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0 0.5 1 1.5 2+ ICU admission 75% Improvement Relative Risk Hospitalization time -1% Vitamin B12  Erfani et al.  LATE TREATMENT  RCT Is late treatment with vitamin B12 beneficial for COVID-19? RCT 34 patients in Iran Lower ICU admission with vitamin B12 (not stat. sig., p=0.34) Erfani et al., Health Science Reports, Sep 2023 Favors vitamin B12 Favors control

Vitamin B12 effectiveness in the management of hospitalized COVID‐19 and its clinical outcomes and complications: A randomized clinical trial

Erfani et al., Health Science Reports, doi:10.1002/hsr2.1509
Sep 2023  
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Small RCT 34 hospitalized patients in Iran showing improved imflammatory markers and lower ICU admission with vitamin B12 treatment, without statistical significance. There was no mortality.
risk of ICU admission, 75.0% lower, RR 0.25, p = 0.34, treatment 1 of 17 (5.9%), control 4 of 17 (23.5%), NNT 5.7.
hospitalization time, 0.8% higher, relative time 1.01, p = 0.97, treatment mean 7.47 (±2.93) n=17, control mean 7.41 (±4.88) n=17.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Erfani et al., 14 Sep 2023, Randomized Controlled Trial, placebo-controlled, Iran, peer-reviewed, median age 52.6, 4 authors.
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This PaperVitamin B12All
Vitamin B12 effectiveness in the management of hospitalized COVID‐19 and its clinical outcomes and complications: A randomized clinical trial
Zahra Erfani, Nafiseh Alizadeh, Neda Faraji, Alireza Teymouri
Health Science Reports, doi:10.1002/hsr2.1509
Background and Aims: Since 2019, severe acute respiratory syndrome coronavirus 2, has spread and challenged the health care system for treatment which is mainly limited to supportive care. It is well-established that malnutrition impedes the immunity in human bodies, and makes it vulnerable to microorganisms. Vitamin B12 is one of the agents that has critical roles in body systems. Thus, the following clinical trial was conducted to assess its possible therapeutic value in COVID-19 patients. Method: The present randomized clinical trial was carried out in Baharlou Hospital, and patients with confirmed COVID-19 infection within 24 h of admission were included. We used quadruple blocks randomization to divide patients into groups of case and control. The case group received 1000 mg of vitamin B12, daily for 7 day while the patients in control group were administered distilled water as placebo. The studied outcomes were duration of hospitalization, need for intensive care unit (ICU), mechanical ventilation, mortality rate and laboratory findings. The statistical analysis was done via SPSS version 22. Results: After implementing inclusion and exclusion criteria, 34 participants were included in the study, 20 of which were male. Serum levels of creatinine, LDH (Lactate dehydrogenase), Ferritin, and CRP (C-reactive protein) had decreased in both groups. The improving changes of CRP, LDH, ferritin and creatinine was higher in case group. The increase of Alanine Transaminase and D-dimer was higher in control group. however there was no statistically significant difference. More patients were admitted to ICU in the control group but the difference was not statistically significant. Duration of hospitalization did not differ statistically between the groups. No in hospital mortality has been recorded. Conclusion: Our study suggests that vitamin B12 supplementation seem to have curative effect in COVID-19. Nutritious diet is necessary for proper functioning of the immune system. Since malnutrition is associated with poor prognosis in COVID-19 patients, and limited number of participants in this study, we suggest performing meta-analysis on similar studies to reach reliable result.
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Late treatment
is less effective
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