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

{ 'indexed': {'date-parts': [[2023, 7, 22]], 'date-time': '2023-07-22T04:48:15Z', 'timestamp': 1690001295881}, 'reference-count': 37, 'publisher': 'Springer Science and Business Media LLC', 'issue': '1', 'license': [ { 'start': { 'date-parts': [[2023, 7, 21]], 'date-time': '2023-07-21T00:00:00Z', 'timestamp': 1689897600000}, 'content-version': 'tdm', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}, { 'start': { 'date-parts': [[2023, 7, 21]], 'date-time': '2023-07-21T00:00:00Z', 'timestamp': 1689897600000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}], 'funder': [{'DOI': '10.13039/501100002386', 'name': 'Cairo University', 'doi-asserted-by': 'publisher'}], 'content-domain': {'domain': ['link.springer.com'], 'crossmark-restriction': False}, 'abstract': '<jats:title>Abstract</jats:title><jats:sec>\n' ' <jats:title>Background</jats:title>\n' ' <jats:p>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.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Methods</jats:title>\n' ' <jats:p>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.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Results</jats:title>\n' ' <jats:p>Median levels of vitamin A in group A [0.16 (0.08–0.23) µg/ml] were ' 'significantly lower than those in group B [0.4 (0.15–0.65) µg/ml] and in group C [0.81 ' '(0.70–1.16) µg/ml] with <jats:italic>P</jats:italic> value\u2009&lt;\u20090.001, while there ' 'was no significant difference between groups concerning vitamin E levels ' '(<jats:italic>P</jats:italic> value\u2009=\u20090.535). 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\u2009&lt;\u20090.65\xa0µg/ml increases ' 'risk of acute respiratory distress syndrome (ARDS)\xa0development with sensitivity 90% and ' 'specificity 83.3%. Logistic regression analysis showed that cases with vitamin A levels\u2009' '&lt;\u20090.65\xa0µg/ml were more prone to develop ARDS (OR\u2009=\u20090.003 [0.000–0.036] ' '<jats:italic>P</jats:italic>\u2009&lt;\u20090.001).</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Conclusion</jats:title>\n' ' <jats:p>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.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Trial registration</jats:title>\n' ' <jats:p>Clinicaltrial.gov, NCT05946499. Registered 12 July ' '2023—Retrospectively registered. \n' '<jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" ' 'xlink:href="https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000DGLS&amp;selectaction=Edit&amp;uid=U00070DC&amp;ts=2&amp;cx=gieusm">https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000DGLS&amp;selectaction=Edit&amp;uid=U00070DC&amp;ts=2&amp;cx=gieusm</jats:ext-link>.</jats:p>\n' ' </jats:sec>', 'DOI': '10.1186/s43168-023-00210-9', 'type': 'journal-article', 'created': {'date-parts': [[2023, 7, 21]], 'date-time': '2023-07-21T11:02:06Z', 'timestamp': 1689937326000}, 'update-policy': 'http://dx.doi.org/10.1007/springer_crossmark_policy', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Evaluation of vitamin A and E deficiency with severity of SARS-COV-2 disease: a case–control ' 'study', 'prefix': '10.1186', 'volume': '17', 'author': [ {'given': 'Iman Atef', 'family': 'Mandour', 