Effects of Vitamin D and K on Interleukin-6 in COVID-19

Abstract

BackgroundPathology during COVID-19 infection arises partly from an excessive inflammatory response with a key role for interleukin (IL)-6. Both vitamin D and K have been proposed as potential modulators of this process.MethodsWe assessed vitamin D and K status by measuring circulating 25-hydroxyvitamin D (25(OH)D) and desphospho-uncarboxylated Matrix Gla-Protein (dp-ucMGP), respectively in 135 hospitalized COVID-19 patients in relation to inflammatory response, elastic fiber degradation and clinical outcomes.ResultsComparing good and poor disease outcomes of COVID-19 patients, vitamin 25(OH)D levels were not significantly different. IL-6 levels, however, were significantly higher in patients with poor outcome, compared to patients with good outcome (30.3 vs. 153.0 pg/mL; p < 0.0001). Dp-ucMGP levels as biomarker of extrahepatic vitamin K status was associated with IL-6 levels (r = 0.35; p < 0.0001). In contrast, 25(OH)D levels were only borderline statistically significant correlated with IL-6 (r = −0.14; p <0.050). A significant association was also found between IL-6 and elastic fiber degradation. Contrary to vitamin K status, 25(OH)D did not correlate with elastic fiber degradation.ConclusionsDp-ucMGP associates with IL-6 as a central component of the destructive inflammatory processes in COVID-19. An intervention trial may provide insight whether vitamin K administration, either or not in combination with vitamin D, improves clinical outcome of COVID-19.

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“…Interestingly, vitamin D supplementation can affect vitamin K levels by influencing vitamin D-dependent proteins and potentially can induce vitamin K deficiency (40,41). As previous studies have demonstrated that a low vitamin K concentration is associated with higher risks of developing severe COVID-19 and increased IL-6 levels, undoubtedly, further research is needed to investigate the levels of vitamin K in the context of vitamin D insufficiency as well as the role of vitamin D supplementation in vitamin K levels and its related outcomes in the COVID-19 population (42)(43)(44)(45).…”

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“…It is cost-effective, without significant adverse effects and widely available, and could have positive implications for the treatment of the disease worldwide. Of course, the evolution of COVID-19 is influenced by many other risk factors, such as age, gender, obesity, and nutritional factors, such as vitamin K have been suggested as disease modifiers of SARS-CoV-22 infection [105].…”