru, Ivan, Cristiana-Smaranda, Boeriu, Estera, Tanasescu, Sonia, Cârstea, Ada Maria, Varga, Norberth-Istvan, Margan, Roxana, Cindrea, Alexandru Cristian, Negrean, Rodica Anamaria
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 16.09.2025
• Subjects: 25-hydroxyvitamin D; Adolescent; Alfacalcidol; Analysis; Calcifediol; Child; Child, Preschool; Children's hospitals; Chronic illnesses; Clinical medicine; Coronaviruses; COVID-19; COVID-19 - epidemiology; COVID-19 pandemic; Data collection; Developing countries; Disease prevention; Female; healthcare policy; Hospitals; Humans; Infant; Infant, Newborn; Male; Mass Screening - methods; Medical research; Medical screening; Medicine, Experimental; Metabolism; national health programme; Otolaryngology; Pandemics; Patients; pediatric screening; Pediatrics; Population; Public health; Retrospective Studies; Rickets; Risk Factors; Romania - epidemiology; SARS-CoV-2; Vitamin D; Vitamin D - analogs & derivatives; Vitamin D - blood; vitamin D deficiency; Vitamin D Deficiency - blood; Vitamin D Deficiency - diagnosis; Vitamin D Deficiency - epidemiology; Vitamin deficiency; Romania; United States; Finland; United States > US; Europe; Germany; COVID-19 pandemic; pediatric screening; healthcare policy; 25-hydroxyvitamin D; risk-based screening; vitamin D insufficiency; national health programme; public health; vitamin D deficiency
• ISSN: 2076-3271; 2076-3271
• DOI: 10.3390/medsci13030193

Background and Objectives: Vitamin D deficiency affects bone health and immune function, especially in children. While universal screening is not cost-effective, targeted screening and supplementation strategies have proven effective. This study evaluates the effectiveness of Romania’s National Vitamin D Screening Programme in detecting vitamin D deficiency in paediatric patients, while also accounting for the impact of the COVID-19 pandemic. Materials and Methods: This retrospective observational study assessed the effectiveness of Romania’s National Vitamin D Screening Initiative in detecting vitamin D deficiency among children admitted to the Clinical Emergency Hospital for Children “Louis Țurcanu”, Timișoara, from January 2018 to December 2024. Serum 25-hydroxyvitamin D levels were analysed in 3596 tested patients out of 22,353 total admitted patients, to evaluate trends from before, during, and after the COVID-19 pandemic. Patients aged 0–18 with at least one admission were included, regardless of diagnosis. Patients in ICU, surgical departments, non-Romanian citizens, and those with life-threatening conditions were excluded. Logistic regression analysis was used to assess programme impact and risk factors for vitamin D insufficiency. Results: The study population had a mean age of 5.36 years, with 53.57% male patients. Patient admissions dropped significantly during pandemic years (mean of 2057 annually in 2020–2022 vs. 4045.5 in pre-/post-pandemic years). Vitamin D insufficiency (<20 ng/mL) peaked at 33.3% in 2020 and 32.5% in 2023, with lowest rates in 2019 (17.2%) and 2021 (16.5%). The National Screening Programme implementation resulted in 57.1% higher odds of vitamin D testing in 2023–2024 compared with 2018–2019 (adjusted OR = 1.571, 95% CI: 1.429–1.726, p < 0.001), with testing rates increasing from 12.6% to 17.5%. Age emerged as the strongest predictor of vitamin D insufficiency, with each additional year associated with 8–9% increased odds of deficiency. Conclusions: The National Vitamin D Screening Programme significantly enhanced detection of vitamin D insufficiency in paediatric populations, despite pandemic-related disruptions. An optimal testing rate of approximately 17% was identified for balancing detection efficiency with resource utilisation. These findings underscore the need for sustained risk-based screening programmes and public health education initiatives to address vitamin D insufficiency in children, particularly in developing countries with limited healthcare resources.