'sequence': 'first', 'affiliation': []}, {'given': 'Sabah Ahmed', 'family': 'Hussein', 'sequence': 'additional', 'affiliation': []}, {'given': 'Hany William Z.', 'family': 'Hanna', 'sequence': 'additional', 'affiliation': []}, {'given': 'Salma Ahmed', 'family': 'Abdellatif', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0002-5900-5274', 'authenticated-orcid': False, 'given': 'Balsam Sherif', 'family': 'Fahmy', 'sequence': 'additional', 'affiliation': []}], 'member': '297', 'published-online': {'date-parts': [[2023, 7, 21]]}, 'reference': [ { 'issue': '10239', 'key': '210_CR1', 'doi-asserted-by': 'publisher', 'first-page': '1763', 'DOI': '10.1016/S0140-6736(20)31189-2', 'volume': '395', 'author': 'MJ Cummings', 'year': '2020', 'unstructured': 'Cummings MJ, Baldwin MR, Abrams D, Jacobson SD, Meyer BJ, Balough EM et ' 'al (2020) Epidemiology, clinical course, and outcomes of critically ill ' 'adults with COVID-19 in New York City: a prospective cohort study. ' 'Lancet 395(10239):1763–1770. ' 'https://doi.org/10.1016/S0140-6736(20)31189-2. Epub 2020 May 19. PMID: ' '32442528; PMCID: PMC7237188', 'journal-title': 'Lancet'}, { 'issue': '11', 'key': '210_CR2', 'doi-asserted-by': 'publisher', 'first-page': '1708', 'DOI': '10.3389/fimmu.2020.01708', 'volume': '10', 'author': 'Y Tang', 'year': '2020', 'unstructured': 'Tang Y, Liu J, Zhang D, Xu Z, Ji J, Wen C (2020) Cytokine Storm in ' 'COVID-19: the current evidence and treatment strategies. Front Immunol ' '10(11):1708. https://doi.org/10.3389/fimmu.2020.01708', 'journal-title': 'Front Immunol'}, { 'key': '210_CR3', 'doi-asserted-by': 'publisher', 'first-page': '1132', 'DOI': '10.3390/nu10091132', 'volume': '10', 'author': 'J Timoneda', 'year': '2018', 'unstructured': 'Timoneda J, Rodriguez-Fernandez L, Zaragoza R, Marin MP, Cabezuelo MT, ' 'Torres L et al (2018) Vitamin A Deficiency and the Lung. Nutrients ' '10:1132', 'journal-title': 'Nutrients'}, { 'key': '210_CR4', 'doi-asserted-by': 'publisher', 'first-page': '257S', 'DOI': '10.1093/jn/134.1.257S', 'volume': '134', 'author': 'BP Chew', 'year': '2004', 'unstructured': 'Chew BP, Park JS (2004) Carotenoid action on the immune response. J Nutr ' '134:257S–261S', 'journal-title': 'J Nutr'}, { 'key': '210_CR5', 'doi-asserted-by': 'publisher', 'first-page': '258', 'DOI': '10.3390/jcm7090258', 'volume': '7', 'author': 'Z Huang', 'year': '2018', 'unstructured': 'Huang Z, Liu Y, Qi G, Brand D, Zheng SG (2018) Role of Vitamin A in the ' 'Immune System. J Clin Med 7:258', 'journal-title': 'J Clin Med'}, { 'issue': '1 Suppl 3', 'key': '210_CR6', 'doi-asserted-by': 'publisher', 'first-page': 'E34', 'DOI': '10.15167/2421-4248/jpmh2021.62.1S3.1895', 'volume': '62', 'author': 'S DE Flora', 'year': '2021', 'unstructured': 'DE Flora S, Balansky R, LA Maestra S (2021) Antioxidants and COVID-19. J ' 'Prev Med Hyg 62(1 Suppl 3):E34–E45. ' 'https://doi.org/10.15167/2421-4248/jpmh2021.62.1S3.1895. PMID: 34622082; ' 'PMCID: PMC8452284. Italian', 'journal-title': 'J Prev Med Hyg'}, { 'issue': '7', 'key': '210_CR7', 'doi-asserted-by': 'publisher', 'first-page': '934', 'DOI': '10.1001/jamainternmed.2020.0994', 'volume': '180', 'author': 'C Wu', 'year': '2020', 'unstructured': 'Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S