Rationale and Experience of Vitamin B12 Usage in Complex Therapy of COVID-19 and Post-COVID Syndrome

Abstract

Aim. Analysis of vitamin B12 deficiency as a risk factor for severe novel coronavirus infection and its possible use as adjuvant therapy in the management of COVID-19. Key points. The COVID-19 poses the greatest risk to older people and patients with diabetes mellitus type 2. These categories of patients often require long-term hospitalization and intensive care, and the prognosis of the disease and the risk of life-threatening complications are much higher than the average in the population. Determining the risk factors for a severe course of COVID-19 and the mechanisms of their occurrence helps to choose the optimal treatment tactics and significantly improve the prognosis of recovery, reduce the negative consequences of the disease, the so-called post-COVID syndrome, and shorten the rehabilitation period for patients after COVID-19. One of the hypotheses explaining the increased risk of severe COVID-19 in these groups of patients is vitamin B12 deficiency. Perhaps this factor is unifying for the elderly and patients with type 2 diabetes mellitus. Thus, the question arises whether the elimination of B12 deficiency will affect mortality from COVID-19 or recovery rates. In this review, we will analize the latest evidence that shows B12 is involved in many immunological, microbiological and hematological processes that are the target of coronavirus infection. Conclusion. Our review data confirms the hypothesis that B12 deficiency is a potential risk factor for severe COVID-19, and replacement of this deficiency by prescribing vitamin B12 therapy can be considered as adjuvant therapy and prevention of complications for these categories of patients. Keywords: novel coronavirus infection, COVID-19, SARS-CoV-2, vitamin B12, cobalamin, diabetes mellitus type 2, metformin, rehabilitation.