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Low vitamin K status is a potential risk factor for COVID-19 infected patients: a systematic review and meta-analysis

Liu et al., Frontiers in Nutrition, doi:10.3389/fnut.2025.1476622, Apr 2025
Meta-analysis of 6 studies examining vitamin K status in COVID-19 patients showing that infected patients have significantly higher levels of dephosphorylated-uncarboxylated Matrix Gla Protein (dp-ucMGP), indicating lower vitamin K status, which correlates with infection severity. The analysis included data from 479 COVID-19 patients and 506 controls, demonstrating that dp-ucMGP levels were higher in infected versus non-infected individuals and in severely infected versus mildly infected patients. Authors hypothesize that COVID-19 infection causes vitamin K depletion through inflammation, elastic fiber damage, and coagulation disruption, suggesting that vitamin K supplementation might potentially reduce disease progression.
Currently there are 2 vitamin K studies and meta analysis shows:
OutcomeImprovement
Mortality200% higher [-87‑6852%]
ICU admission200% higher [-66‑2545%]
Hospitalization17% lower [-43‑51%]
Cases14% fewer [1‑26%]
Liu et al., 7 Apr 2025, Netherlands, peer-reviewed, 4 authors, study period January 2024 - April 2024. Contact: 26200003@hebmu.edu.cn.
Low vitamin K status is a potential risk factor for COVID-19 infected patients: a systematic review and meta-analysis
Wei Liu, Xin Liu, Shiwei Kang, Yadong Yuan
Frontiers in Nutrition, doi:10.3389/fnut.2025.1476622
Objective: To provide further data support for the treatment of COVID-19 by conducting a comprehensive analysis of reports on dephosphorylateduncarboxylated Matrix Gla Protein (dp-ucMGP), which detects the functional vitamin K status post COVID-19 infection, using meta-analysis. Methods: This study conducted a comprehensive review and analysis of relevant research on dp-ucMGP detection in patients infected with COVID-19 through meta-analysis. The article collection period ranged from January 2024 to April 2024. Results: A total of 6 articles were included in this study. Baseline data analysis showed that the age of patients in the COVID-19 infected group was greater than that of the non-infected control group (p = 0.030); similarly, the age of patients in the severe infection group was also greater than that of the mild infection group (p = 0.003). In the analysis of underlying diseases, statistical differences were found between the Severe group and Mild group in the presence of CVD (p = 0.010). A total of 5 studies conducted dp-ucMGP detection in both the COVID-19 infected group and the control group. The results showed that the expression of dp-ucMGP was higher in the infected group than in the control group (p < 0.001). Subgroup analysis revealed that the expression of dp-ucMGP in the severe infection group was also higher than that in the mild infection group (p < 0.001). Conclusion: COVID-19 infected patients exhibit Low Vitamin K Status, which correlates positively with the severity of infection. Supplementation of vitamin K during COVID-19 infection may potentially mitigate the progression toward severe infection, necessitating further support from clinical data.
Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Publisher's note All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. Supplementary material The Supplementary material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fnut.2025.1476622/ full#supplementary-material SUPPLEMENTARY FIGURE 1 The four chemical structures of vitamin K.
