Reduced Vitamin K Status as A Potentially Modifiable Prognostic Risk Factor in COVID-19

Abstract

Introduction: Coronavirus 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus-2. The majority of patients have at most mild symptoms, however, a significant proportion develops respiratory failure. COVID-19 may also progress beyond the lungs. Coagulopathy and thromboembolism are prevalent in severe COVID-19 and relate to decreased survival. Coagulation is an intricate balance between clot promoting and dissolving processes in which vitamin K plays a well-known role. We hypothesized that vitamin K status is reduced in patients with severe COVID-19. Methods: Vitamin K status was assessed by measuring desphospho-uncarboxylated matrix Gla protein (dp-ucMGP; inversely related to vitamin K status) and the rate of elastin degradation by measuring desmosine. We included 123 patients who were admitted with COVID-19 and 184 controls. Results: Dp-ucMGP levels were significantly elevated in COVID-19 patients (1,673Å}1,584 pmol/L) compared to controls (536±291 pmol/L; p<0.0005). Dp-ucMGP levels were significantly higher in COVID-19 patients with unfavorable outcome compared to those with less severe disease. Furthermore, dp-ucMGP and desmosine levels were significantly associated (r=0.65; p<0.0005). Conclusions: Vitamin K status was reduced in patients with COVID-19 and related to poor prognosis. Also, low vitamin K status seems to be associated with accelerated elastin degradation. An intervention trial is now needed to assess whether vitamin K administration improves outcome in patients with COVID-19.

The COVID-19 Pandemic: Does Our Early Life Environment, Life Trajectory and Socioeconomic Status Determine Disease Susceptibility and Severity?

“…On the other hand, patients with comorbidities such as diabetes present a lack in vitamin K which is involved in blood coagulation or bone calcification mechanisms. In case of COVID-19 patients, insufficient levels of vitamin K could be associated with a risk of complications due to elastic fiber pathologies such as idiopathic pulmonary fibrosis (IPF) [156]. Coagulation has been reported as a common comorbidity linked to COVID-19 severity and mortality.…”

Review of novel human β‐coronavirus (2019‐nCoV or SARS‐CoV‐2) from the food industry perspective—Appropriate approaches to food production technology

“…• COVID-19 may also progress beyond the lungs • Vitamin K status is reduced in patients with severe COVID-19, and low vitamin K status seems to be associated with accelerated elastin degradation and vitamin K administration improves outcome in patients with COVID-19 (Dofferhoff et al, 2020) Production and distribution of industrial foods fortified and enriched with tannins especially hydrolysable tannins, for example, gallotannin…”

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“…The Cytochrome P450 inhibition as metabolic indicators including CYPs: 1A2, 2C19, 2C9, 2D6 and 3A4 are predicted. Nevertheless, only CYP2D6 and CYP3A4 are responsible for drug metabolism [41][42].…”

“…With numerous biological activities, the passion fruit also contains vitamins A, C, E, K, minerals such as Zn (0.10 g), Mg (29 mg), K (348 mg), Ca (12 mg), etc[41]. On one hand, vitamins A and K could help to ght the COVID-19[42]. On the other hand, these chemical elements mainly Zn, although indispensable as enzymatic co-factors, a slight increase in their intracellular concentration inhibits the replication of retroviruses including SARS-CoV-1[43] important in the management of COVID-19.…”