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0 0.5 1 1.5 2+ Mortality 70% Improvement Relative Risk Progression 45% Vitamin A for COVID-19  Tepasse et al.  Sufficiency Are vitamin A levels associated with COVID-19 outcomes? Prospective study of 40 patients in Germany Lower mortality (p=0.042) and progression (p=0.048) Tepasse et al., Nutrients, June 2021 Favors vitamin A Favors control

Vitamin A Plasma Levels in COVID-19 Patients: A Prospective Multicenter Study and Hypothesis

Tepasse et al., Nutrients, doi:10.3390/nu13072173
Jun 2021  
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Vitamin A for COVID-19
12th treatment shown to reduce risk in January 2021
*, now known with p = 0.045 from 12 studies.
Lower risk for recovery.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,000+ studies for 60+ treatments.
Prospective analysis of 40 hospitalized patients and 47 age-matched convalescent patients, showing significantly lower vitamin A levels in critical patients, and significantly lower vitamin A levels in hospitalized patients vs. controls. Low vitamin A levels were significantly associated with ARDS and mortality in hospitalized patients.
risk of death, 69.7% lower, RR 0.30, p = 0.04, high vitamin A levels 4 of 29 (13.8%), low vitamin A levels 5 of 11 (45.5%), NNT 3.2, inverted to make RR<1 favor high vitamin A levels, odds ratio converted to relative risk, >2mg/L, logistic regression.
risk of progression, 45.2% lower, RR 0.55, p = 0.048, high vitamin A levels 13 of 29 (44.8%), low vitamin A levels 9 of 11 (81.8%), NNT 2.7, inverted to make RR<1 favor high vitamin A levels, odds ratio converted to relative risk, progression to ARDS, >2mg/L, logistic regression.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Tepasse et al., 24 Jun 2021, prospective, Germany, peer-reviewed, 8 authors.
This PaperVitamin AAll
Vitamin A Plasma Levels in COVID-19 Patients: A Prospective Multicenter Study and Hypothesis
Phil-Robin Tepasse, Richard Vollenberg, Manfred Fobker, Iyad Kabar, Hartmut Schmidt, Jörn Arne Meier, Tobias Nowacki, Anna Hüsing-Kabar
Nutrients, doi:10.3390/nu13072173
COVID-19 is a pandemic disease that causes severe pulmonary damage and hyperinflammation. Vitamin A is a crucial factor in the development of immune functions and is known to be reduced in cases of acute inflammation. This prospective, multicenter observational cross-sectional study analyzed vitamin A plasma levels in SARS-CoV-2 infected individuals, and 40 hospitalized patients were included. Of these, 22 developed critical disease (Acute Respiratory Distress Syndrome [ARDS]/Extracorporeal membrane oxygenation [ECMO]), 9 developed severe disease (oxygen supplementation), and 9 developed moderate disease (no oxygen supplementation). A total of 47 age-matched convalescent persons that had been earlier infected with SARS-CoV-2 were included as the control group. Vitamin A plasma levels were determined by high-performance liquid chromatography. Reduced vitamin A plasma levels correlated significantly with increased levels of inflammatory markers (CRP, ferritin) and with markers of acute SARS-CoV-2 infection (reduced lymphocyte count, LDH). Vitamin A levels were significantly lower in hospitalized patients than in convalescent persons (p < 0.01). Of the hospitalized patients, those who were critically ill showed significantly lower vitamin A levels than those who were moderately ill (p < 0.05). Vitamin A plasma levels below 0.2 mg/L were significantly associated with the development of ARDS ]; p = 0.048) and mortality ], p = 0.042). Taken together, we conclude that vitamin A plasma levels in COVID-19 patients are reduced during acute inflammation and that severely reduced plasma levels of vitamin A are significantly associated with ARDS and mortality.
Supplementary Materials: The following are available online at .3390/nu13072173/s1, Supplementary Figure S1 Informed Consent Statement: Informed consent was obtained from all subjects involved in the study. Data Availability Statement: Data cannot be made public as personal patient data are included. Conflicts of Interest: The authors declare no conflict of interest.
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