et al (2020) Risk factors ' 'associated with acute respiratory distress syndrome and death in ' 'patients with coronavirus disease 2019 Pneumonia in Wuhan. China JAMA ' 'Intern Med 180(7):934–943. ' 'https://doi.org/10.1001/jamainternmed.2020.0994. ' 'Erratum.In:JAMAInternMed.2020Jul1;180(7):1031.PMID:32167524;PMCID:PMC7070509', 'journal-title': 'China JAMA Intern Med'}, { 'issue': '7', 'key': '210_CR8', 'doi-asserted-by': 'publisher', 'first-page': '2173', 'DOI': '10.3390/nu13072173', 'volume': '13', 'author': 'PR Tepasse', 'year': '2021', 'unstructured': 'Tepasse PR, Vollenberg R, Fobker M, Kabar I, Schmidt H, Meier JA et al ' '(2021) Vitamin A Plasma Levels in COVID-19 Patients: a prospective ' 'multicenter study and hypothesis. Nutrients 13(7):2173. ' 'https://doi.org/10.3390/nu13072173. PMID:34202697;PMCID:PMC8308355', 'journal-title': 'Nutrients'}, { 'key': '210_CR9', 'doi-asserted-by': 'publisher', 'first-page': '104370', 'DOI': '10.1016/j.jcv.2020.104370', 'volume': '127', 'author': 'F Liu', 'year': '2020', 'unstructured': 'Liu F, Li L, Xu M, Wu J, Luo D, Zhu Y et al (2020) Prognostic value of ' 'interleukin-6, C-reactive protein, and procalcitonin in patients with ' 'COVID-19. J Clin Virol 127:104370. ' 'https://doi.org/10.1016/j.jcv.2020.104370. PMID: 32344321; PMCID: ' 'PMC7194648', 'journal-title': 'J Clin Virol'}, { 'issue': '12', 'key': '210_CR10', 'doi-asserted-by': 'publisher', 'first-page': '1833', 'DOI': '10.1016/j.jiph.2020.07.014', 'volume': '13', 'author': 'H Ejaz', 'year': '2020', 'unstructured': 'Ejaz H, Alsrhani A, Zafar A, Javed H, Junaid K, Abdalla AE et al (2020) ' 'COVID-19 and comorbidities: Deleterious impact on infected patients. J ' 'Infect Public Health 13(12):1833–1839. ' 'https://doi.org/10.1016/j.jiph.2020.07.014. Epub 2020 Aug 4. PMID: ' '32788073; PMCID: PMC7402107', 'journal-title': 'J Infect Public Health'}, { 'issue': '16', 'key': '210_CR11', 'doi-asserted-by': 'publisher', 'first-page': '2114', 'DOI': '10.1093/cid/ciaa601', 'volume': '71', 'author': 'R Fadel', 'year': '2020', 'unstructured': 'Fadel R, Morrison AR, Vahia A, Smith ZR, Chaudhry Z, Bhargava P et al ' '(2020) Early short-course corticosteroids in hospitalized patients with ' 'COVID-19. Clin Infect Dis 71(16):2114–2120. ' 'https://doi.org/10.1093/cid/ciaa601. PMID:32427279;PMCID:PMC7314133', 'journal-title': 'Clin Infect Dis'}, { 'issue': '2', 'key': '210_CR12', 'doi-asserted-by': 'publisher', 'first-page': '259', 'DOI': '10.1111/joim.13145', 'volume': '289', 'author': 'F Sanz Herrero', 'year': '2021', 'unstructured': 'Sanz Herrero F, PuchadesGimeno F, Ortega García P, Ferrer Gómez C, ' 'OceteMochón MD, García Deltoro M (2021) Methylprednisolone added to ' 'tocilizumab reduces mortality in SARS-CoV-2 pneumonia: An observational ' 'study. J Intern Med 289(2):259–263. https://doi.org/10.1111/joim.13145. ' 'PMID: 32603493; PMCID: PMC7361229', 'journal-title': 'J Intern Med'}, { 'issue': '10', 'key': '210_CR13', 'doi-asserted-by': 'publisher', 'first-page': 'e13319', 'DOI': '10.1111/eci.13319', 'volume': '50', 'author': 'DR Giacobbe', 'year': '2020', 'unstructured': 'Giacobbe DR, Battaglini D, Ball L, Brunetti I, Bruzzone B, Codda G et al ' '(2020) Bloodstream