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

{ 'indexed': { 'date-parts': [[2021, 11, 15]], 'date-time': '2021-11-15T08:12:44Z', 'timestamp': 1636963964628}, 'reference-count': 29, 'publisher': 'Springer Science and Business Media LLC', 'issue': '1', 'license': [ { 'start': { 'date-parts': [[2021, 11, 14]], 'date-time': '2021-11-14T00:00:00Z', 'timestamp': 1636848000000}, 'content-version': 'tdm', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}, { 'start': { 'date-parts': [[2021, 11, 14]], 'date-time': '2021-11-14T00:00:00Z', 'timestamp': 1636848000000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}], 'funder': [ { 'DOI': '10.13039/501100004484', 'name': 'Tehran University of Medical Sciences and Health Services', 'doi-asserted-by': 'publisher', 'award': ['99-1-101-47104']}], 'content-domain': {'domain': ['link.springer.com'], 'crossmark-restriction': False}, 'short-container-title': ['Trials'], 'published-print': {'date-parts': [[2021, 12]]}, 'abstract': '<jats:title>Abstract</jats:title><jats:sec>\n' ' <jats:title>Background and objective</jats:title>\n' ' <jats:p>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 COVID-19.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Methods</jats:title>\n' ' <jats:p>This study was a randomized and single-blinded clinical trial in ' 'which 60 subjects were randomly assigned to two groups. The intervention group ' '(<jats:italic>n</jats:italic>=30) received vitamins, and the control group did not receive ' 'any vitamin or placebo. The intervention was included 25,000\u2009IU daily of vitamins A, ' '600,000\u2009IU once during the study of D, 300\u2009IU twice daily of E, 500\u2009mg 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, <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" ' 'xlink:href="https://www.irct.ir/trial/46838">https://www.irct.ir/trial/46838</jats:ext-link>).</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Results</jats:title>\n' ' <jats:p>Significant changes were detected in serum levels of vitamins ' '(<jats:italic>p</jats:italic> &lt; 0.001 for all vitamins), ESR (<jats:italic>p</jats:italic> ' '&lt; 0.001), CRP (<jats:italic>p</jats:italic> = 0.001), IL6 (<jats:italic>p</jats:italic> = ' '0.003), TNF-a (<jats:italic>p</jats:italic> = 0.001), and SOFA score ' '(<jats:italic>p</jats:italic> &lt; 0.001) after intervention compared with the control group. ' 'The effect of vitamins on the mortality rate was not statistically significant ' '(<jats:italic>p</jats:italic>=0.112). The prolonged hospitalization rate to more than 7\u2009' 'days was significantly lower in the intervention group than the control group ' '(<jats:italic>p</jats:italic>=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; <jats:italic>p</jats:italic>=0.002); however, after adjusting for ' 'confounders, it was not significant (OR=0.402, 95% CI 0.086–1.883; ' '<jats:italic>p</jats:italic>=0.247).</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Conclusion</jats:title>\n' ' <jats:p>Supplementation with vitamins A, B, C, D, and E could improve the ' 'inflammatory response and decrease the severity of disease in ICU-admitted patients with ' 'COVID-19.</jats:p>\n' ' </jats:sec>', 'DOI': '10.1186/s13063-021-05795-4', 'type': 'journal-article', 'created': { 'date-parts': [[2021, 11, 14]], 'date-time': '2021-11-14T19:02:32Z', 'timestamp': 1636916552000}, 'update-policy': 'http://dx.doi.org/10.1007/springer_crossmark_policy', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': [ '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'], 'prefix': '10.1186', 'volume': '22', 'author': [ {'given': 'Mohammad Taghi', 'family': 'Beigmohammadi', 'sequence': 'first', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0003-1451-7900', 'authenticated-orcid': False, 'given': 'Sama', 'family': 'Bitarafan', 'sequence': 'additional', 'affiliation': []}, {'given': 'Azin', 'family': 'Hoseindokht', 'sequence': 'additional', 'affiliation': []}, {'given': 'Alireza', 'family': 'Abdollahi', 'sequence': 'additional', 'affiliation': []}, {'given': 'Laya', 'family': 'Amoozadeh', 'sequence': 'additional', 'affiliation': []}, {'given': 'Danesh', 'family': 'Soltani', 'sequence': 'additional', 'affiliation': []}], 'member': '297', 'published-online': {'date-parts': [[2021, 11, 14]]}, 'reference': [ { 'issue': '13', 'key': '5795_CR1', 'doi-asserted-by': 'publisher', 'first-page': '1239', 'DOI': '10.1001/jama.2020.2648', 'volume': '323', 'author': 'Z Wu', 'year': '2020', 'unstructured': 'Wu Z, McGoogan JM. 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