Evaluation and comparison of vitamin A supplementation with standard therapies in the treatment of patients with COVID-19

Abstract

Background: Incomplete data are presented to determine the role of vitamin A supplement therapy to improve outcomes in patients with coronavirus disease 2019 (COVID-19). Aims: We compared treatment effects between a groups that received vitamin A added to the standard COVID-19 treatment and a group that received the standard drug treatment alone. Methods: In this triple-blind controlled trial, the participants comprised 182 COVID-19 outpatients in Saveh city, Markazi Province, Islamic Republic of Iran, in 2020. Patients were randomly divided into experimental (n = 91) and control (n = 91) groups. Patients in the control group received the national standard treatment for COVID-19 (hydroxychloroquine), and those in the intervention group received 25 000 IU/d oral vitamin A for 10 days in addition to the standard treatment recommended by the national protocol. We evaluated the clinical symptoms, paraclinical criteria and hospitalization status before and 10 days after both interventions. Results: The treatment groups did not differ significantly in terms of clinical and paraclinical symptoms before the intervention, but clinical symptoms such as fever, body ache, weakness and fatigue, paraclinical symptoms, white blood cell count and C-reactive protein showed a significantly greater decrease in the experimental group 10 days post-intervention compared with the standard treatment alone (P < 0.05). Conclusion: Vitamin A supplement demonstrated efficacy in improving some clinical and paraclinical symptoms in patients with COVID-19. Future studies should evaluate vitamin A supplementation with a larger sample size and compare different dosages, especially in hospitalized patients.

Role of Antioxidant Therapy in the Treatment and Prognosis of COVID-19: A Systematic Review and Meta-analysis of Randomized Controlled Trials

“…Supplemental Table 1 presents the key data extracted from each included study. Studies included were published between 2020 and 2023, with 1 published in 2020 [ 19 ], 12 in 2021 [ [7] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [29] , [30] , [31] ], 10 in 2022 [ [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] ], and 2 in 2023 [ 42 , 43 ].…”

“…Geographic setting varied across the studies, with 9 studies from Iran [ [20] , [21] , [22] , [23] , [32] , [33] , [34] , [35] , [36] ], 3 from the United States [ 24 , 37 , 43 ], 2 from China [ 25 , 39 ], 2 from Tunisia [ 42 , 43 ], 2 from India [ 7 , 41 ] and the remaining 7, with 1 each from Egypt [ 26 ], Saudi Arabia [ 27 ], Israel [ 40 ], Pakistan [ 19 ], Australia [ 29 ], Spain [ 30 ], and Turkey [ 31 ].…”

“…The study populations were primarily in-patients with SARS-CoV-2 infection and moderate disease severity, as seen in 19 studies [ [7] , [19] , [20] , [21] , [22] , [23] , [25] , [26] , [27] , [29] , [30] , [31] , [32] , [33] , 35 , 36 , [38] , [39] , [40] ], whereas 6 focused on outpatients exhibiting acute symptoms [ 24 , 28 , 34 , 37 , 41 , 42 ]. Interestingly, 1 study assessed both inpatient and outpatient groups [ 43 ].…”

“…Regarding the specific interventions, 3 studies (12%) [ 26 , 29 , 43 ] assessed the impact of zinc interventions on outcomes such as time to recovery, mortality, number of ICU admissions, hospitalization length and rate, symptom duration, and requirement for oxygen support ( Table 1 ). Two studies (8%) [ 34 , 35 ] assessed the impact of vitamin A on symptom duration, oxygen saturation, number and duration of hospitalizations, mortality, use of invasive mechanical ventilation, and change in inflammatory markers ( Table 2 ). Vitamin C, either alone or in combination with standard of care treatment, was evaluated in 8 (32%) studies [ 19 , 22 , 23 , 25 , 33 , [36] , [37] , [38] ] ( Table 3 ), with outcomes including clinical improvement, time to discharge, number and duration of hospitalizations, inflammatory marker changes, mortality, and the need for mechanical ventilation.…”

Nutraceuticals for Complementary Treatment of Multisystem Inflammatory Syndrome in Children: A Perspective from Their Use in COVID-19

“…On the other hand, in COVID-19 patients, vitamin A plasma levels are reduced, which is related to acute respiratory syndrome due to vitamin A having immune regulatory functions [ 188 ]. It also reduces fever, body aches, weakness and fatigue, paraclinical symptoms, WBC count, and CRP levels [ 130 ]. However, excessive utilization of vitamin A often results in local and systemic toxicity [ 189 ].…”