On the prospects for the use of thiamine, pyridoxine, and cyanocobalamin in the complex therapy and rehabilitation of patients with COVID-19

Abstract

The new coronavirus infection COVID-19 has highlighted the importance of ongoing support for innate antiviral immunity systems. The aim. Conduct a systematic review of publications on the research of the use of B vitamins to support immunity and rehabilitation of patients with COVID-19. Methods. Intelligent analysis of so-called Big Data and special computational methods for analyzing Big Data of biomedical publications, based on the topological theory of sentiment analysis of medical texts from PubMed/MEDLINE. Results. Low levels of B vitamins contribute to chronic comorbidities and aggravate the clinical course of COVID-19 significantly. Increasing the supply of B vitamins in COVID-19 patients is essential for the maintenance of energy and oxygen metabolism; the direct antiviral effects of vitamins (reduction of SARS-CoV-2 replication); compensation of chronic comorbidities (thromboembolism, impaired liver and kidney functions, diabetes mellitus, polyneuropathy), which aggravate the course of COVID-19; reducing hyperhomocysteinemia and chronic aseptic inflammation; inhibiting carbonic anhydrases to improve oxygen metabolism in the lungs, and increasing the clearance of lactate from the blood and preventing sepsis. Conclusion. By improving myelination of the olfactory sensory neurons, vitamin B 12 can help overcome anosmia, which occurs in 80% of COVID-19 patients. Short courses (up to 2 – 3 weeks) of high-dose parenteral therapy with thiamine, pyridoxine, and cyanocobalamin can be used as a part of a complex of therapeutic measures to improve clinical outcomes in patients with COVID-19, especially in elderly patients with polyhypovitaminosis, diabetes mellitus, hyperhomocysteinemia, thrombophilia, and high risk of sepsis. Oral therapy with thiamine, pyridoxine, and cyanocobalamin is justified as a part of rehabilitation measures after COVID-19 in patients who have faced its consequences in the form of clinical signs of vitamin B vitamin deficiency.