Relação das vitaminas A e E na infecção por Sars-Cov-2

Abstract

COVID-19 is a disease caused by SARS-CoV-2, a new coronavirus first identified in Wuhan (China) and quickly explained worldwide, which affects the immune system causing exacerbated inflammation. Viral infections can lead to depleted levels of some vitamins, such as vitamins A and E, and inadequate nutrient levels can be harmful to health. The aim of this study was to investigate the association between COVID-19 and serum levels of these vitamins. Two works were carried out: a systematic review and an experimental study. A systematic review was performed according to the PRISMA statement, using three different databases. Data from the articles were collected and analyzed by two independent investigators. The quality of in vivo studies was also assessed. A total of 4,572 articles were identified, of which 10 met the inclusion criteria. Three of them were related to vitamin A, two to vitamin E and five related both vitamins to COVID-19. The case-control study was carried out between May and October 2020. Clinical data were collected through face-to-face interviews or telephone contact and through access to the medical records of patients hospitalized with COVID-19. The control group came from the database of a previous study by our research group, recruited from a university hospital in the city of Natal/RN - Brazil, whose data collection was carried out before 2019 (before the pandemic) and the participants never diagnosis of COVID-19. Thus, participants were allocated into two groups according to the severity of the disease, classified as levels (n = 88) or critical (n = 106) and a control group (n = 46). As a result of this study, patients with COVID-19 showed reduced concentrations of vitamin A and E, being below or close to the reference values for deficiency. Our medications suggest that COVID-19 and critically ill patients have reduced retinol levels compared to healthy controls (p = 0.03), which may vary according to severity. Additionally, higher levels of COVID-19 cases were associated with increased symptoms and prolonged symptoms after 90 days from the onset of infection. However, a survival analysis showed no association between higher deaths among patients with vitamin A deficiency (p = 0.509). More studies are needed to understand how nutritional status, including vitamin A levels, may influence longterm COVID syndrome.