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DOI record: { "DOI": "10.3389/fnut.2025.1476622", "ISSN": [ "2296-861X" ], "URL": "http://dx.doi.org/10.3389/fnut.2025.1476622", "abstract": "<jats:sec><jats:title>Objective</jats:title><jats:p>To provide further data support for the treatment of COVID-19 by conducting a comprehensive analysis of reports on dephosphorylated-uncarboxylated Matrix Gla Protein (dp-ucMGP), which detects the functional vitamin K status post COVID-19 infection, using meta-analysis.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This study conducted a comprehensive review and analysis of relevant research on dp-ucMGP detection in patients infected with COVID-19 through meta-analysis. The article collection period ranged from January 2024 to April 2024.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>A total of 6 articles were included in this study. Baseline data analysis showed that the age of patients in the COVID-19 infected group was greater than that of the non-infected control group (<jats:italic>p</jats:italic> = 0.030); similarly, the age of patients in the severe infection group was also greater than that of the mild infection group (<jats:italic>p</jats:italic> = 0.003). In the analysis of underlying diseases, statistical differences were found between the Severe group and Mild group in the presence of CVD (<jats:italic>p</jats:italic> = 0.010). A total of 5 studies conducted dp-ucMGP detection in both the COVID-19 infected group and the control group. The results showed that the expression of dp-ucMGP was higher in the infected group than in the control group (<jats:italic>p</jats:italic> &amp;lt; 0.001). Subgroup analysis revealed that the expression of dp-ucMGP in the severe infection group was also higher than that in the mild infection group (<jats:italic>p</jats:italic> &amp;lt; 0.001).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>COVID-19 infected patients exhibit Low Vitamin K Status, which correlates positively with the severity of infection. Supplementation of vitamin K during COVID-19 infection may potentially mitigate the progression toward severe infection, necessitating further support from clinical data.</jats:p></jats:sec>", "alternative-id": [ "10.3389/fnut.2025.1476622" ], "author": [ { "affiliation": [], "family": "Liu", "given": "Wei", "sequence": "first" }, { "affiliation": [], "family": "Liu", "given": "Xin", "sequence": "additional" }, { "affiliation": [], "family": "Kang", "given": "Shiwei", "sequence": "additional" }, { "affiliation": [], "family": "Yuan", "given": "Yadong", "sequence": "additional" } ], "container-title": "Frontiers in Nutrition", "container-title-short": "Front. 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"journal-title": "Clin Infect Dis", "key": "ref3", "volume": "73", "year": "2020" }, { "DOI": "10.3390/nu14020233", "article-title": "The effect of circulating zinc, selenium, copper and vitamin K1 on Covid-19 outcomes: a Mendelian randomization study", "author": "Sobczyk", "doi-asserted-by": "publisher", "first-page": "233", "journal-title": "Nutrients", "key": "ref4", "volume": "14", "year": "2022" }, { "DOI": "10.1007/978-1-0716-2395-4_25", "article-title": "Multiplex testing of oxidative-reductive pathway in patients with Covid-19", "author": "Guest", "doi-asserted-by": "publisher", "first-page": "333", "journal-title": "Methods Mol Biol", "key": "ref5", "volume": "2511", "year": "2022" }, { "DOI": "10.3390/foods10123136", "article-title": "Relationship between structure and biological activity of various vitamin K forms", "author": "Bus", "doi-asserted-by": "publisher", "first-page": "3136", "journal-title": "Food Secur", "key": "ref6", "volume": "10", "year": "2021" }, { "DOI": "10.1093/nutrit/nuab061", "article-title": "Vitamin K – sources, physiological role, kinetics, deficiency, detection, therapeutic use, and toxicity", "author": "Mladěnka", "doi-asserted-by": "publisher", "first-page": "677", "journal-title": "Nutr Rev", "key": "ref7", "volume": "80", "year": "2022" }, { "DOI": "10.1160/TH08-02-0087", "article-title": "Matrix Gla-protein: the calcification inhibitor in need of vitamin K", "author": "Schurgers", "doi-asserted-by": "publisher", "first-page": "593", "journal-title": "Thromb Haemost", "key": "ref8", "volume": "100", "year": "2008" }, { "DOI": "10.3324/haematol.2019.229047", "article-title": "Vitamin K-dependent carboxylation of coagulation factors: insights from a cell-based functional