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0 0.5 1 1.5 2+ Severe case 61% Improvement Relative Risk Case 84% Vitamin A for COVID-19  Pavlyshyn et al.  Sufficiency Are vitamin A levels associated with COVID-19 outcomes? Retrospective 135 patients in Ukraine Lower severe cases (p=0.14) and fewer cases (p=0.2), not sig. c19early.org Pavlyshyn et al., Неонатологія, хірург.., Apr 2024 Favors vitamin A Favors control

Micronutrient status (vitamins A and D) and its effect on the severity of the course of COVID-19 in children

Pavlyshyn et al., Неонатологія, хірургія та перинатальна медицина, doi:10.24061/2413-4260.XIV.1.51.2024.6
Apr 2024  
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Vitamin A for COVID-19
39th treatment shown to reduce risk in June 2023
 
*, now known with p = 0.031 from 13 studies.
Lower risk for recovery and cases.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,100+ studies for 60+ treatments. c19early.org
Retrospective 112 pediatric COVID-19 patients and 23 healthy controls showing lower levels of vitamins A and D associated with more severe disease. Patients with moderate and severe COVID-19 had significantly lower vitamin A, vitamin D, and retinol-binding protein 4 (RBP4) levels compared to those with mild disease and healthy controls. Lower vitamin A and D levels were associated with higher levels of inflammatory markers such as CRP, leukocytes, and ESR.
Study covers vitamin D and vitamin A.
risk of severe case, 60.6% lower, RR 0.39, p = 0.14, high vitamin A levels (≥200ng/ml) 9 of 99 (9.1%), low vitamin A levels (<200ng/ml) 3 of 13 (23.1%), NNT 7.1, (mild) deficiency vs. other.
risk of case, 84.3% lower, OR 0.16, p = 0.20, high vitamin A levels (≥200ng/ml) 99 of 112 (88.4%) cases, 23 of 23 (100.0%) controls, NNT 5.3, case control OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Pavlyshyn et al., 5 Apr 2024, retrospective, Ukraine, peer-reviewed, 3 authors.
This PaperVitamin AAll
Neonatology, surgery and perinatal medicine
H A Pavlyshyn, O V Labivka, K V Kozak
doi:10.24061/2413-4260
A strong immune response is important during recovery from COVID-19, and its status is infl uenced by several micronutrients. Vitamin D is important in regulating the immune response and protecting against respiratory infections. Vitamin A also has immunomodulatory eff ects, inhibiting viral replication and enhancing immune responses, thereby reducing morbidity and mortality from COVID-19. The aim of research was to study the levels of vitamins A, D, and retinol-binding protein 4 in children with COVID-19, and their associations with the severity of the disease. Material and Methods. 112 children aged 1 month to 18 years with COVID-19 confi rmed by polymerase chain reaction (PCR) in nasal swabs or by a positive serologic test (IgM and IgG or IgM). In all children, vitamin D levels were determined by the colorimetric enzyme-linked immunosorbent assay (ELISA) using the Monobind test system. Vitamin A and retinol binding protein 4 (RBP4) levels were determined by the colorimetric enzyme-linked immunosorbent assay (ELISA) using the Elabscience test system. Statistical analysis was performed using Stat Plus (its 95 % confi dence interval (95 % CI) was calculated for the mean values, and the Kruskal-Wallis test (H-test) was used as the reliability criterion for checking the equality of the medians of several samples). The level of statistical signifi cance was set at P<0.05). The study was conducted in accordance with the rules of patient safety and ethical principles of scientifi c medical research involving human subjects (2000). The permission to conduct this study was granted by the Bioethics Commission (Protocol No. 73, dated April 3, 2023). The parents (legal representatives) of the patients gave their written consent to the conduct of this study. No. 0123U100064, 2023No. 0123U100064, -2025)). This study is a fragment of research work «Optimizing the diagnosis of clinical and pathogenetic characteristics of the COVID-19 coronavirus infection in children with comorbid pathology and treatment features» (state registration Results. The mean age of the children was (7.04±5.75) years . According to the severity of the disease, 57 children ( 50 .89 %) had a mild course, 43 children (38.39 %) had a moderate course, and 12 children (10.72 %) had a severe course. The concentration of vitamin D in children with mild course of COVID-19 was 30.91 ng/ml, in children with moderate course -29.10 ng/ml, in children with severe course -22.42 ng/ml (Р<0.05). The level of vitamin A also varied in children with diff erent severity of the disease: in mild COVID-19 it was 456.10 ng/ml, in moderate -347.30 ng/ml, and in severe -242.90 ng/ ml (Р <0.001). At the same time, the level of retinol binding protein 4 was 30.66 ng/ml in mild disease, 33.07 ng/ml in moderate disease and 23.28 ng/ml in severe disease. Conclusions. Children with moderate and severe COVID-19 have signifi cantly lower levels of vitamins A, D, and RBP4 compared to uninfected..
