{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T15:32:22Z","timestamp":1772292742146,"version":"3.50.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2021,7,29]],"date-time":"2021-07-29T00:00:00Z","timestamp":1627516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"University Hospitals Cleveland Medical Center"},{"DOI":"10.13039\/100012729","name":"Clinical and Translational Science Collaborative of Cleveland","doi-asserted-by":"publisher","award":["UL1TR002548"],"award-info":[{"award-number":["UL1TR002548"]}],"id":[{"id":"10.13039\/100012729","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>We investigated the association of vitamin K and vitamin D with coronavirus disease 2019 (COVID-19) outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Levels of inactive vitamin K\u2013dependent dephosphorylated uncarboxylated matrix Gla protein (dp-ucMGP; marker of vitamin K status) and 25-hydroxyvitamin D (25(OH)D; vitamin D status) were measured in plasma samples from participants with confirmed acute COVID-19 and were age- and sex-matched to healthy controls. Unadjusted odds ratios and adjusted odds ratios (AORs) with 95% CIs were computed using cumulative logistic regression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>One hundred fifty subjects were included, 100 COVID-19+ and 50 controls. The median age (interquartile range) was 55 (48\u201363) years, and 50% were females. Thirty-four percent had mild COVID-19 disease, 51% moderate disease, and 15% severe. Dp-ucMGP levels were higher (ie, worse K status) in COVID-19+ vs controls (776.5 ng\/mL vs 549.8 ng\/mL; P &amp;lt; .0001) with similar 25(OH)D between groups (25.8 vs 21.9 ng\/mL; P = .09). Participants who were vitamin D deficient (&amp;lt;20 ng\/mL) had the worse vitamin K status (dp-ucMGP &amp;gt;780 ng\/mL) and experienced the most severe COVID-19 outcomes. In adjusted models, every 1-unit increase in the log2 dp-ucMGP nearly doubled the odds of acute critical disease or death (AOR, 1.84; 95% CI, 1.01\u20133.45), and every 1-unit decrease in the natural log 25(OH)D was associated with &amp;gt;3 times the likelihood of severe COVID-19 disease (AOR, 0.29; 95% CI, 0.11\u20130.67).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Early in acute COVID-19, both vitamin K and vitamin D deficiency were independently associated with worse COVID-19 disease severity, suggesting a potential synergistic interplay between these 2 vitamins in COVID-19.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofab408","type":"journal-article","created":{"date-parts":[[2021,7,29]],"date-time":"2021-07-29T15:14:25Z","timestamp":1627571665000},"source":"Crossref","is-referenced-by-count":33,"title":["Vitamin K &amp; D Deficiencies Are Independently Associated With COVID-19 Disease Severity"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5478-4814","authenticated-orcid":false,"given":"Ankita P","family":"Desai","sequence":"first","affiliation":[{"name":"University Hospitals Cleveland Medical Center; Cleveland, Ohio, USA"},{"name":"Rainbow Babies and Children\u2019s Hospital, Cleveland, Ohio, USA"},{"name":"Case Western Reserve University, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sahera","family":"Dirajlal-Fargo","sequence":"additional","affiliation":[{"name":"University Hospitals Cleveland Medical Center; Cleveland, Ohio, USA"},{"name":"Rainbow Babies and Children\u2019s Hospital, Cleveland, Ohio, USA"},{"name":"Case Western Reserve University, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jared C","family":"Durieux","sequence":"additional","affiliation":[{"name":"University Hospitals Cleveland Medical Center; Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather","family":"Tribout","sequence":"additional","affiliation":[{"name":"University Hospitals Cleveland Medical Center; Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle","family":"Labbato","sequence":"additional","affiliation":[{"name":"University Hospitals Cleveland Medical Center; Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace A","family":"McComsey","sequence":"additional","affiliation":[{"name":"University Hospitals Cleveland Medical Center; Cleveland, Ohio, USA"},{"name":"Rainbow Babies and Children\u2019s Hospital, Cleveland, Ohio, USA"},{"name":"Case Western Reserve University, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,7,29]]},"reference":[{"key":"2021100907124301300_CIT0001","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1001\/jama.2020.12839","article-title":"Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review","volume":"324","author":"Wiersinga","year":"2020","journal-title":"JAMA"},{"key":"2021100907124301300_CIT0002","doi-asserted-by":"crossref","first-page":"2199","DOI":"10.1093\/cid\/ciaa576","article-title":"Risk factors for severe disease and efficacy of treatment in patients infected with COVID-19: a systematic review, meta-analysis, and meta-regression analysis","volume":"71","author":"Zhang","year":"2020","journal-title":"Clin Infect Dis"},{"key":"2021100907124301300_CIT0003","article-title":"COVID-19: the inflammation link and the role of nutrition in potential mitigation","volume":"12:1466","author":"Zabetakis","year":"2020","journal-title":"Nutrients"},{"key":"2021100907124301300_CIT0004","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/S0304-4165(02)00147-2","article-title":"Differential lipoprotein transport pathways of K-vitamins in healthy subjects","volume":"1570","author":"Schurgers","year":"2002","journal-title":"Biochim Biophys Acta"},{"key":"2021100907124301300_CIT0005","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/j.critrevonc.2013.07.004","article-title":"Protein S: a multifunctional anticoagulant vitamin K-dependent protein at the crossroads of coagulation, inflammation, angiogenesis, and cancer","volume":"88","author":"Suleiman","year":"2013","journal-title":"Crit Rev Oncol Hematol"},{"key":"2021100907124301300_CIT0006","first-page":"; 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