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

Background Coronavirus 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. Methods This 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. Results Median levels of vitamin A in group A [0.16 (0.08-0.23) mu g/ml] were significantly lower than those in group B [0.4 (0.15-0.65) mu g/ml] and in group C [0.81 (0.70-1.16) mu g/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 mu g/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 mu g/ml were more prone to develop ARDS (OR = 0.003 [0.000-0.036] P < 0.001). Conclusion Levels 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.

Automated summary

This study aimed to determine the levels of vitamins A and E in COVID-19 patients. The results showed that vitamin A levels were significantly reduced in ICU-admitted COVID-19 patients, and vitamin A deficiency was associated with disease severity. The study suggests the importance of vitamin A supplementation in disease management.