infections in critically ill patients with COVID-19. ' 'Eur J Clin Invest 50(10):e13319. https://doi.org/10.1111/eci.13319. ' 'PMID: 32535894; PMCID: PMC7323143', 'journal-title': 'Eur J Clin Invest'}, { 'issue': '9', 'key': '210_CR14', 'doi-asserted-by': 'publisher', 'first-page': '565', 'DOI': '10.3390/metabo11090565', 'volume': '11', 'author': 'TM Tomasa-Irriguible', 'year': '2021', 'unstructured': 'Tomasa-Irriguible TM, Bielsa-Berrocal L, Bordejé-Laguna L, Tural-Llàcher ' 'C, Barallat J, Manresa-Domínguez JM et al (2021) Low Levels of Few ' 'Micronutrients May Impact COVID-19 Disease Progression: an observational ' 'study on the first wave. Metabolites 11(9):565. ' 'https://doi.org/10.3390/metabo11090565. PMID:34564381;PMCID:PMC8467487', 'journal-title': 'Metabolites'}, { 'key': '210_CR15', 'first-page': '26', 'volume-title': 'Zinc and vitamin a deficiency predisposes to the need for intubation and ' 'icu admission in patients with COVID-19. An observational study.\xa0' 'Research Square', 'author': 'LB Berrocal', 'year': '2020', 'unstructured': 'Berrocal LB, Irriguible TT, Philibert V, Llàcher CT, de Osaba JB, ' 'Domínguez JM et al (2020) Zinc and vitamin a deficiency predisposes to ' 'the need for intubation and icu admission in patients with COVID-19. An ' 'observational study.\xa0Research Square. p 26'}, { 'key': '210_CR16', 'doi-asserted-by': 'publisher', 'first-page': '167', 'DOI': '10.1146/annurev.nutr.21.1.167', 'volume': '21', 'author': 'CB Stephensen', 'year': '2001', 'unstructured': 'Stephensen CB (2001) Vitamin A, infection, and immune function. Annu Rev ' 'Nutr 21:167–192', 'journal-title': 'Annu Rev Nutr'}, { 'key': '210_CR17', 'doi-asserted-by': 'publisher', 'first-page': '904', 'DOI': '10.1194/jlr.M600528-JLR200', 'volume': '48', 'author': 'SH Gieng', 'year': '2007', 'unstructured': 'Gieng SH, Green MH, Green JB, Rosales FJ (2007) Model-based ' 'compartmental analysis indicates a reduced mobilization of hepatic ' 'vitamin A during inflammation in rats. J Lipid Res 48:904–913', 'journal-title': 'J Lipid Res'}, { 'key': '210_CR18', 'doi-asserted-by': 'crossref', 'unstructured': 'Aklamati EK, Mulenga M, Dueker SR, Buchholz BA, Peerson JM, Kafwembe, et ' 'al. Accelerator mass spectrometry can be used to assess vitamin A ' 'metabolism quantitatively in boys in a community setting. J Nutr. ' '2010;140:1588–1594', 'DOI': '10.3945/jn.110.125500'}, { 'key': '210_CR19', 'doi-asserted-by': 'publisher', 'first-page': '110250', 'DOI': '10.1016/j.mehy.2020.110250', 'volume': '144', 'author': 'AR Sarohan', 'year': '2020', 'unstructured': 'Sarohan AR (2020) COVID-19: endogenous retinoic acid theory and retinoic ' 'acid depletion syndrome. Med Hypotheses 144:110250. ' 'https://doi.org/10.1016/j.mehy.2020.110250', 'journal-title': 'Med Hypotheses'}, { 'key': '210_CR20', 'doi-asserted-by': 'publisher', 'first-page': '431', 'DOI': '10.1016/S0098-2997(03)00039-6', 'volume': '24', 'author': 'HK Biesalski', 'year': '2003', 'unstructured': 'Biesalski HK, Nohr D (2003) Importance of vitamin-A for lung function ' 'and development. Mol Aspects Med 24:431–440', 'journal-title': 'Mol Aspects Med'}, { 'issue': '2', 'key': '210_CR21', 'doi-asserted-by': 'publisher', 'first-page': '72', 