Deficiencies in vitamins D and K appear to be independently associated with worse disease severity early in acute COVID-19, suggesting the vitamins could have a beneficial effect in addressing the infection, according to research out of University Hospitals Cleveland Medical Center, Ohio. In the prospective observational cohort study, published in Open Forum Infectious Disease (DOI:10.1093/ofid/ofa408), the team assessed vitamin status and COVID-19 outcomes in 150 subjects (100 COVID-19 positive, 50 controls). For vitamin K status, the team looked at circulating dephosporylated uncarboxylated matrix Gla protein (dp-ucMGP) levels to quantify vitamin K status. Vitamin D status was assessed by measuring 25-hydroxyvitamin D (25(OH)D) levels.

Patients with COVID-19 had higher levels of dp-ucMGP (776.5 ng/mL) compared to controls (549.8 ng/mL), showing a deficiency in vitamin K. While there was no significant difference in 25(OH)D levels between groups, participants who were deficient in vitamin D (<20 ng/mL) had worse vitamin K status (dp-ucMGP >780 ng/mL) and experienced the most severe COVID-19 outcomes. The team concluded in adjusted models, every 1-unit increase in the log2 dp-ucMGP nearly doubled the odds of acute critical disease or death; ever 1-unit decrease in natural log 25(OH)D was associated with more than three times the likelihood of severe COVID-19 disease.

The study was supported by Kappa Bioscience, supplier of vitamin K2 MK-7 as K2VITAL®. In a statement from Kappa Bioscience about the results, Grace McComsey, MD, corresponding author of the study, commented: “Interestingly, both vitamin D and K may display complementary effects on the cytokine storm, thrombosis, and lung damage during COVID-19. Specifically, they display similar inhibitory effects on inhibition of NF-kB and cytokine release, and vitamin D and K appear to work synergistically to help protect against calcification and damage in the lungs. …  I am now planning a study looking to see if vitamins K2 and D status affect development of ‘long hauler’ whose COVID-19 symptoms persist for many months after the infection.”

Kappa Bioscience supported the Cleveland Medical Center study but had no access to raw data or detailed study results. The company announced earlier this year the initiation of the first-ever clinical trial using its K2VITAL® ingredient in COVID-19 patients. The interventional trial aims to discover whether supplementation with vitamin K2 MK-7 could reduce pulmonary damage and coagulopathy in patients with severe COVID-19. Results are expected by the end of 2021.