Evaluation of vitamin A and E deficiency with severity of SARS-COV-2 disease: a case–control study

Abstract

BackgroundCoronavirus disease 2019 can cause severe inflammation and damage to the lungs. Vitamins A and E are essential in the enhancement of immunity and they tend to decrease in cases with inflammation. Determination of serum levels of vitamins A and E in COVID-19 patients was the aim of the study.MethodsThis case–control study was carried out on 30 ICU–admitted SARS-CoV-2–infected individuals (group A), 30 ward–admitted SARS-CoV-2–infected individuals (group B) and 30 healthy controls (group C). High-performance liquid chromatography was used to measure vitamin A and E levels.ResultsMedian levels of vitamin A in group A [0.16 (0.08–0.23) µg/ml] were significantly lower than those in group B [0.4 (0.15–0.65) µg/ml] and in group C [0.81 (0.70–1.16) µg/ml] with P value < 0.001, while there was no significant difference between groups concerning vitamin E levels (P value = 0.535). Vitamin A deficiency showed significant correlation with lower hemoglobin levels, lower platelet counts, higher total leucocyte counts, higher C- reactive protein levels, and higher D-dimer levels. ROC curve construction showed that vitamin A level with cut off < 0.65 µg/ml increases risk of acute respiratory distress syndrome (ARDS) development with sensitivity 90% and specificity 83.3%. Logistic regression analysis showed that cases with vitamin A levels < 0.65 µg/ml were more prone to develop ARDS (OR = 0.003 [0.000–0.036] P < 0.001).ConclusionLevels of vitamin A were reduced in COVID-19 patients particularly in ICU–admitted cases. This ensures the association of decreased vitamin A with disease morbidity and the importance of vitamin A supplementation as part of disease management.Trial registrationClinicaltrial.gov, NCT05946499. Registered 12 July 2023—Retrospectively registered. https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000DGLS&selectaction=Edit&uid=U00070DC&ts=2&cx=gieusm.