'DOI': '10.1093/tropej/48.2.72.84', 'volume': '48', 'author': 'RM D’Souza', 'year': '2002', 'unstructured': 'D’Souza RM, D’Souza R (2002) Vitamin A for preventing secondary ' 'infections in children with measles–a systematic review. J Trop Pediatr ' '48(2):72–77. https://doi.org/10.1093/tropej/48.2.72.84', 'journal-title': 'J Trop Pediatr'}, { 'issue': '1', 'key': '210_CR22', 'doi-asserted-by': 'publisher', 'first-page': '15157', 'DOI': '10.1038/s41598-019-51684-x', 'volume': '9', 'author': 'JL McGill', 'year': '2019', 'unstructured': 'McGill JL, Kelly SM, Guerra-Maupome M, Winkley E, Henningson J, ' 'Narasimhan B et al (2019) Vitamin A deficiency impairs the immune ' 'response to intranasal vaccination and RSV infection in neonatal calves. ' 'Sci Rep 9(1):15157. https://doi.org/10.1038/s41598-019-51684-x', 'journal-title': 'Sci Rep'}, { 'issue': '11', 'key': '210_CR23', 'doi-asserted-by': 'publisher', 'first-page': '1663', 'DOI': '10.1017/S0007114521000246', 'volume': '126', 'author': 'CB Stephensen', 'year': '2021', 'unstructured': 'Stephensen CB, Lietz G (2021) Vitamin A in resistance to and recovery ' 'from infection: relevance to SARS-CoV2. Br J Nutr 126(11):1663–1672. ' 'https://doi.org/10.1017/S0007114521000246. Epub 2021 Jan 20. PMID: ' '33468263; PMCID: PMC7884725', 'journal-title': 'Br J Nutr'}, { 'issue': '9', 'key': '210_CR24', 'doi-asserted-by': 'publisher', 'first-page': '2550', 'DOI': '10.3390/nu12092550', 'volume': '12', 'author': 'TH Jovic', 'year': '2020', 'unstructured': 'Jovic TH, Ali SR, Ibrahim N, Jessop ZM, Tarassoli SP, Dobbs TD et al ' '(2020) Could Vitamins Help in the Fight Against COVID-19? Nutrients ' '12(9):2550. https://doi.org/10.3390/nu12092550', 'journal-title': 'Nutrients'}, { 'key': '210_CR25', 'doi-asserted-by': 'publisher', 'first-page': '7347', 'DOI': '10.31838/SRP.2021.1.33', 'volume': '14', 'author': 'MM Al-Sumiadai', 'year': '2020', 'unstructured': 'Al-Sumiadai MM, Ghazzay H, Al-Dulaimy WZS (2020) Therapeutic effect of ' 'Vitamin A on severe COVID-19 patients. Eurasia J Biosci 14:7347–7350. ' 'https://doi.org/10.31838/SRP.2021.1.33', 'journal-title': 'Eurasia J Biosci'}, { 'issue': '10', 'key': '210_CR26', 'doi-asserted-by': 'publisher', 'first-page': '2115', 'DOI': '10.1007/s40520-020-01669-y', 'volume': '32', 'author': 'S Fiorino', 'year': '2020', 'unstructured': 'Fiorino S, Gallo C, Zippi M, Sabbatani S, Manfredi R, Moretti R et al ' '(2020) Cytokine storm in aged people with CoV-2: possible role of ' 'vitamins as therapy or preventive strategy. Aging Clin Exp Res ' '32(10):2115–2131. https://doi.org/10.1007/s40520-020-01669-y', 'journal-title': 'Aging Clin Exp Res'}, { 'key': '210_CR27', 'doi-asserted-by': 'publisher', 'first-page': '366', 'DOI': '10.1136/bmj.306.6874.366', 'volume': '306', 'author': 'PP Glasziou', 'year': '1993', 'unstructured': 'Glasziou PP, Mackerras DE (1993) Vitamin A supplementation in infectious ' 'diseases: A meta-analysis. BMJ 306:366–370', 'journal-title': 'BMJ'}, { 'key': '210_CR28', 'doi-asserted-by': 'publisher', 'first-page': '1835', 'DOI': '10.1093/jn/138.10.1835', 'volume': '138', 'author': 'A Sommer', 'year': '2008', 'unstructured': 'Sommer A (2008) Vitamin a deficiency and clinical disease: An