References
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Kozak -Cadidate Of, Павлишин Галина Андріївнадоктор медичних наук, завідувач кафедри педіатрії № 2 Тернопільського національного медичного університету
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Дане Дослідження, фрагментом науково-дослідної роботи «Оптимізація діагностики клініко-патогенетичних характеристик коронавірусної інфекції COVID-19 у дітей з коморбідною патологією та особливості лікування, державна реєстрація
Метою, Матеріал і методи дослідження: обстежено 112 дітей віком від 1 місяця до 18 років із COVID-19, підтвердженим методом полімеразної ланцюгової реакції (ПЛР) у мазках з носа або позитивним серологічним тестом (IgM та IgG або IgM). У всіх дітей визначали рівень вітаміну D колориметричним методом імуноферментного аналізу (ІФА) з використанням тест-системи Monobind. Рівні вітаміну А та ретинолзв'язуючого білка 4 (RBP4) визначали колориметричним методом імуноферментного аналізу (ELISA) з використанням тест-системи Elabscience. Комісія з біоетики Тернопільського національного медичного університету імені І, значущості прийнято
Нижчий, Пов, язаний з більш високим рівнем прозапальних маркерів
Результати Дослідження, вік дітей становив (7,04 ± 5,75) років (95 % ДІ 5,96-8,12). За ступенем тяжкості у 57 дітей (50,89 %) перебіг захворювання був легким, у 43 дітей (38,39 %)середньої тяжкості, у
{ 'DOI': '10.24061/2413-4260.xiv.1.51.2024.6', 'ISSN': ['2413-4260', '2226-1230'], 'URL': 'http://dx.doi.org/10.24061/2413-4260.XIV.1.51.2024.6', 'abstract': '<jats:p>A strong immune response is important during recovery from COVID-19, and its status ' 'is infl uenced by several micronutrients. Vitamin D is important in regulating the immune ' 'response and protecting against respiratory infections. Vitamin A also has immunomodulatory ' 'eff ects, inhibiting viral replication and enhancing immune responses, thereby reducing ' 'morbidity and mortality from COVID-19. The aim of research was to study the levels of ' 'vitamins A, D, and retinol- binding protein 4 in children with COVID-19, and their ' 'associations with the severity of the disease.Material and Methods. 112 children aged 1 month ' 'to 18 years with COVID-19 confi rmed by polymerase chain reaction (PCR)in nasal swabs or by a ' 'positive serologic test (IgM and IgG or IgM). In all children, vitamin D levels were ' 'determined by thecolorimetric enzyme- linked immunosorbent assay (ELISA) using the Monobind ' 'test system. Vitamin A and retinol binding protein 4 (RBP4) levels were determined by the ' 'colorimetric enzyme- linked immunosorbent assay (ELISA) using the Elabscience test system. ' 'Statistical analysis was performed using Stat Plus (its 95 % confi dence interval (95 % CI) ' 'was calculated for the mean values, and the Kruskal- Wallis test (H-test) was used as the ' 'reliability criterion for checking the equality of the medians of several samples). The level ' 'of statistical signifi cance was set at P&lt;0.05). The study was conducted in accordance ' 'with the rules of patient safety and ethical principles of scientifi c medical research ' 'involving human subjects (2000). The permission to conduct this study was granted by the ' 'Bioethics Commission (Protocol No. 73, dated April 3, 2023). The parents (legal ' 'representatives) of the patients gave their written consent to the conduct of this study. ' 'This study is a fragment of research work «Optimizing the diagnosis of clinical and ' 'pathogenetic characteristics of the COVID-19 coronavirus infection in children with comorbid ' 'pathology and treatment features» (state registration