Antioxidants and clinical outcomes of patients with coronavirus disease 2019: A systematic review of observational and interventional studies

Abstract

Coronavirus disease 2019 (COVID‐19) is a newly emerging viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). Oxidative stress appears to be a prominent contributor to the pathogenicity of SARS‐CoV‐2. Therefore, we carried out a systematic review of human observational and interventional studies to investigate the role of some antioxidants such as vitamins A, E, D, and C, selenium, zinc, and α‐lipoic acid in the main clinical outcomes of subjects with COVID‐19. Google Scholar, Cochrane Library, Web of Science, Scopus, and Medline were searched using Medical Subject Headings (MeSH) and non‐MeSH terms without restrictions. Finally, 36 studies for vitamins C and D, selenium, and zinc were included in this systematic review; however, no eligible studies were found for vitamins A and E as well as α‐lipoic acid. The results showed the promising role of vitamin C in inflammation, Horowitz index, and mortality; vitamin D in disease manifestations and severity, inflammatory markers, lung involvement, ventilation requirement, hospitalization, intensive care unit (ICU) admission, and mortality; selenium in cure rate and mortality; and zinc in ventilation requirement, hospitalization, ICU admission, biomarkers of inflammation and bacterial infection, and disease complications. In conclusion, it seems that antioxidants, especially vitamins C and D, selenium, and zinc, can improve multiple COVID‐19 clinical outcomes. Nevertheless, more studies are necessary to affirm these results.

The effect of ginger (Zingiber officinale) supplementation on clinical, biochemical, and anthropometric parameters in patients with multiple sclerosis: a double-blind randomized controlled trial

“…In the follow-up period, one participant in the intervention group and two participants in the control group dropped out due to coronavirus disease 2019 (COVID-19), a respiratory illness caused by SARS-CoV-2. 36 Nevertheless, all 52 participants were included in the statistical analysis according to the ITT principle (Fig. 1).…”

“…(COVID-19), a respiratory illness caused by SARS-CoV-2. 36 Nevertheless, all 52 participants were included in the statistical analysis according to the ITT principle (Fig. 1).…”

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

“…In the context of existing literature, a previous systematic review of observational and intervention studies ( n = 36) investigated the impact of antioxidants, such as vitamins C and D, selenium, and zinc, on key clinical outcomes in patients with SARS-CoV-2 infection [ 44 ]. The study noted improvements in inflammation, the Horowitz index, and mortality rates following vitamin C supplementation, with selenium and zinc influencing cure rates, ventilation requirements, ICU admissions, and disease complications.…”

The effectiveness of nano‐curcumin on patients with COVID‐19: A systematic review of clinical trials

“…For example, nano‐curcumin supplementation caused significant improvement in IL‐6, IL‐8, IL‐10, IL‐18, IL‐1β, TNF‐α, procalcitonin, toll‐like receptor‐4, B‐cell lymphoma‐2, BCL‐2‐associated X protein, malondialdehyde, NRF2, catalase, superoxide dismutase (SOD), total antioxidant capacity, erythrocyte sedimentation rate, WBC, neutrophils, lymphocytes, platelets, sequential organ failure assessment score, and mechanical ventilation duration in ICU patients with sepsis (Karimi et al, 2020; Karimi et al, 2022; Naeini et al, 2022). These clinical outcomes, especially consecutive monitoring of IL‐6 (Chen et al, 2021), are important for patients with COVID‐19 (Foshati et al, 2022). Therefore, as the results of this systematic review showed, nano‐curcumin supplementation may be regarded as a promising choice for COVID‐19 management.…”