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.
Highlights
Coronavirus disease (COVID)-19 remains a major global health problem
Pathology during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection appears to arise at least in part from an excessive inflammatory response with a key role for the cytokine interleukin (IL)6, which is consistently upregulated in severe COVID-19 [1,2,3]
Plasma IL-6 was measured in 133 hospitalized COVID-19 patients
Summary
Pathology during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection appears to arise at least in part from an excessive inflammatory response with a key role for the cytokine interleukin (IL), which is consistently upregulated in severe COVID-19 [1,2,3]. Besides vaccination and general preventative measures to control the pandemic, there is a need for new interventions to reduce disease severity. Both vitamin D and vitamin K have been proposed as treatments that may ameliorate these IL-6-induced pathogenic processes. Pathology 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
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