Could Vitamins Help in the Fight Against COVID-19?

Jovic, Thomas H.; Ali, Stephen R; Ibrahim, N. B. N.; Jessop, Zita M.; Tarassoli, Sam P.; Dobbs, Thomas D.; Holford, Patrick; Thornton, Catherine A.; Whitaker, Iain S.

doi:10.3390/nu12092550

Cited by 191 publications

(249 citation statements)

References 188 publications

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“…In addition to its role in cellular and humoral immunity, vitamin D, similar to zinc and vitamin C, plays an important role in the formation and maintenance of epithelial and endothelial barriers, including lung tissue (17,19,(144)(145)(146). Using a vitamin D receptor knockout mouse model, Chen et al (146) observed that in the absence of this hormone signaling, the animals exhibited lung inflammation and impaired lung function, which can be explained by the increased pulmonary permeability resulting from impairment of the integrity of the epithelial barrier.…”

Section: Vitamin Dmentioning

confidence: 99%

“…Inadequate nutrition is considered a contributing factor to the emergence of viral infection due to its contribution to weakness of immune system, which increases the rate of infections and the risk of mortality and morbidity. Moreover, viral infections increase the demand for several micronutrients such as vitamin A, B, C, D, zinc, and selenium (17)(18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

“…Dietary supplementation of micronutrients with recognized roles in immune function can optimize the modulation of the body's immune response, reducing the risk of infections (19,(21)(22)(23)(24)(25). In this context, zinc and vitamins C and D are the micronutrients for which there is robust evidence of their immunomodulating activity, such that their deficiency, even if marginal, can compromise metabolism and, consequently, their action on the immune system, a concept grounded by the triage theory 1 proposed by Ames (26) and the Law of the Minimum 2 proposed by Justus von Liebig in 1840 (10,17,(24)(25)(26)(27)(28)(29)(30).…”

Section: Introductionmentioning

confidence: 99%

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Zinc, Vitamin D and Vitamin C: Perspectives for COVID-19 With a Focus on Physical Tissue Barrier Integrity

et al. 2020

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Some nutrients play key roles in maintaining the integrity and function of the immune system, presenting synergistic actions in steps determinant for the immune response. Among these elements, zinc and vitamins C and D stand out for having immunomodulatory functions and for playing roles in preserving physical tissue barriers. Considering the COVID-19 pandemic, nutrients that can optimize the immune system to prevent or lower the risk of severe progression and prognosis of this viral infection become relevant. Thus, the present review aims to provide a comprehensive overview of the roles of zinc and vitamins C and D in the immune response to viral infections, focusing on the synergistic action of these nutrients in the maintenance of physical tissue barriers, such as the skin and mucous membranes. The evidence found in the literature shows that deficiency of one or more of these three elements compromises the immune response, making an individual more vulnerable to viral infections and to a worse disease prognosis. Thus, during the COVID-19 pandemic, the adequate intake of zinc and vitamins C and D may represent a promising pharmacological tool due to the high demand for these nutrients in the case of contact with the virus and onset of the inflammatory process. Ongoing clinical trials will help to clarify the role of these nutrients for COVID-19 management.

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Section: Vitamin Dmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Zinc, Vitamin D and Vitamin C: Perspectives for COVID-19 With a Focus on Physical Tissue Barrier Integrity

et al. 2020

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“…with doses between 2 and 8 g/day in hospitalised patients due to increased need when fighting a viral infection as concluded by three recent reviews. [128] [129] [130] People in high-risk groups for COVID-19 mortality, and at risk of vitamin C deficiency, should be encouraged to supplement with vitamin C daily to ensure vitamin C adequacy at all times, and to increase the dose when virally infected to up to 6-8 g/day [131]. Whether or not this will prevent conversion to the critical phase in COVID-19 has yet to be determined.…”

Section: Discussionmentioning

confidence: 99%

Vitamin C—An Adjunctive Therapy for Respiratory Infection, Sepsis and COVID-19

Holford¹,

Carr²,

Jovic³

et al. 2020

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There are limited proven therapies for the treatment of COVID-19. Vitamin C’s antioxidant, anti-inflammatory and immunomodulating effects, make it a potential therapeutic candidate, both for the prevention and amelioration of COVID-19 infection, and as an adjunctive therapy in the critical care of COVID-19, supporting anti-inflammatory treatment. This literature review focuses on vitamin C deficiency in respiratory infections including COVID-19; the mechanism of action in infectious disease and adrenal function supporting the anti-inflammatory actions of glucocorticosteroids: its role in preventing and treating colds and pneumonia and its role in treating sepsis and COVID-19. The evidence to date indicates that oral vitamin C (2-8g/d) may reduce incidence and duration of respiratory infections and intravenous vitamin C (2-24g/d) has been shown to reduce mortality, Intensive Care Unit and hospital stays, time on mechanical ventilation in severe respiratory infections. Further trials are urgently warranted. Given the favourable safety profile and low cost of vitamin C, and frequency of vitamin C deficiency in respiratory infections it may be worthwhile testing patients’ vitamin C status and treating accordingly with intravenous use within ICUs and orally with doses between 2 and 8g/day in hospitalised and infected persons.

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“…Vitamin B [7] This is a group of water-soluble vitamins. Vitamin B6 (pyridoxine) and B12 (cobalamin) play an important role in the innate and adaptive immune response.…”

Section: Introductionmentioning

confidence: 99%

Zinc and Vitamin a Deficiency Predisposes to the Need for Intubation and Icu Admission in Patients With COVID-19. An Observational Study

Berrocal

Irriguible

Philibert

et al. 2020

Preprint

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Objective: To analyse whether the micronutrient deficit predicts a worse prognosis in patients infected by SARS-CoV-2 who developed the COVID-19 disease.Methods: We carried out an observational and retrospective study with 120 patients admitted for COVID-19 in the ICU and in the Internal Medicine ward of a tertiary hospital. In the nutritional admission analysis of these patients, we analysed plasmatic levels of vitamins A, B6, C, D, E and zinc. In addition, different variables of interest were collected, such as the need for orotracheal intubation, hospital stay, mortality and multi-organ failure.Results: One hundred and twenty patients were included. The independent variables associated with the need for ICU admission were low levels of zinc (standard error 0.566, 95% CI 0.086 to 0.790, p = 0.017), low levels of vitamin A (standard error 0.582, 95% CI 0.061 to 0.594, p = 0.004), age over 65 (standard error 0.018, 95% CI 0.917 to 0.985, p = 0.005) and male gender (standard error 0.458, 95% CI 1.004 to 6.040, p = 0.049). The only variable that was independently associated with the need for orotracheal intubation was vitamin A deficiency (standard error 0.58, 95% CI 0.042 to 0.405, p = 0.000).Conclusions: Low levels of vitamin A and zinc are associated with a greater need for admission to the ICU and orotracheal intubation. Patients older than 65 years had higher mortality. Randomized clinical trials are needed to examine whether micronutrient supplementation could be beneficial as an adjunctive treatment in COVID-19.

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Could Vitamins Help in the Fight Against COVID-19?

Cited by 191 publications

References 188 publications

Zinc, Vitamin D and Vitamin C: Perspectives for COVID-19 With a Focus on Physical Tissue Barrier Integrity

Zinc, Vitamin D and Vitamin C: Perspectives for COVID-19 With a Focus on Physical Tissue Barrier Integrity

Vitamin C—An Adjunctive Therapy for Respiratory Infection, Sepsis and COVID-19

Zinc and Vitamin a Deficiency Predisposes to the Need for Intubation and Icu Admission in Patients With COVID-19. An Observational Study

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