Vitamins C and D and COVID-19 Susceptibility, Severity and Progression: An Evidence Based Systematic Review

Abstract

Background and Objectives: Starting in early December 2019, the novel Coronavirus Disease (COVID-19) from infection with COVID-19 has caused a global pandemic. Many aspects of its pathogenesis and related clinical consequences are still unclear. Early diagnosis and dynamic monitoring of prognostic factors are essential to improve the ability to manage COVID-19 infection. This study aimed to provide an account of the role played by vitamins C and D on the onset, progression and severity of COVID-19. Clinical features and infection-related risk factors are also briefly discussed. Material and Methods: In March 2022, the main online databases were accessed. All the articles that investigate the possible role of vitamins C and D on COVID-19 susceptibility, severity and progression were considered. Results: The current evidence on vitamin C and D supplementation in patients with COVID-19 infection is inconsistent and controversial. In some studies, vitamins were used as coadjuvant of a formal experimental therapy, while in others as main treatment. Ethnicity and hospital setting (inpatient/outpatient) were also variable. Moreover, there was no consensus between studies in administration protocol: high heterogeneity in dosage, administration, and duration of the treatment were evident. Finally, some studies administered vitamins pre- and/or during COVID infection, in patients with different risk factors and infection severity. Conclusions: While waiting to develop a targeted, safe and effective therapy, it is important to investigate individual predisposition and proper disease management. Concluding, available data on the use of nutraceuticals in COVID-19 are inconsistent. However, there is a lack of evidence-based guidelines which recommend vitamin C and D supplementation in patients with COVID-19, and results from high quality randomised controlled trials (RCTs) are inconsistent. Current investigations so far are mostly observational, and include a relatively small sample size which can lead to biased results. Large-scale multicentre studies are therefore needed.

Vitamin C Supplementation for the Treatment of COVID-19: A Systematic Review and Meta-Analysis

“…Gavrielatou et al revealed that the use of vitamin C in the ICU has no impact on mortality rate, at least in the short course of treatment, which is in line with our findings [ 37 ]. Moreover, Migliorini et al stated that it is too soon to make any evidence-based recommendations regarding the role of vitamin C in COVID-19 treatment [ 58 ]. A meta-analysis of randomized clinical trials showed that vitamin C did not affect mortality, the ICU length of stay, or the need for invasive mechanical ventilation.…”

Risk factors for postoperative medical morbidity and 3-month mortality in elderly patients with hip fracture following hip arthroplasty during COVID-19 pandemic

“…Previous studies also showed that preoperative risk factors for in-hospital mortality were advanced age, presence of comorbid diseases such as dementia, and renal or cerebrovascular disease [ 27 , 28 ], and patients with a diagnosis of dementia had higher in-hospital mortality ( P < 0.001) [ 28 ]. The two retrospective studies included a combined total of 40,958 and showed that patients with dementia and age over 90 years old have a higher 90 day and 1-year mortality with hazards of 88% ( P = 0.01) and 75% ( P = 0.01), respectively [ 29 , 30 ]. In this study, dementia was not associated with 3-month mortality, which may be related to the low number of dementia patients.…”

“…When patients sustain a hip fracture, they are forced to lie flat in a bed and are either in pain or needing analgesic medications, which often have side effects [ 34 , 35 ]. Previous study found that patients who received operation within 2 days after injury had lower in-hospital mortality and had better outcomes [ 30 , 36 , 37 ]. In this study, we found the mean fracture to operation duration was 7.10 days in COVID-19 pandemic group, and 5.31 days in no COVID-19 pandemic group, the difference between the two groups was about 2 days, and the incidence of postoperative medical complications and 3-month mortality was 21.90% and 5.20% for COVID-19 pandemic group compared to 12.53% and 3.22% for no COVID-19 pandemic group in patients ≥ 70 years with hip fracture following HA.…”

Schützt Vitamin D vor COVID-19? Eine beschreibende Übersicht

“…Ein neuerer systematischer Review von 2022 [ 36 ] identifizierte 14 Therapiestudien mit Vitamin D, davon aber nur 5 Publikationen von randomisierten kontrollierten Studien [ 37 – 41 ]. Davon wurde eine Studie, die einen Effekt auf Besserung inflammatorischer Marker zeigte, mittlerweile zurückgezogen [ 39 ].…”