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
-Chlamydas, Papavassiliou, Piperi, Epigenetic mechanisms regulating COVID-19 infection, Epigenetics
-Cohen, Hydroxychloroquine for the Prevention of Covid-19 Searching for Evidence, N Engl J Med
-Das, Hampton, Jirtle, Imprinting evolution and human health, Mamm Genome
-Heidary, Gharebaghi, Ivermectin: a systematic review from antiviral effects to COVID-19 complementary regimen, J Antibiot
-Mani, Budak, Lan, Prevalence of Coronavirus Disease 2019 Infection and Outcomes Among Symptomatic Healthcare Workers in Seattle, Washington, Clin Infect Dis
-Nehme, Pasquereau, Herbein, Control of viral infections by epigenetic-targeted therapy, Clin Epigenet
-Pruimboom, Methylation pathways and SARS-CoV-2 lung infiltration and cell membrane-virus fusion are both subject to epigenetics, Front. Cell. Infect. Microbiol
-Rolain, Colson, Raoult, Recycling of chloroquine and its hydroxyl analogue to face bacterial, fungal and viral infections in the 21st century, Int J Antimicrob Agents
-Sheybani, Dokoohaki, Negahdaripour, Dehdashti, Zolghadr et al., The role of folic acid in the management of respiratory disease caused by COVID-19
Balmford, Annan, Hargreaves, Altoè, Bateman, Cross-Country Comparisons of Covid-19: Policy, Politics and the Price of Life, Environ Resource Econ
Boyles, Yetley, Thayer, Coates, Safe use of high intakes of folic acid: research challenges and paths forward, Nutr Rev
Crider, Yang, Berry, Bailey, Folate and DNA methylation: a review of molecular mechanisms and the evidence for folate's role, Adv Nutr
Farag, Ouda, Dwedar, Bilal, Said et al., The use of folic acid as a prophylaxis against COVID-19 among healthcare workers, Microbes Infect Dis
Hernandez, Roman, Pasupuleti, Barboza, White, Hydroxychloroquine or chloroquine for treatment or prophylaxis of COVID-19: a living systematic review, Ann Intern Med
Merrell, Mcmurry, Field, Ms, Stover, Safety of folic acid
Yao, Qian, Zhu, Wang, Wang, A systematic review of lopinavir therapy for SARS coronavirus and MERS coronavirus -a possible reference for coronavirus disease-19 treatment option, J Med Virol