Concentrations of both vitamins D and K could play a role in the severity of COVID-19 infections, according to a new independent study supported by Kappa Bioscience, expounding upon previous publications which have observed links between these deficiencies and severe COVID-19. While the trial was preliminary in nature and observational, the results warranted further research investigating preventive measures in larger population sizes, the authors said.
 
The present study, published in Open Forum Infectious Diseases, examined the influence of both of these vitamins independently on the course of COVID-19 in 100 COVID-19 patients, compared to a control group of 50 people, measuring their vitamin D and vitamin K levels.
 
Compared to the healthy control group, the authors of the study noted that levels of DP-ucMGP, a biomarker for vitamin K status, was significantly lower in the COVID-19 group.
 
While across the COVID-19 and control groups, vitamin D levels were not significantly different, vitamin D deficiency experienced the most severe COVID-19 outcomes. Approximately 15% of the COVID-19 group was classified as having a severe case. Vitamin K deficiencies were also strongly associated with vitamin D deficiency.
 
Specifically, every one-unit increase in DP-ucMGP levels (stronger vitamin K deficiency) nearly doubled the odds of acute critical disease or death, and every one-unit decrease in blood concentrations of vitamin D was associated with greater than three-times the likelihood of severe COVID-19 disease.
 
The two vitamins have been previously-established to exhibit synergistic benefits to bone and cardiovascular health, but as this is an observational study, no mechanisms of action could be established for the independent, protective benefits that vitamins K and D had in the COVID-19 patients studied. However, the authors of the study proposed that it may have to do with previously-established benefits to calcium metabolism dependent on adequate intakes on both vitamins.
 
“Put simply, vitamin D enables the production of some key proteins, which paly a role in calcium metabolism. But they are produced in an inactive state, and vitamin K2 is the catalyst that activates them,” Trygve Bergeland, vice president of science at Kappa Bioscience, said. “These proteins mobilize calcium, carrying it away from our arteries and soft tissues, and incorporating it into our bones, where it is needed. In COVID-19, it was shown that patients with low vitamin K status had increased elastic fiber degradation and vascular calcifications. On its own, vitamin K also regulates blood clotting, which seems crucial to prevent thromboembolism, as often observed in more severe COVID-19.”
 
“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 vitamins D and K appear to work synergistically to help protect against calcification and damage in the lungs,” said Dr. Grace McComsey, MD, FIDSA, vice president of research and associate chief scientific officer at University Hospitals. McComsey is a corresponding author of the study.
 
“Optimizing vitamins K and D prior to acute COVID-19 infection may help to regulate overwhelming calcification, inflammation, and coagulopathy, which may subsequently lead to improved clinical outcomes,” McComsey continued. “As the long-chain menaquinones, such as K2 MK-7 [a specific form of vitamin K] have an extrahepatic distribution, they possess the capacity to optimize the vitamin K status in tissues that are deficient, however, large preventive clinical trials are needed.”