Erfani Zahra, Alizadeh Nafiseh, Faraji Neda, Teymouri Alireza
School of Medicine Tehran University of Medical Sciences Tehran Iran.
Baharlou Hospital Research Center Tehran University of Medical Sciences Tehran Iran.
Health Sci Rep. 2023 Sep 14;6(9):e1509. doi: 10.1002/hsr2.1509. eCollection 2023 Sep.
Since 2019, severe acute respiratory syndrome coronavirus 2, has spread and challenged the health care system for treatment which is mainly limited to supportive care. It is well-established that malnutrition impedes the immunity in human bodies, and makes it vulnerable to microorganisms. Vitamin B12 is one of the agents that has critical roles in body systems. Thus, the following clinical trial was conducted to assess its possible therapeutic value in COVID-19 patients.
The present randomized clinical trial was carried out in Baharlou Hospital, and patients with confirmed COVID-19 infection within 24 h of admission were included. We used quadruple blocks randomization to divide patients into groups of case and control. The case group received 1000 mg of vitamin B12, daily for 7 day while the patients in control group were administered distilled water as placebo. The studied outcomes were duration of hospitalization, need for intensive care unit (ICU), mechanical ventilation, mortality rate and laboratory findings. The statistical analysis was done via SPSS version 22.
After implementing inclusion and exclusion criteria, 34 participants were included in the study, 20 of which were male. Serum levels of creatinine, LDH (Lactate dehydrogenase), Ferritin, and CRP (C-reactive protein) had decreased in both groups. The improving changes of CRP, LDH, ferritin and creatinine was higher in case group. The increase of Alanine Transaminase and D-dimer was higher in control group. however there was no statistically significant difference. More patients were admitted to ICU in the control group but the difference was not statistically significant. Duration of hospitalization did not differ statistically between the groups. No in hospital mortality has been recorded.
Our study suggests that vitamin B12 supplementation seem to have curative effect in COVID-19. Nutritious diet is necessary for proper functioning of the immune system. Since malnutrition is associated with poor prognosis in COVID-19 patients, and limited number of participants in this study, we suggest performing meta-analysis on similar studies to reach reliable result.
自2019年以来，严重急性呼吸综合征冠状病毒2已传播并对主要局限于支持性治疗的医疗保健系统构成挑战。众所周知，营养不良会阻碍人体免疫力，使人易受微生物侵害。维生素B12是在人体系统中发挥关键作用的物质之一。因此，开展了以下临床试验以评估其在新冠肺炎患者中的潜在治疗价值。
本随机临床试验在巴哈卢医院进行，纳入入院24小时内确诊为新冠肺炎感染的患者。我们采用四重区组随机化将患者分为病例组和对照组。病例组每天接受1000毫克维生素B12，共7天，而对照组患者则给予蒸馏水作为安慰剂。研究的结果指标包括住院时间、入住重症监护病房（ICU）的需求、机械通气、死亡率和实验室检查结果。通过SPSS 22版进行统计分析。
在实施纳入和排除标准后，34名参与者被纳入研究，其中20名男性。两组的血清肌酐、乳酸脱氢酶（LDH）、铁蛋白和C反应蛋白（CRP）水平均有所下降。病例组中CRP、LDH、铁蛋白和肌酐的改善变化更高。对照组中丙氨酸转氨酶和D-二聚体的升高更高。然而，差异无统计学意义。对照组有更多患者入住ICU，但差异无统计学意义。两组之间的住院时间在统计学上没有差异。未记录到院内死亡病例。
我们的研究表明，补充维生素B12似乎对新冠肺炎有治疗作用。营养饮食对于免疫系统的正常运作是必要的。由于营养不良与新冠肺炎患者的不良预后相关，且本研究的参与者数量有限，我们建议对类似研究进行荟萃分析以获得可靠结果。