No. 0123U100064, 2023-2025).Results. ' 'The mean age of the children was (7.04±5.75) years (95 % CI 5.96-8.12). According to the ' 'severity of the disease,57 children (50.89 %) had a mild course, 43 children (38.39 %) had a ' 'moderate course, and 12 children (10.72 %) had a severe course. The concentration of vitamin ' 'D in children with mild course of COVID-19 was 30.91 ng/ml, in children with moderate course ' '– 29.10 ng/ml, in children with severe course – 22.42 ng/ml (Р&lt;0.05). The level of vitamin ' 'A also varied in children with diff erent severity of the disease: in mild COVID-19 it was ' '456.10 ng/ml, in moderate – 347.30 ng/ml, and in severe – 242.90 ng/ ml (Р &lt;0.001). At the ' 'same time, the level of retinol binding protein 4 was 30.66 ng/ml in mild disease, 33.07 ' 'ng/ml in moderate disease and 23.28 ng/ml in severe disease.Conclusions. Children with ' 'moderate and severe COVID-19 have signifi cantly lower levels of vitamins A, D, and ' 'RBP4compared to uninfected individuals. Vitamin A and RBP4 levels were age-dependent, and ' 'vitamin D levels did not show agerelated patterns. Lower levels of vitamins A and D are ' 'associated with higher levels of pro-infl ammatory markers – CRP,leukocytes and ESR.</jats:p>', 'author': [ {'affiliation': [], 'family': 'Pavlyshyn', 'given': 'H.', 'sequence': 'first'}, {'affiliation': [], 'family': 'Labivka', 'given': 'O.', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Kozak', 'given': 'K.', 'sequence': 'additional'}], 'container-title': 'Neonatology, Surgery and Perinatal Medicine', 'container-title-short': 'Neonatol. hìr. perinat. med.', 'content-domain': {'crossmark-restriction': False, 'domain': []}, 'created': {'date-parts': [[2024, 4, 8]], 'date-time': '2024-04-08T14:48:14Z', 'timestamp': 1712587694000}, 'deposited': { 'date-parts': [[2024, 4, 8]], 'date-time': '2024-04-08T14:48:52Z', 'timestamp': 1712587732000}, 'indexed': {'date-parts': [[2024, 4, 9]], 'date-time': '2024-04-09T00:34:00Z', 'timestamp': 1712622840392}, 'is-referenced-by-count': 0, 'issue': '1(51)', 'issued': {'date-parts': [[2024, 4, 5]]}, 'journal-issue': {'issue': '1(51)', 'published-online': {'date-parts': [[2024, 4, 8]]}}, 'license': [ { 'URL': 'http://creativecommons.org/licenses/by/4.0', 'content-version': 'unspecified', 'delay-in-days': 0, 'start': { 'date-parts': [[2024, 4, 5]], 'date-time': '2024-04-05T00:00:00Z', 'timestamp': 1712275200000}}], 'link': [ { 'URL': 'http://neonatology.bsmu.edu.ua/article/download/301276/293438', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'http://neonatology.bsmu.edu.ua/article/download/301276/293587', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'http://neonatology.bsmu.edu.ua/article/download/301276/293438', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'member': '10153', 'original-title': [], 'page': '41-47', 'prefix': '10.24061', 'published': {'date-parts': [[2024, 4, 5]]}, 'published-online': {'date-parts': [[2024, 4, 5]]}, 'publisher': 'Higher State Educational Establishment of Ukraine Bukovinian State Medical University', 'reference-count': 0, 'references-count': 0, 'relation': {}, 'resource': {'primary': {'URL': 'http://neonatology.bsmu.edu.ua/article/view/301276'}}, 'score': 1, 'short-title': [], 'source': 'Crossref', 'subject': [ 'Surgery', 'Pediatrics, Perinatology and Child Health', 'Obstetrics and Gynecology', 'Genetics (clinical)'], 'subtitle': [], 'title': 'MICRONUTRIENT STATUS (VITAMINS A AND D) AND ITS EFFECT ON THE SEVERITY OF THE COURSE OF COVID-19 ' 'IN CHILDREN', 'type': 'journal-article', 'volume': '14'}
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