A cohort study to evaluate the effect of combination Vitamin D, Magnesium and Vitamin B12 (DMB) on progression to severe outcome in older COVID-19 patients

Abstract

Objective: To determine the clinical outcomes of older COVID-19 patients who received DMB compared to those who did not. We hypothesized that fewer patients administered DMB would require oxygen therapy and/or intensive care support than those who did not. Methodology: Cohort observational study of all consecutive hospitalized COVID-19 patients aged 50 and above in a tertiary academic hospital who received DMB compared to a recent cohort who did not. Patients were administered oral vitamin D3 1000 IU OD, magnesium 150mg OD and vitamin B12 500mcg OD (DMB) upon admission if they did not require oxygen therapy. Primary outcome was deterioration post-DMB administration leading to any form of oxygen therapy and/or intensive care support. Results: Between 15 January and 15 April 2020, 43 consecutive COVID-19 patients aged ≥50 were identified. 17 patients received DMB and 26 patients did not. Baseline demographic characteristics between the two groups was significantly different in age. In univariate analysis, age and hypertension showed significant influence on outcome while DMB retained protective significance after adjusting for age or hypertension separately in multivariate analysis. Fewer DMB patients than controls required initiation of oxygen therapy during their hospitalization (17.6% vs 61.5%, P=0.006). DMB exposure was associated with odds ratios of 0.13 (95% CI: 0.03 − 0.59) and 0.20 (95% CI: 0.04 − 0.93) for oxygen therapy and/or intensive care support on univariate and multivariate analyses respectively. Conclusions: DMB combination in older COVID-19 patients was associated with a significant reduction in proportion of patients with clinical deterioration requiring oxygen support and/or intensive care support. This study supports further larger randomized control trials to ascertain the full benefit of DMB in ameliorating COVID-19 severity.

A Basic Review of the Preliminary Evidence That COVID-19 Risk and Severity Is Increased in Vitamin D Deficiency

“…Tan et al, compared the 26 consecutive patients 50 years or older not requiring oxygen on admission who were hospitalized immediately prior to initiation of a daily oral combination of 1,000 IU vitamin D 3 , 150 mg magnesium, and 500 mcg vitamin B 12 with the next 17 consecutive patients meeting the same criteria to determine if these supplements altered support needs (217). Of the 9 patients supplemented within a week of symptom onset, only one required oxygen, and that was within 24 h of supplement initiation (217).…”

Effective Immune Functions of Micronutrients against SARS-CoV-2

“…Vitamins B 6 , B 12 , and B 9 (folic acid) enhance natural killer cell activity, which provides an important antiviral defense [ 80 ]. These findings suggest that B vitamins have the potential to limit the complication related to COVID-19 infection [ 81 ]. In view of the studies mentioned above, it is obvious that vitamin B has a crucial role in regulating the inflammatory response, amino acid synthesis, and the proliferation of lymphocytes.…”

Clinical Impact Potential of Supplemental Nutrients as Adjuncts of Therapy in High-Risk COVID-19 for Obese Patients

“…Li et al (78) reported that MgSO 4 administration reduced the PARP-1 and apoptosis-inducing factor levels in LPS induced ALI mice. Recently Tan et al (165) observed that the administration of oral vitamin D, Mg, and vitamin B12 combination reduces the clinical deterioration in COVID-19 patients. Mg nutrition may be an effective strategy for the treatment and prevention of COVID-19 infection (166,167).…”