Retinol Depletion in Severe COVID-19
Aziz Rodan Sarohan, Hakan Akelma, Eşref Araç, Özgür Özgür Aslan
doi:10.1101/2021.01.30.21250844
Background and Purpose: Vitamin A is depleted during infections. Vitamin A has been used successfully in measles, RSV and AIDS patients and is an effective vaccine adjuvant. In this study, low retinol levels were found in patients with severe COVID-19. Retinoid signaling impairment in COVID-19 disrupts Type-I interferon synthesis. Material and Method: Two groups were formed in the study. The patient group consisted of 27 (Group 1) severe COVID-19 patients hospitalized in the intensive care unit with respiratory failure, and the control group consisted of 23 (Group 2) patients without COVID-19 symptoms. Serum retinol levels were analyzed by ELIZA and HPLC in both groups. Findings: Retinol levels were found to be significantly lower in the patient group (P <0.001). There was no difference in retinol between two different age groups in the patient group (P> 0.05). There was no significant difference in retinol between men and women (P> 0.05). Comorbidity did not affect serum retinol levels (P >0.05).
Conclusion: Serum retinol levels were low in patients with severe COVID-19. Drugs preventing retinol excretion were not stopped in the patient group. Some patients took vitamin A externally. Despite this, retinol was low in COVID-19 patients. Retinol depletion impairs Type-I interferon synthesis by impairing retinoid signaling. Retinoid signaling may be the main pathogenetic disorder in COVID-19. This pathogenesis can serve as a guide for adjuvants, drug targets, and candidate drugs. Retinol, retinoic acid derivatives, and some CYP450 inhibitors may work on COVID-19.
Disclosure Statement: The authors are not a party of any affiliations, memberships, funding, or financial holdings that might be perceived as affecting the objectivity of this review.
The Basis of the Study and the Decision of the Ethics Committee This study was conducted with the approval of the ethics committee and the approval of Diyarbakır Gazi Yaşargil Training and Research Hospital, University of Health Sciences, and the approval of the Ministry of Health dated 03.06.2020 and numbered T22_10_40.xml. All protocols were implemented within the recommendations of the local ethics committee. All subjects were included in the study following the protocols approved by the local ethics committee. When the patients were hospitalized, they were informed about the study and were included in the study after obtaining their consent for signature.
The Contents of the Formulas and TPN Administered to the Patients The contents of the formulas and TPN administered to the patients were given below: More than one type of TPN and formulas were administered to some patients.
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