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0 0.5 1 1.5 2+ Case, 1000µg 88% Improvement Relative Risk Case, 500µg 66% Vitamin B9  Farag et al.  Prophylaxis  RCT Does vitamin B9 reduce COVID-19 infections? RCT 363 patients in Egypt (May - June 2020) Fewer cases with vitamin B9 (p=0.000004) c19early.org Farag et al., Microbes and Infectious .., Nov 2022 Favors vitamin B9 Favors control

The Use of Folic acid as a Prophylaxis against COVID-19 among Healthcare Workers

Farag et al., Microbes and Infectious Diseases, doi:10.21608/mid.2022.170328.1405, PACTR202005599385499
Nov 2022  
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Cluster RCT 526 healthcare workers in Egypt, showing lower COVID-19 cases with folic acid supplementation, and a dose-response relationship. Each wave of health care workers was randomized within 14 day isolation periods, introducing potential confounding by time.
risk of case, 87.6% lower, RR 0.12, p < 0.001, treatment 4 of 224 (1.8%), control 20 of 139 (14.4%), NNT 7.9, 1000µg.
risk of case, 65.9% lower, RR 0.34, p = 0.005, treatment 8 of 163 (4.9%), control 20 of 139 (14.4%), NNT 11, 500µg.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Farag et al., 20 Nov 2022, Cluster Randomized Controlled Trial, Egypt, peer-reviewed, mean age 37.5, 9 authors, study period 17 May, 2020 - 30 June, 2020, trial PACTR202005599385499. Contact: yasminelkholy@kasralainy.edu.eg.
This PaperVitamin B9All
The Use of Folic acid as a Prophylaxis against COVID-19 among Healthcare Workers
Ahmed Farag, Nadia Ouda, Reham A Dwedar, Dalia Bilal, Aml Said, Mohamed Yehia Elbarmelgi, Ahmad Al Shafie, Hala Hala Talaat Talaat, Yasmine Elkholy
Microbes and Infectious Diseases, doi:10.21608/mid.2022.170328.1405
Background: Vaccines may be thought of as a reliable intervention to prevent SARS-CoV-2 infection. Prophylactic drugs may be a sound alternative. We aimed to assess the use of folic acid to protect against COVID-19 infection. Methods: This randomized controlled study was conducted in an isolation hospital at Cairo University Hospitals on three groups of nurses caring for COVID-19 patients: group I; the control group, group II whose participants received 500 micrograms of folic acid daily, and group III whose participants received 1000 micrograms daily. PCR conversion was tested for the three groups as a primary endpoint. Results: In total, 526 nurse were included. Group I comprised 139 nurse, group II comprised 163 nurse, and group III comprised 224 nurses. The rates of PCR conversion from negative to positive were 4.9% (8/163) in group II and 1.8% in group III (4/224) compared with 14.4% in the control group I (20/139). Statistically significant (p<0.005) and highly statistically significant (p<0.001) differences respectively were found. Conclusions: Prescribing folic acid daily may significantly decrease the risk of COVID-19 infection among exposed healthcare workers.
Conclusions and recommendations Using folic acid in the mass protection of communities in conjunction with infection control practices may be a step towards protecting HCWs. We recommend constructing trials to study the role of folic acid in treatment of COVID-19 cases the ICU. We also recommend studying the effect of folic acid oral supplementation in prophylaxis of influenza type A and B. We finally recommend conducting epidemiologic studies correlating the incidence and severity of the COVID-19 pandemic with daily folic acid consumption in food and drinks such as green leafy vegetables, beans and orange juice as this may elucidate differences observed in the severity of the pandemic the difference between countries. Declarations Ethical committee approval: The study was approved by the Research Ethics Committee of Cairo University as well as the Pan African Clinical Trial Registry. Competing interests: The authors declare that they have no competing interests. The study was funded by Cairo University Hospitals. Authorship All authors have made contributions to the following: (1) the conception and design of the study and interpretation of data, (2) drafting the article or revising it critically for important intellectual content, (3) final approval of the version to be submitted. Conflicts of interest: None. Financial disclosure: None
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