A research group from the Canisius-Wilhelmina Hospital in The Netherlands, which has a scientific collaboration with vitamin K2 manufacturer Kappa Bioscience, has published an article in the medical journal Frontiers in Nutrition describing associations between both vitamin D and K status with inflammation in hospitalised patients with COVID-19.
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.
The research group, led by translational researcher Rob Janssen, PhD, who was the first to discover vitamin K deficiency in COVID-19, assessed vitamin D and K status by measuring circulating 25-hydroxyvitamin D and desphospho-uncarboxylated Matrix Gla-Protein (dp-ucMGP), respectively in 135 hospitalised COVID-19 patients in relation to inflammatory response, elastic fibre degradation and clinical outcomes.
Comparing 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 outcomes, compared to patients with good outcomes. A patient’s level of of extrahepatic vitamin K status was associated with their IL-6 levels, while vitamin D levels were borderline statistically significant correlated with IL-6. A significant association was also found between IL-6 and elastic fibre degradation. Contrary to vitamin K status, vitamin D did not correlate with elastic fibre degradation.
This publication is part of the PhD-trajectory of first author Margot Visser, who is researching the role of vitamin K in COVID-19.
“IL-6 is a pro-inflammatory cytokine that plays a key role in the development of severe COVID-19 and is regarded as an important therapeutic target” said Senior Author Jona Walk, PhD. “We demonstrated a highly significant correlation between elevated IL-6 levels and poor vitamin K status, whereas the association with vitamin D was only borderline significant.”
Dp-ucMGP associates with IL-6 as a central component of the destructive inflammatory processes in COVID-19. An intervention trial may provide insight into whether vitamin K can improve clinical outcomes in COVID-19 patients.
Janssen added: “There are many vitamin D proponents from scientists and medical doctors to influencers and eminent politician, advocating the distribution of vitamin D among the general population to reduce the burden of COVID-19. However, administration of vitamin D without K may not be without risk, as vitamin D increases the demand for K. This may cause further vitamin K depletion, which could be harmful in patients with moderate or severe COVID-19 who are without exception already vitamin K deficient. Based on our current data and previous work (Br J Nutr), I strongly suggest that vitamin K2 should be added to D supplementation, particularly against the background of the ongoing pandemic.”