historical ' 'overview. J Nutr 138:1835–1839', 'journal-title': 'J Nutr'}, { 'issue': '10', 'key': '210_CR29', 'doi-asserted-by': 'publisher', 'first-page': '907', 'DOI': '10.3390/v11100907', 'volume': '11', 'author': 'N Patel', 'year': '2019', 'unstructured': 'Patel N, Penkert RR, Jones BG, Sealy RE, Surman SL, Sun Y et al (2019) ' 'Baseline serum vitamin A and D levels determine benefit of oral vitamin ' 'A&D supplements to humoral immune responses following pediatric ' 'influenza vaccination. Viruses 11(10):907. ' 'https://doi.org/10.3390/v11100907', 'journal-title': 'Viruses'}, { 'key': '210_CR30', 'doi-asserted-by': 'publisher', 'first-page': 'e08', 'DOI': '10.34172/ipp.2022.08', 'volume': '8', 'author': 'A Hakamifard', 'year': '2021', 'unstructured': 'Hakamifard A, Soltani R, Maghsoudi A, Rismanbaf A, Aalinezhad M, Tarrahi ' 'MJ et al (2021) The effect of vitamin E and vitamin C in patients with ' 'COVID-19 pneumonia; a randomized controlled clinical trial. Immunopathol ' 'Persa 8:e08. https://doi.org/10.34172/ipp.2022.08', 'journal-title': 'Immunopathol Persa'}, { 'key': '210_CR31', 'doi-asserted-by': 'publisher', 'first-page': '111047', 'DOI': '10.1016/j.nut.2020.111047', 'volume': '82', 'author': 'A Gorji', 'year': '2021', 'unstructured': 'Gorji A, Ghadiri MK (2021) Potential roles of micronutrient deficiency ' 'and immune system dysfunction in the coronavirus disease 2019 (COVID-19) ' 'pandemic. Nutrition 82:111047', 'journal-title': 'Nutrition'}, { 'issue': '4', 'key': '210_CR32', 'doi-asserted-by': 'publisher', 'first-page': '367', 'DOI': '10.1016/j.dsx.2020.04.015', 'volume': '14', 'author': 'R Jayawardena', 'year': '2020', 'unstructured': 'Jayawardena R, Sooriyaarachchi P, Chourdakis M, Jeewandara C, Ranasinghe ' 'P (2020) Enhancing immunity in viral infections, with special emphasis ' 'on COVID-19: a review. Diabetes Metab Syndr 14(4):367–382. ' 'https://doi.org/10.1016/j.dsx.2020.04.015', 'journal-title': 'Diabetes Metab Syndr'}, { 'issue': '4', 'key': '210_CR33', 'first-page': '727', 'volume': '38', 'author': 'J Tanaka', 'year': '1979', 'unstructured': 'Tanaka J, Fujiwara H, Torisu M (1979) Vitamin E and immune response I ' 'Enhancement of Helper T-Cell Activity by Dietary Supplementation of ' 'Vitamin E in Mice. Immunology 38(4):727–734.146', 'journal-title': 'Immunology'}, { 'issue': '4', 'key': '210_CR34', 'doi-asserted-by': 'publisher', 'first-page': '487', 'DOI': '10.1002/iub.1976', 'volume': '71', 'author': 'ED Lewis', 'year': '2019', 'unstructured': 'Lewis ED, Meydani SN, Wu D (2019) Regulatory role of vitamin E in the ' 'immune system and inflammation. IUBMB Life 71(4):487–494. ' 'https://doi.org/10.1002/iub.1976', 'journal-title': 'IUBMB Life'}, { 'issue': '14', 'key': '210_CR35', 'doi-asserted-by': 'publisher', 'first-page': '2091', 'DOI': '10.2147/JIR.S307333', 'volume': '21', 'author': 'N Samad', 'year': '2021', 'unstructured': 'Samad N, Dutta S, Sodunke TE, Fairuz A, Sapkota A, Miftah ZF et al ' '(2021) Fat-Soluble Vitamins and the Current Global Pandemic of COVID-19: ' 'Evidence-Based Efficacy from Literature Review. J Inflamm Res ' '21(14):2091–2110. https://doi.org/10.2147/JIR.S307333. ' 'PMID:34045883;PMCID:PMC8149275', 'journal-title': 'J Inflamm