Cohort study to evaluate the effect of combination Vitamin D, Magnesium and Vitamin B12 (DMB) on progression to severe outcome in older COVID-19 patients
Tan et al.
, Cohort study to evaluate the effect of combination Vitamin D, Magnesium and Vitamin B12 (DMB) on progression..
, Nutrition, doi:10.1016/j.nut.2020.111017 (date from earlier preprint)
Observational study of 43 patients >= 50 years old, with 17 patients receiving vitamin D, magnesium, and vitamin B12 (DMB); and 26 control patients, showing a significantly lower need for oxygen therapy and ICU admission with treatment. DMB OR 0.20 [0.04–0.93] for oxygen therapy and/or intensive care support with multivariate analysis.
risk of oxygen therapy, 80.5% lower, RR 0.20, p = 0.04, treatment 3 of 17 (17.6%), control 16 of 26 (61.5%), NNT 2.3, adjusted per study, multivariate.
risk of ICU admission, 80.9% lower, RR 0.19, p = 0.07, treatment 1 of 17 (5.9%), control 8 of 26 (30.8%), NNT 4.0, no adjusted result available.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Tan et al., 10 Jun 2020, retrospective, Singapore, peer-reviewed, 14 authors, dosage 1,000IU daily, this trial uses multiple treatments in the treatment arm (combined with magnesium and vitamin B12) - results of individual treatments may vary.
Abstract: Nutrition 79 80 (2020) 111017
Contents lists available at ScienceDirect
journal homepage: www.nutritionjrnl.com
Applied nutritional investigation
Cohort study to evaluate the effect of vitamin D, magnesium, and
vitamin B12 in combination on progression to severe outcomes in older
patients with coronavirus (COVID-19)
Chuen Wen Tan M.R.C.P., F.R.C.Path a,1, Liam Pock Ho F.R.C.P.A. a,b,c,1,
Shirin Kalimuddin M.B.B.S., M.R.C.P., M.P.H. d,e, Benjamin Pei Zhi Cherng M.B.B.S., M.R.C.P. d,
Yii Ean Teh M.B.B.S., M.R.C.P.(UK) d, Siew Yee Thien M.R.C.P.(UK) d,
Hei Man Wong M.R.C.P.(UK), M.Med(NUS) d, Paul Jie Wen Tern M.B B.Chir d,
Manju Chandran M.D., F.A.C.P., F.A.C.E., F.A.M.S., C.C.D. f, Jason Wai Mun Chay M.R.C.P., F.R.C.Path(UK) b,c,
Chandramouli Nagarajan F.R.C.P.(Edin), F.R.C.Path(UK) a,
Rehena Sultana M.Sc. (Statistics), MBA (Systems Management) g,
Jenny Guek Hong Low M.R.C.P.(UK), M.P.H.(US) d,e, Heng Joo Ng M.R.C.P.(UK), F.R.C.Path(UK) a,*
Department of Hematology, Singapore General Hospital, Singapore
Department of Clinical Pathology, Singapore General Hospital, Singapore
Department of Pathology, Sengkang General Hospital, Singapore
Department of Infectious Diseases, Singapore General Hospital, Singapore
Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore
Department of Endocrinology, Singapore General Hospital, Singapore
Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore
A R T I C L E
I N F O
Received 24 June 2020
Received in revised form 25 August 2020
Accepted 1 September 2020
A B S T R A C T
Objectives: The aim of this study was to determine clinical outcomes of older patients with coronavirus
(COVID-19) who received a combination of vitamin D, magnesium, and vitamin B12 (DMB) compared with
those who did not. We hypothesized that fewer patients administered this combination would require oxygen therapy, intensive care support, or a combination of both than those who did not.
Methods: This was a cohort observational study of all consecutive hospitalized patients 50 y of age with
COVID-19 in a tertiary academic hospital. Before April 6, 2020, no patients received the (DMB) combination.
After this date, patients were administered 1000 IU/d oral vitamin D3, 150 mg/d oral magnesium, and
500 mcg/d oral vitamin B12 upon admission if they did not require oxygen therapy. Primary outcome was
deterioration leading to any form of oxygen therapy, intensive care support, or both.
Results: Between January 15 and April 15, 2020, we identiﬁed 43 consecutive patients 50 y of age with
COVID-19. Seventeen patients received DMB before onset of primary outcome and 26 patients did not.
Baseline demographic characteristics between the two groups were signiﬁcantly different by age. In univariate analysis, age and hypertension had a signiﬁcant inﬂuence on outcome. After adjusting for age or
hypertension separately in a multivariate analysis, the intervention group retained protective signiﬁcance. Fewer treated patients than controls required initiation of oxygen therapy during hospitalization
(17.6 vs 61.5%, P = 0.006). DMB exposure was associated with odds ratios of 0.13 (95% conﬁdence interval
[CI], 0.03 0.59) and 0.20 (95% CI, 0.04 0.93) for oxygen therapy, intensive care support, or both on univariate and multivariate analyses, respectively.
Conclusions: A vitamin D / magnesium / vitamin B12 combination in..
is less effective
Please send us corrections, updates, or comments. Vaccines and
treatments are complementary. All practical, effective, and safe means should
be used based on risk/benefit analysis. No treatment, vaccine, or intervention
is 100% available and effective for all current and future variants. We do not
provide medical advice. Before taking any medication, consult a qualified
physician who can provide personalized advice and details of risks and
benefits based on your medical history and situation. FLCCC
provide treatment protocols.