Vitamins in Prevention and Treatment of COVID-19

Vitamins and COVID-19

Our options for preventing and treating COVID-19 are very limited. The role and potential of vitamin and mineral supplementation (sometimes called “immunonutrition”) in intensive care have been explored by numerous clinical studies, and there are several hypotheses that support its routine use. However, do these hypotheses reflect real clinical practice?

A review paper addressed this question by examining the physiological role of vitamins, their interactions with immune functions, their potential in respiratory infections and acute respiratory distress syndrome (ARDS), and most importantly, their potential benefit for COVID-19 patients. It builds on numerous previous primary sources from databases such as Medline, Embase, Cochrane Trials Register, WHO International Clinical Trial Registry, and Nexis media, focusing particularly on vitamins A through E.

Vitamin A

The pulmonary immunomodulatory and antimicrobial role of vitamin A could play an important role in combating viral diseases, including COVID-19. Retinoic acid partakes in modulating the pathogenesis of ARDS, affects lung infiltration by neutrophils through signaling of alveolar macrophages, and promotes lung regeneration. It also influences the immune system, with some studies suggesting it enhances both innate and adaptive immunity, and its deficiency in chickens is associated with greater epithelial damage. However, these are mere indications, and its actual benefit in treating COVID-19 is still being intensely studied.

Vitamin B

Vitamins of the B group were primarily studied as strong ligands to the surface structures of the new type of coronavirus, potentially allowing targeted drug delivery directly onto the virion.

Vitamin C

There are some reports on the beneficial effects of vitamin C in sepsis and ARDS, which naturally directed attention to it. However, despite what we know about its antioxidant potential, antiviral action, and pleiotropic effects on the human body, it cannot be definitively said whether it has a beneficial effect in treating COVID-19. Nevertheless, given its favorable safety profile, it can be administered even on theoretical grounds alone.

Vitamin D

Vitamin D is perhaps the most talked-about in connection with COVID-19. The interest stems from the knowledge of its pathophysiological mechanisms, where it appears involved in the mechanism of coronavirus entry into cells and alveolar inflammation, as well as from observational population studies showing a negative correlation between average vitamin D levels and COVID-19 mortality on a Europe-wide scale. On the other hand, vitamin D is one of those vitamins whose levels must be monitored due to the risk of overdose.

Vitamin E

Vitamin E prevents the aging of the immune system, protects biological membranes, and enhances the response to tetanus vaccination, so it is expected to have similar effects against COVID-19.

Conclusion

The antioxidant and immunomodulatory effects of vitamins, their support of natural barrier function, and their mediation of local paracrine signaling seem crucial. The highest quality evidence regarding their benefit in the treatment of COVID-19 and similar respiratory infections, ARDS, and sepsis pertains to the use of vitamins B₁ (thiamine), C, and D. It would be inappropriate to claim that vitamins are the solution to the pandemic situation, but there is growing evidence that they could play a significant role in both the prevention and treatment of COVID-19. These findings still await definitive confirmation by clinical studies.

While no one probably doubted the nonspecific effect of vitamins in treating infections, a deeper understanding of their role in treatment allows for targeted correction of their levels instead of indiscriminate supplementation with large doses, which can be particularly harmful for fat-soluble vitamins. Today, hypervitaminosis is almost always a consequence of improper supplementation.

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Source: Jovic T. H., Ali S. R., Ibrahim N. et al. Could vitamins help in the fight against COVID-19? Nutrients 2020 Aug 23; 12 (9): 2550, doi: 10.3390/nu12092550.