The effect of supplementation with vitamins A, B, C, D, and E on disease severity and inflammatory responses in patients with COVID-19: a randomized clinical trial
Small RCT 60 ICU patients in Iran, 30 treated with vitamins A, B, C, D, and E, showing significant improvement in SOFA score and several inflammatory markers at day 7 with treatment.
5,000 IU vitamin A daily, 600,000 IU vitamin D once, 300 IU of vitamin E twice a day, 500 mg vitamin C four times a day, and one ampule daily of B vitamins [thiamine nitrate 3.1 mg, sodium riboflavin phosphate 4.9 mg (corresponding to vitamin B2 3.6 mg), nicotinamide 40 mg, pyridoxine hydrochloride 4.9 mg (corresponding to vitamin B6 4.0 mg), sodium pantothenate 16.5 mg (corresponding to pantothenic acid 15 mg), sodium ascorbate 113 mg (corresponding to vitamin C 100 mg), biotin 60 μg, folic acid 400 μg, and cyanocobalamin 5 μg]. [irct.ir]
risk of death, 88.9% lower, RR 0.11, p = 0.11, treatment 0 of 30 (0.0%), control 4 of 30 (13.3%), NNT 7.5, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
risk of hospitalization >7 days, 41.0% lower, RR 0.59, p = 0.25, treatment 4 of 30 (13.3%), control 16 of 30 (53.3%), NNT 2.5, adjusted per study, odds ratio converted to relative risk.
relative SOFA score @day 7, 45.5% better, RR 0.55, p < 0.001, treatment 30, control 30.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Beigmohammadi et al., 14 Nov 2021, Single Blind Randomized Controlled Trial, Iran, peer-reviewed, 6 authors, study period April 2020 - July 2020, this trial uses multiple treatments in the treatment arm (combined with vitamins B, C, D, E) - results of individual treatments may vary, trial IRCT20200319046819N1
Abstract: Beigmohammadi et al. Trials
The effect of supplementation with
vitamins A, B, C, D, and E on disease
severity and inflammatory responses in
patients with COVID-19: a randomized
Mohammad Taghi Beigmohammadi1, Sama Bitarafan2,3* , Azin Hoseindokht1, Alireza Abdollahi4,5,
Laya Amoozadeh1 and Danesh Soltani2
Background and objective: Because of the effect of vitamins on modulating the immune system function, we
have evaluated the effect of supplementation with vitamins A, B, C, D, and E in ICU-admitted patients with COVID19.
Methods: This study was a randomized and single-blinded clinical trial in which 60 subjects were randomly
assigned to two groups. The intervention group (n=30) received vitamins, and the control group did not receive
any vitamin or placebo. The intervention was included 25,000 IU daily of vitamins A, 600,000 IU once during the
study of D, 300 IU twice daily of E, 500 mg four times daily of C, and one amp daily of B complex for 7 days. At
baseline and after the 7-day intervention, the serum levels of inflammatory markers, vitamins, and the SOFA score
were assessed. In addition, the mortality rate and duration of hospitalization were evaluated after the intervention
(IRCT registration number: IRCT20200319046819N1/registration date: 2020-04-04, https://www.irct.ir/trial/46838).
Results: Significant changes were detected in serum levels of vitamins (p < 0.001 for all vitamins), ESR (p < 0.001),
CRP (p = 0.001), IL6 (p = 0.003), TNF-a (p = 0.001), and SOFA score (p < 0.001) after intervention compared with the
control group. The effect of vitamins on the mortality rate was not statistically significant (p=0.112). The prolonged
hospitalization rate to more than 7 days was significantly lower in the intervention group than the control group
(p=0.001). Regarding the effect size, there was a significant and inverse association between receiving the
intervention and prolonged hospitalization (OR = 0.135, 95% CI 0.038–0.481; p=0.002); however, after adjusting for
confounders, it was not significant (OR=0.402, 95% CI 0.086–1.883; p=0.247).
* Correspondence: Bitarafans@gmail.com
Iranian Center of Neurological Research, Neuroscience Institute, Imam
Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran,
FHMS Clinic, Burnaby Hospital, Neurology Department, University of British
Columbia, Vancouver, Canada
Full list of author information is available at the end of the article
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