Retinol Depletion in Severe COVID-19
Retrospective 27 severe COVID-19 patients and 23 non-COVID-19 patients, showing significantly lower vitamin A levels in COVID-19 patients (0.37mg/L vs. 0.52 mg/L, p<0.001). 10 of 27 COVID-19 patients received vitamin A, with higher mortality. Group details are not provided but authors note that 8 of 10 had comorbidities.
This study is excluded in the after exclusion results of meta
analysis:
unadjusted results with no group details, comments suggest significant group differences and confounding.
risk of death, 282.5% higher, RR 3.83, p = 0.001, treatment 9 of 10 (90.0%), control 4 of 17 (23.5%).
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Sarohan et al., 1 Feb 2021, retrospective, Turkey, preprint, 4 authors.
Abstract: medRxiv preprint doi: https://doi.org/10.1101/2021.01.30.21250844; this version posted February 1, 2021. The copyright holder for this preprint
(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
It is made available under a CC-BY-NC-ND 4.0 International license .
Retinol Depletion in Severe COVID-19
1. Aziz Rodan Sarohan*
2. Hakan Akelma
3. Eşref Araç
4. Özgür Aslan
Abstract
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 COVID19 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.
Keywords: Retinol; Retinoid; Retinoic acid; Type-I IFN; RIG-I; CYP450; COVID-19;
Retinoid Signaling
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