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Article

Vitamin A Plasma Levels in COVID-19 Patients: A Prospective Multicenter Study and Hypothesis

1
Department of Medicine B for Gastroenterology, Hepatology, Endocrinology and Clinical Infectiology, University Hospital Muenster, 48149 Muenster, Germany
2
Center for Laboratory Medicine, University Hospital Muenster, 48149 Muenster, Germany
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Academic Editors: Dimitrios T. Karayiannis and Zafeiria Mastora
Nutrients 2021, 13(7), 2173; https://doi.org/10.3390/nu13072173
Received: 27 May 2021 / Revised: 17 June 2021 / Accepted: 20 June 2021 / Published: 24 June 2021
(This article belongs to the Special Issue Medical Nutrition Therapy in Critically Ill and COVID-19 Patients)
COVID-19 is a pandemic disease that causes severe pulmonary damage and hyperinflammation. Vitamin A is a crucial factor in the development of immune functions and is known to be reduced in cases of acute inflammation. This prospective, multicenter observational cross-sectional study analyzed vitamin A plasma levels in SARS-CoV-2 infected individuals, and 40 hospitalized patients were included. Of these, 22 developed critical disease (Acute Respiratory Distress Syndrome [ARDS]/Extracorporeal membrane oxygenation [ECMO]), 9 developed severe disease (oxygen supplementation), and 9 developed moderate disease (no oxygen supplementation). A total of 47 age-matched convalescent persons that had been earlier infected with SARS-CoV-2 were included as the control group. Vitamin A plasma levels were determined by high-performance liquid chromatography. Reduced vitamin A plasma levels correlated significantly with increased levels of inflammatory markers (CRP, ferritin) and with markers of acute SARS-CoV-2 infection (reduced lymphocyte count, LDH). Vitamin A levels were significantly lower in hospitalized patients than in convalescent persons (p < 0.01). Of the hospitalized patients, those who were critically ill showed significantly lower vitamin A levels than those who were moderately ill (p < 0.05). Vitamin A plasma levels below 0.2 mg/L were significantly associated with the development of ARDS (OR = 5.54 [1.01–30.26]; p = 0.048) and mortality (OR 5.21 [1.06–25.5], p = 0.042). Taken together, we conclude that vitamin A plasma levels in COVID-19 patients are reduced during acute inflammation and that severely reduced plasma levels of vitamin A are significantly associated with ARDS and mortality. View Full-Text
Keywords: COVID-19; vitamin A; retinol; retinoic acid; ARDS; pneumonia; pandemic; SARS-CoV-2; inflammation COVID-19; vitamin A; retinol; retinoic acid; ARDS; pneumonia; pandemic; SARS-CoV-2; inflammation
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MDPI and ACS Style

Tepasse, P.-R.; Vollenberg, R.; Fobker, M.; Kabar, I.; Schmidt, H.; Meier, J.A.; Nowacki, T.; Hüsing-Kabar, A. Vitamin A Plasma Levels in COVID-19 Patients: A Prospective Multicenter Study and Hypothesis. Nutrients 2021, 13, 2173. https://doi.org/10.3390/nu13072173

AMA Style

Tepasse P-R, Vollenberg R, Fobker M, Kabar I, Schmidt H, Meier JA, Nowacki T, Hüsing-Kabar A. Vitamin A Plasma Levels in COVID-19 Patients: A Prospective Multicenter Study and Hypothesis. Nutrients. 2021; 13(7):2173. https://doi.org/10.3390/nu13072173

Chicago/Turabian Style

Tepasse, Phil-Robin, Richard Vollenberg, Manfred Fobker, Iyad Kabar, Hartmut Schmidt, Jörn Arne Meier, Tobias Nowacki, and Anna Hüsing-Kabar. 2021. "Vitamin A Plasma Levels in COVID-19 Patients: A Prospective Multicenter Study and Hypothesis" Nutrients 13, no. 7: 2173. https://doi.org/10.3390/nu13072173

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