study", "author": "Hao", "doi-asserted-by": "publisher", "first-page": "2164", "journal-title": "Haematologica", "key": "ref9", "volume": "105", "year": "2020" }, { "author": "Seligsohn", "key": "ref10", "volume-title": "Inherited deficiencies of coagulation 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"doi-asserted-by": "publisher", "first-page": "49", "journal-title": "Clin Biochem", "key": "ref13", "volume": "83", "year": "2020" }, { "DOI": "10.1136/bmj.n71", "article-title": "The Prisma 2020 statement: an updated guideline for reporting systematic reviews", "author": "Page", "doi-asserted-by": "publisher", "first-page": "372", "journal-title": "BMJ", "key": "ref14", "year": "2021" }, { "article-title": "Low vitamin K status predicts mortal ity in a cohort of 138 hospitalized patients with Covid-19 (preprint)", "author": "Linneberg", "journal-title": "medRXiv", "key": "ref15", "year": "2020" }, { "DOI": "10.1016/j.ijid.2022.10.030", "article-title": "Enhanced vitamin K expenditure as a major contributor to vitamin K deficiency in Covid-19", "author": "Visser", "doi-asserted-by": "publisher", "first-page": "275", "journal-title": "Int J Infect Dis", "key": "ref16", "volume": "125", "year": "2022" }, { "DOI": "10.1186/s40560-023-00712-0", "article-title": "Higher levels of circulating Desphospho-Uncarboxylated matrix Gla protein over time are associated with worse survival: the prospective Maastricht intensive care Covid cohort", "author": "Mulder", "doi-asserted-by": "publisher", "first-page": "63", "journal-title": "J Intensive Care", "key": "ref17", "volume": "11", "year": "2023" }, { "DOI": "10.21608/eajbsc.2023.321787", "article-title": "Altered insulin, Irs/Pi3k/Akt/Mtor signaling, Ace2 and angiotensin ii, correlating with vitamin K status and severity in metabolically disordered Covid-19 Egyptian patients", "author": "Ismail Abo-Elfadl", "doi-asserted-by": "publisher", "first-page": "453", "journal-title": "Egypt Acad J Biol Sci C Physiol Mol Biol", "key": "ref18", "volume": "15", "year": "2023" }, { "DOI": "10.1183/13993003.01112-2020", "article-title": "Association between age and clinical characteristics and outcomes of Covid-19", "author": "Liu", "doi-asserted-by": "publisher", "first-page": "2001112", "journal-title": "Eur Respir J", "key": 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Covid-19–related hospitalization, intensive care unit admission, invasive mechanical ventilation, and death—United States, march–December 2020", "author": "Kompaniyets", "doi-asserted-by": "publisher", "first-page": "355", "journal-title": "MMWR Morb Mortal Wkly Rep", "key": "ref23", "volume": "70", "year": "2021" }, { "DOI": "10.1016/j.dsx.2020.03.013", "article-title": "Cardiovascular disease and Covid-19", "author": "Bansal", "doi-asserted-by": "publisher", "first-page": "247", "journal-title": "Diabetes Metab Syndr Clin Res Rev", "key": "ref24", "volume": "14", "year": "2020" }, { "DOI": "10.1016/j.ajem.2020.10.022", "article-title": "Cardiovascular diseases burden in Covid-19: systematic review and Meta-analysis", "author": "Hessami", "doi-asserted-by": "publisher", "first-page": "382", "journal-title": "Am J Emerg Med", "key": "ref25", "volume": "46", "year": "2021" }, { "DOI": "10.1016/j.jare.2020.03.005", "article-title": "Covid-19 infection: emergence, transmission, and characteristics of human coronaviruses", "author": "Shereen", "doi-asserted-by": "publisher", "first-page": "91", "journal-title": "J Adv Res", "key": "ref26", "volume": "24", "year": "2020" }, { "DOI": "10.1111/ijcp.14970", "article-title": "Effect of Il-6, Il-8/Cxcl8, Ip-10/Cxcl 10 levels on the severity in Covid 19 infection", "author": "Can", "doi-asserted-by": "publisher", "first-page": "e14970", "journal-title": "Int J Clin Pract", "key": "ref27", "volume": "75", "year": "2021" }, { "DOI": "10.3390/biom12050604", "article-title": "Matrix metalloproteinases on severe Covid-19 lung disease pathogenesis: cooperative actions of Mmp-8/Mmp-2 Axis on immune response through Hla-G shedding and oxidative stress", "author": "da Silva-Neto", "doi-asserted-by": "publisher", "first-page": "604", "journal-title": "Biomol Ther", "key": "ref28", "volume": "12", "year": "2022" }, { "DOI": "10.1016/j.blre.2020.100745", "article-title": "Coagulation dysfunction in Covid-19: the interplay between 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Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. IMA and WCH provide treatment protocols.
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