Could Vitamins Help in the Fight Against COVID-19?

Thomas H Jovic,Thomas H Jovic,Patrick Holford,Zita M Jessop,Zita M Jessop,Iain S Whitaker,Iain S Whitaker,Stephen R Ali,Stephen R Ali,Catherine A Thornton,Sam P Tarassoli,Thomas D Dobbs,Thomas D Dobbs,Nader Ibrahim,Nader Ibrahim

doi:10.3390/nu12092550

Thomas H Jovic, Thomas H Jovic + Show 13 more

Open Access

https://doi.org/10.3390/nu12092550

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Journal: Nutrients	Publication Date: Aug 23, 2020
Citations: 155	License type: CC BY 4.0

Affiliation: Swansea University, Morriston Hospital

Abstract

There are limited proven therapeutic options for the prevention and treatment of COVID-19. The role of vitamin and mineral supplementation or “immunonutrition” has previously been explored in a number of clinical trials in intensive care settings, and there are several hypotheses to support their routine use. The aim of this narrative review was to investigate whether vitamin supplementation is beneficial in COVID-19. A systematic search strategy with a narrative literature summary was designed, using the Medline, EMBASE, Cochrane Trials Register, WHO International Clinical Trial Registry, and Nexis media databases. The immune-mediating, antioxidant and antimicrobial roles of vitamins A to E were explored and their potential role in the fight against COVID-19 was evaluated. The major topics extracted for narrative synthesis were physiological and immunological roles of each vitamin, their role in respiratory infections, acute respiratory distress syndrome (ARDS), and COVID-19. Vitamins A to E highlighted potentially beneficial roles in the fight against COVID-19 via antioxidant effects, immunomodulation, enhancing natural barriers, and local paracrine signaling. Level 1 and 2 evidence supports the use of thiamine, vitamin C, and vitamin D in COVID-like respiratory diseases, ARDS, and sepsis. Although there are currently no published clinical trials due to the novelty of SARS-CoV-2 infection, there is pathophysiologic rationale for exploring the use of vitamins in this global pandemic, supported by early anecdotal reports from international groups. The final outcomes of ongoing trials of vitamin supplementation are awaited with interest.

Highlights

December 2019 saw clusters of patients in the city of Wuhan, Hubei Provence, China presenting with a severe acute respiratory syndrome coronavirus (SARS-CoV)-like illness
This review aims to interrogate the current evidence base, and to present the potential immune-mediating, antioxidant, and antimicrobial roles of vitamins A to E in the context of respiratory disease, and to extrapolate this evidence to evaluate the potential roles in the fight against COVID-19
There is currently no evidence from completed randomized controlled trials to conclusively and demonstrate a role for vitamin supplementation in the fight against COVID-19, there is strong scientific evidence, based on studies of vitamin physiology, pharmacology, and their role in clinical studies of infection and acute respiratory distress syndrome (ARDS) to indicate a role for vitamins in the battle against this global pandemic

Summary

Introduction

December 2019 saw clusters of patients in the city of Wuhan, Hubei Provence, China presenting with a severe acute respiratory syndrome coronavirus (SARS-CoV)-like illness. Previous viral pandemics due to novel corona and influenza viruses, such as SARS-CoV, Middle Eastern respiratory syndrome coronavirus (MERS-CoV), and H1N1 influenza A have been a warning to global healthcare. None of these pathogens have had such a catastrophic impact worldwide as the novel coronavirus SARS-CoV-2, a positive-sense. RNA viruses are known to possess very high mutation rates, which correlate with enhanced virulence and evolvability [2]. COVID-19 highlights the potency of this, with a case-fatality rate of 2.3% and over

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