A recent independent study, supported by Kappa Bioscience, has indicated vitamins K and D could play independent roles in the COVID-19 pathogenesis.
Previously studies have suggested a significant correlation between serum vitamin K status and COVID-19 severity1,2. Many studies have also associated vitamin D deficiency with higher risk for severe COVID-19, Kappa says.
The paper, published in Open Forum Infectious Diseases, is the first to examine both vitamins’ influence on the course of COVID-193. The observational study included 150 subjects (100 Covid-19 patients and 50 controls), measuring their vitamin D and vitamin K levels.
Vitamin K status was lower in infected patients than in healthy controls, with similar vitamin D levels in each group. Participants who were vitamin D deficient, however, had worse vitamin K status, and experienced the most severe COVID-19 outcomes (Figure 1). The authors concluded the results suggest a potential synergistic interplay between the two vitamins in COVID-19.
Figure 1: Median dp-ucMGP by vitamin D(25(OH) classification and World Health Organization (WHO) COVID-19 outcomes
The synergistic benefits of the two vitamins have been flagged by Kappa before in relation to bone and cardiovascular health.
“Put simply, vitamin D enables the production of some key proteins, which play a role in calcium metabolism. But they are produced in an inactive state, and vitamin K2 is the catalyst that activates them,” said Trygve Bergeland, VP Science at Kappa Bioscience. “These proteins mobilise calcium, carrying it away from our arteries and soft tissues, and incorporating it into our bones, where it is needed.”
He continues: “In COVID-19, it was shown that patients with low vitamin K status had increased elastic fiber degradation and vascular calcifications.1 On its own, vitamin K also regulates blood clotting, which seems crucial to prevent thromboembolism, as often observed in more severe COVID-19. This paper suggests a potential anti-inflammatory role of vitamin K, which warrants further research.”
“Interestingly, both vitamin D and K may display complementary effects on the cytokine storm, thrombosis, and lung damage during COVID-19. Specifically, they display similar inhibitory effects on inhibition of NF-kB and cytokine release, and vitamin D and K appear to work synergistically to help protect against calcification and damage in the lungs,” said Dr Grace McComsey, MD, FIDSA, VP of Research and Associate CSO at University Hospitals (USA), and corresponding author of the study.
“Optimising vitamin K and D prior to acute COVID-19 infection may help to regulate overwhelming calcification, inflammation, and coagulopathy, which may subsequently lead to improved clinical outcomes. As the long-chain menaquinones, such as K2 MK-7, have an extrahepatic distribution, they possess the capacity to optimize the vitamin K status in tissues that are deficient, however, large preventive clinical trials are needed.”
“The many studies on vitamins D and K2 published during the pandemic represent new knowledge that has to be spread. Many of us know of the key roles played by vitamin D, but K2 benefits remain overlooked. I believe vitamin K2 is a 21st-century ingredient,” Dr McComsey said.
“I am now planning a study looking to see if vitamins K2 and D status affect development of ‘long hauler’ whose COVID-19 symptoms persist for many months after the infection.” This may lead to an interventional study to see if this interesting pair of vitamins can prevent or even treat “long hauler” syndrome.
Kappa Bioscience, a developer of all-trans vitamin K2 MK-7 ingredients, who participated in the study’s funding but had no access to raw data or detailed study results, announced earlier this year the initiation of a clinical trial using its K2Vital ingredient in COVID-19 patients. The interventional trial aims to discover whether supplementation with vitamin K2 MK-7 could reduce pulmonary damage and coagulopathy in patients with severe COVID-19. Results are expected later this year. 4
References
1. Dofferhoff, A. S., Piscaer, I., Schurgers, L. J., Visser, M. P., van den Ouweland, J. M., de Jong, P. A., ... & Janssen, R. (2020). Reduced Vitamin K Status as a Potentially Modifiable Risk Factor of Severe Coronavirus Disease 2019. Clinical Infectious Diseases.
2. Linneberg, A., Kampmann, F. B., Israelsen, S. B., Andersen, L. R., Jørgensen, H. L., Sandholt, H., ... & Benfield, T. (2021). The Association of Low Vitamin K Status with Mortality in a Cohort of 138 Hospitalized Patients with COVID-19. Nutrients, 13(6), 1985. https://doi.org/10.3390/nu13061985
3. Desai, A. P., Dirajlal-Fargo, S., Durieux, J. C., Tribout, H., Labbato, D., & McComsey, G. A. (2021). Vitamin K & D Deficiencies Are Independently Associated With Covid-19 Disease Severity. In Open Forum Infectious Diseases. Jul 29;8(10):ofab408. doi: 10.1093/ofid/ofab408. eCollection 2021 Oct.
4. https://www.clinicaltrials.gov/ct2/show/NCT04770740
