The Use of Antiviral Agents against SARS-CoV-2: Ineffective or Time and Age Dependent Result? A Retrospective, Observational Study among COVID-19 Older Adults
Desai et al.,
The Use of Antiviral Agents against SARS-CoV-2: Ineffective or Time and Age Dependent Result? A Retrospective,..,
J. Clinical Medicine, doi:10.3390/jcm10040686
Retrospective 143 COVID-19 hospitalized patients >65yo, showing adjusted OR for antiviral treatment starting within 6 days of 0.44 [0.2-0.9], p = 0.02, compared to treatment started later.
Desai et al., 10 Feb 2021, peer-reviewed, 9 authors.
Abstract: Open Forum Infectious Diseases
Major Article
Vitamin K & D Deficiencies Are Independently Associated
With COVID-19 Disease Severity
Ankita P. Desai,1,2,3,a, Sahera Dirajlal-Fargo,1,2,3,a Jared C. Durieux,1 Heather Tribout,1 Danielle Labbato,1 and Grace A. McComsey1,2,3
1
University Hospitals Cleveland Medical Center; Cleveland, Ohio, USA, 2Rainbow Babies and Children’s Hospital, Cleveland, Ohio, USA, and 3Case Western Reserve University, Cleveland, Ohio,
USA
Since the emergence of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in late 2019, there has
been a substantial worldwide effort in understanding the pathogenesis of coronavirus disease 2019 (COVID-19), treatment
modalities, and prevention. Those infected with this virus may
have a wide range of symptoms from an asymptomatic or mild
state to severe pneumonia, coagulopathy, and death [1]. The
ability to predict severe disease and response to treatment remains elusive [2]. Several risk factors have been identified for
disease severity, including advanced age, male sex, non-White
race, obesity, vitamin and mineral deficiencies (specifically vitamin D, vitamin C, and selenium), diabetes, and hypertension.
Received 23 June 2021; editorial decision 12 July 2021; accepted 28 July 2021.
a
Equal contribution
Correspondence: Grace A. McComsey, MD, FIDSA, University Hospitals Cleveland Medical
Center and Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106
(grace.mccomsey@uhhospitals.org).
Open Forum Infectious Diseases®2021
© The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases
Society of America. This is an Open Access article distributed under the terms of the Creative
Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/
licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the
work, in any medium, provided the original work is not altered or transformed in any way, and that
the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
https://doi.org/10.1093/ofid/ofab408
Severe outcomes have been associated with multiorgan failure,
which may correspond to the underlying inflammatory response postinfection. Host factors triggered by the virus can
lead to an exaggerated inflammatory response or “cytokine
storm,” leading to pulmonary damage through calcification of
pulmonary interstitial arteriolar walls, hypercoagulation, and
disseminated intravascular coagulation [3].
Vitamin K is the name given to a group of essential fat-soluble
vitamins, phylloquinone (vitamin K1) and menaquinones
(vitamin K2), which are co-factors for several proteins involved in coagulation homeostasis and calcium homeostasis.
Phylloquinone and menaquinones share the same head group
(2-methyl-napthoquinone) but have different compositions of
the poly-isoprenoid side chain (at the 3-position). In the circulation, there is a differential distribution of vitamin K to
lipoproteins, where the majority of short-chain vitamin K
(phylloquinone) is associated with triacylglycerol-rich lipoproteins, and the longer menaquinones are more associated
with low-density lipoproteins (LDLs). The associations with
different lipoproteins allow different distribution in the body,
where the long-chain menaquinones reach extrahepatic tissues
that possess LDL receptors [4]. Vitamin K activates both hepatic coagulation factors and extrahepatic endothelial..
Please send us corrections, updates, or comments. Vaccines and
treatments are complementary. All practical, effective, and safe means should
be used based on risk/benefit analysis. No treatment, vaccine, or intervention
is 100% available and effective for all current and future variants. We do not
provide medical advice. Before taking any medication, consult a qualified
physician who can provide personalized advice and details of risks and
benefits based on your medical history and situation.
FLCCC and
WCH
provide treatment protocols.
Submit