Res'}, { 'key': '210_CR36', 'doi-asserted-by': 'publisher', 'first-page': '64', 'DOI': '10.3945/ajcn.111.023812', 'volume': '95', 'author': 'A Duncan', 'year': '2011', 'unstructured': 'Duncan A, Talwar D, McMillan D, Stefanowicz F, O’Reilly DSJ (2011) ' 'Quantitative data on the magnitude of the systemic inflammatory response ' 'and its effect on micronutrient status based on plasma measurements. Am ' 'J Clin Nutr 95:64–71', 'journal-title': 'Am J Clin Nutr'}, { 'issue': '9', 'key': '210_CR37', 'doi-asserted-by': 'publisher', 'first-page': '756217', 'DOI': '10.3389/fped.2021.756217', 'volume': '24', 'author': 'X Wang', 'year': '2021', 'unstructured': 'Wang X, Li X, Jin C, Bai X, Qi X, Wang J et al (2021) Association ' 'Between Serum Vitamin A Levels and Recurrent Respiratory Tract ' 'Infections in Children. Front Pediatr. 24(9):756217. ' 'https://doi.org/10.3389/fped.2021.756217. PMID: 35004539; PMCID: ' 'PMC8740126', 'journal-title': 'Front Pediatr.'}], 'container-title': 'The Egyptian Journal of Bronchology', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://link.springer.com/content/pdf/10.1186/s43168-023-00210-9.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/article/10.1186/s43168-023-00210-9/fulltext.html', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/content/pdf/10.1186/s43168-023-00210-9.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2023, 7, 21]], 'date-time': '2023-07-21T11:05:58Z', 'timestamp': 1689937558000}, 'score': 1, 'resource': {'primary': {'URL': 'https://ejb.springeropen.com/articles/10.1186/s43168-023-00210-9'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2023, 7, 21]]}, 'references-count': 37, 'journal-issue': {'issue': '1', 'published-online': {'date-parts': [[2023, 12]]}}, 'alternative-id': ['210'], 'URL': 'http://dx.doi.org/10.1186/s43168-023-00210-9', 'relation': {}, 'ISSN': ['2314-8551'], 'subject': ['General Earth and Planetary Sciences', 'General Environmental Science', 'General Medicine'], 'container-title-short': 'Egypt J Bronchol', 'published': {'date-parts': [[2023, 7, 21]]}, 'assertion': [ { 'value': '25 May 2023', 'order': 1, 'name': 'received', 'label': 'Received', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '14 July 2023', 'order': 2, 'name': 'accepted', 'label': 'Accepted', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '21 July 2023', 'order': 3, 'name': 'first_online', 'label': 'First Online', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, {'order': 1, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Declarations'}}, { 'value': "The study has received approval from Cairo University's Faculty of Medicine's " 'research ethics committee (approval number: MS-59–2020; date: 29/4/2020).\xa0' 'Informed consent was obtained from all individual participants included in the ' 'study.', 'order': 2, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Ethics approval and consent to participate'}}, { 'value': 'Not applicable.', 'order': 3, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Consent for publication'}}, { 'value': 'The authors declare that there is no conflict of interests.', 'order': 4, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Competing interests'}}], 'article-number': '36'}