Baseline serum vitamin A and vitamin C levels and their association with disease severity in COVID-19 patients: Serum Vitamin A and C levels and COVID-19 severity

Gulseren Yilmaz; Huri Bulut; Derya Ozden Omaygenc; Aysu Akca; Esra Can; Nevin Tuten; Aysegul Bestel; Baki Erdem; Uygar Ozan Atmaca; Yasin Kara; Ebru Kaya; Murat Unsel; Ayca Sultan Sahin; Ziya Salihoglu

doi:10.23750/abm.v94i1.13655

Baseline serum vitamin A and vitamin C levels and their association with disease severity in COVID-19 patients

Serum Vitamin A and C levels and COVID-19 severity

Authors

Gulseren Yilmaz Kanuni Sultan Suleyman Training & Research Hospital, Department of Anesthesiology, Istanbul, Turkey https://orcid.org/0000-0003-2984-156X
Huri Bulut Istinye University, Faculty of Medicine, Department of Biochemistry, Istanbul, Turkey https://orcid.org/0000-0003-2706-9625
Derya Ozden Omaygenc Istanbul Haseki Training and Research Hospital https://orcid.org/0000-0003-1037-8915
Aysu Akca Kanuni Sultan Suleyman Training & Research Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey https://orcid.org/0000-0002-8644-7908
Esra Can Kanuni Sultan Suleyman Training & Research Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey https://orcid.org/0000-0001-7851-4026
Nevin Tuten Kanuni Sultan Suleyman Training & Research Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey https://orcid.org/0000-0001-8609-4770
Aysegul Bestel Kanuni Sultan Suleyman Training & Research Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey https://orcid.org/0000-0002-0700-6400
Baki Erdem Acıbadem University, Faculty of Medicine, Department of Gynecologic Oncology, Istanbul, Turkey https://orcid.org/0000-0002-6407-8718
Uygar Ozan Atmaca Kanuni Sultan Suleyman Training & Research Hospital, Department of Anesthesiology, Istanbul, Turkey https://orcid.org/0000-0002-7823-4400
Yasin Kara Kanuni Sultan Suleyman Training & Research Hospital, Department of General Surgery, Istanbul, Turkey https://orcid.org/0000-0002-9723-1774
Ebru Kaya Kanuni Sultan Suleyman Training & Research Hospital, Department of Critical Care, Istanbul, Turkey https://orcid.org/0000-0002-9506-0756
Murat Unsel Basaksehir Cam ve Sakura City Hospital, Department of Anesthesiology and Critical Care, Istanbul, Turkey https://orcid.org/0000-0002-2786-6811
Ayca Sultan Sahin Kanuni Sultan Suleyman Training & Research Hospital, Department of Anesthesiology, Istanbul, Turkey https://orcid.org/0000-0002-7765-5297
Ziya Salihoglu Istanbul University – Cerrahpasa, Faculty of Medicine, Department of Anesthesiology, Istanbul, Turkey https://orcid.org/0000-0002-6905-2664

DOI: https://doi.org/10.23750/abm.v94i1.13655

Keywords:

Ascorbic acid, COVID-19, Hospital stay, Pulmonary disease, Vitamin A

Abstract

Aim: We aimed to investigate the association between the serum concentrations of Vitamin A and Vitamin C and the severity of the COVID-19.

Methods: Fifty-three consecutive PCR (+) COVID-19 patients admitted to a dedicated ward were enrolled in this study. Blood samples for serum Vitamin A and C measurements were drawn from all participants upon admission. All subjects underwent thoracic CT imaging prior to hospitalization. CT severity score (CT-SS) was then calculated for determining the extent of pulmonary involvement. A group of healthy volunteers, in whom COVID-19 was ruled out, were assigned to the control group (n=26). These groups were compared by demographic features and serum vitamin A and C levels. The relationship between serum concentrations of these vitamins and pre-defined outcome measures, CT-SS and length of hospitalization (LOH), was also assessed.

Results: In COVID-19 patients, serum Vitamin A (ng/ml, 494±96 vs. 698±93; p<0.001) and Vitamin C (ng/ml, 2961 [1991-31718] vs. 3953 [1385-8779]; p=0.007) levels were significantly lower with respect to healthy controls. According to the results of correlation analyses, there was a significant negative association between Vitamin A level and outcome measures (LOH, r=-0.293; p=0.009 and CT-SS, r=-0.289; p=0.010). The negative correlations between Vitamin C level and those measures were even more prominent (LOH, r=-0.478; p<0.001 and CT-SS, r=-0.734: p<0.001).

Conclusion: COVID-19 patients had lower baseline serum Vitamin A and Vitamin C levels as compared to healthy controls. In subjects with COVID-19, Vitamin A and Vitamin C levels were negatively correlated with CT-SS and LOH.

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