Multivitamin supplementation reduced disease severity of COVID-19 in ICU patients – Iranian clinical trial
They undertook a randomized and single-blinded clinical trial in which 60 subjects were assigned to two groups.
The intervention group (n=30) received vitamins, and the control group did not receive any vitamin or placebo.
The intervention included 25,000 IU daily of vitamins A, 600,000 IU once during the study of D, 300 IU twice daily of E, 500 mg four times daily of C, and one amp daily of B complex for 7 days.
At baseline and after the 7-day intervention, the serum levels of inflammatory markers, vitamins, and the Sequential Organ Failure Assessment (SOFA) score.
The SOFA score is a tool for evaluating organ failure and the risk of mortality in the ICU, by assigning individual scores for each organ to determine progression of dysfunction.
In addition, the mortality rate and duration of hospitalisation were evaluated after the intervention.
While the effect of vitamins on the mortality rate was not statistically significant, it did significantly decrease the serum levels of inflammatory markers and severity of the disease.
It also appeared to reduce the prolonged hospitalisation rate, although the likelihood of this effect was not significant after adjusting for confounders.
There were also significant improvements in the SOFA score among the intervention group.
The researchers wrote: ”Significant changes were detected in serum levels of vitamins (p < 0.001 for all vitamins), ESR (p < 0.001), CRP (p = 0.001), IL6 (p = 0.003), TNF-a (p = 0.001), and SOFA score (p < 0.001) after intervention compared with the control group. The effect of vitamins on the mortality rate was not statistically significant (p=0.112).
“The prolonged hospitalisation rate to more than 7 days was significantly lower in the intervention group than the control group (p=0.001). Regarding the effect size, there was a significant and inverse association between receiving the intervention and prolonged hospitalisation (OR = 0.135, 95% CI 0.038–0.481; p=0.002); however, after adjusting for confounders, it was not significant (OR=0.402, 95% CI 0.086–1.883; p=0.247).”
The researchers believe the study is the first RCT to examine whether the simultaneous use of supplements including different vitamins has beneficial effects on clinical and laboratory outcomes of patients with COVID-19 admitted to ICU.
They added: “Other strength points were the homogenous group of patients and the complete follow-up for the intention-to-treat analysis of the main endpoints.
“However, this study could not show the effect of any type of vitamins separately, we have expressed our applicable results of the synergistic effect of simultaneous usage of all vitamins that are recommended in numerous studies especially in the critical situation of COVID-19 all over the world. This study recommended further studies that result in anti-coronavirus multivitamin production.”
They acknowledged that limitations included the relatively small sample size and the inability to use a placebo in the ICU setting.
However, they concluded: “Overall, in ICU-admitted patients with COVID-19, supplementation with vitamins A, B, C, D, and E was associated with less severe COVID-19 presentation and reduced serum levels of inflammatory markers.”
“The effect of supplementation with vitamins A, B, C, D, and E on disease severity and inflammatory responses in patients with COVID-19: a randomized clinical trial”
Authors: Mohammad Taghi Beigmohammadi, et al