Volume 31, Issue 2 (Avicenna Journal of Clinical Medicine-Summer 2024)
Avicenna J Clin Med 2024, 31(2): 107-115 |
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Shaghaghi Z, Hashemi S H, Alvandi M, Ghasemibasir H R, Marzhoseyni Z, Mohammadian Khoshnood6 M et al . Examining the Correlation between Serum Folate Levels and Disease Severity in Hospitalized Patients with COVID-19. Avicenna J Clin Med 2024; 31 (2) :107-115
URL: http://sjh.umsha.ac.ir/article-1-3010-en.html
URL: http://sjh.umsha.ac.ir/article-1-3010-en.html
Zahra Shaghaghi1 
, Seyyed Hamid Hashemi2 , Maryam Alvandi3 , Hamid Reza Ghasemibasir4 , Zeynab Marzhoseyni5 , Maryam Mohammadian Khoshnood66 , Soghra Farzipour7
, Seyyed Hamid Hashemi2 , Maryam Alvandi3 , Hamid Reza Ghasemibasir4 , Zeynab Marzhoseyni5 , Maryam Mohammadian Khoshnood66 , Soghra Farzipour7
1- Cancer Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
2- Department of Infectious Disease, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
3- Cardiovascular Research Center, Hamadan University of Medical Sciences, Hamadan, Iran ,maryamalvandi@yahoo.com
4- Department of Pathology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
5- Department of Paramedicine, Amol School of Paramedical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
6- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
7- Department of Radiopharmacy, School of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
2- Department of Infectious Disease, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
3- Cardiovascular Research Center, Hamadan University of Medical Sciences, Hamadan, Iran ,
4- Department of Pathology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
5- Department of Paramedicine, Amol School of Paramedical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
6- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
7- Department of Radiopharmacy, School of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
Abstract: (1495 Views)
Background and Objective: Extensive research is underway to find effective treatments for clinical manifestations of COVID-19. Given the proven effectiveness of certain micronutrients, such as vitamins, in antimicrobial activity and immune system modulation for treating or preventing infectious diseases, the potential role of vitamins in the treatment or prevention of COVID-19 should be considered. The present study aimed to assess the correlation between serum folate levels in patients hospitalized with COVID-19 and the severity of the disease, emphasizing the importance of relevant awareness regarding different folate levels.
Materials and Methods: In this cross-sectional study, folate levels were measured in 117 COVID-19-infected patients hospitalized from January 2020 to November 2020 at Sina Hospital, Hamadan. Patients were categorized based on disease severity into three groups: mild to moderate, severe, and critical. Group differences were statistically analyzed using appropriate tests.
Results: Our study revealed a statistically significant difference in folate levels among the three examined groups. Logistic regression analyses demonstrated that for every one microgram per milliliter increase in folate, the probability of severe COVID-19 symptoms decreased by 23%. The large area under the ROC curve (0.864) indicates that mortality in COVID-19 patients can be well predicted based on folate levels.
Conclusion: As evidenced by the obtained results, it can be stated that a reduction in serum folate levels among hospitalized patients with COVID-19 is common and is recognized as a predictive factor for COVID-19-related mortality. Consequently, monitoring folate levels and considering supplementation, if necessary, should be considered for hospitalized COVID-19 patients.
Materials and Methods: In this cross-sectional study, folate levels were measured in 117 COVID-19-infected patients hospitalized from January 2020 to November 2020 at Sina Hospital, Hamadan. Patients were categorized based on disease severity into three groups: mild to moderate, severe, and critical. Group differences were statistically analyzed using appropriate tests.
Results: Our study revealed a statistically significant difference in folate levels among the three examined groups. Logistic regression analyses demonstrated that for every one microgram per milliliter increase in folate, the probability of severe COVID-19 symptoms decreased by 23%. The large area under the ROC curve (0.864) indicates that mortality in COVID-19 patients can be well predicted based on folate levels.
Conclusion: As evidenced by the obtained results, it can be stated that a reduction in serum folate levels among hospitalized patients with COVID-19 is common and is recognized as a predictive factor for COVID-19-related mortality. Consequently, monitoring folate levels and considering supplementation, if necessary, should be considered for hospitalized COVID-19 patients.
Type of Study: Original |
Subject:
Infectious Diseases
Extended Abstract [HTML 36 KB] (105 Download)
References
1. Zu ZY, Jiang MD, Xu PP, Chen W, Ni QQ, Lu GM, Zhang LJ. Coronavirus Disease 2019 (COVID-19): A Perspective from China. Radiology. 2020;296(2): E15-E25. PMID: 32083985 DOI: 10.1148/radiol.2020200490
2. Abulmeaty MMA, Aljuraiban GS, Shaikh SM, ALEid NE, Mazrou LRA, Turjoman AA, et al. The Efficacy of Antioxidant Oral Supplements on the Progression of COVID-19 in Non-Critically Ill Patients: A Randomized Controlled Trial. Antioxidants. 2021;10(5):804. PMID: 34069549 DOI: 10.3390/antiox10050804
3. Daei Sorkhabi A, Sarkesh A, Daei Sorkhabi A, Entezari-Maleki T, Rashedi J, Bannazadeh Baghi H. Vitamin supplementation as a potential adjunctive therapeutic approach for COVID-19: biological and clinical plausibility. J Basic Clin Physiol Pharmacol. 2021;33(1):55-77. PMID: 34380185 DOI: 10.1515/jbcpp-2021-0111
4. Ragan I, Hartson L, Pidcoke H, Bowen R, Goodrich R. Pathogen reduction of SARS-CoV-2 virus in plasma and whole blood using riboflavin and UV light. PLoS One. 2020;15(5):e0233947. PMID: 32470046 DOI: 10.1371/journal.pone.0233947
5. Kunisawa J, Kiyono H. Vitamin-mediated regulation of intestinal immunity. Front Immunol. 2013; 4:189. PMID: 23874335 DOI: 10.3389/fimmu.2013.00189
6. Karakousis ND, Gourgoulianis KI, Kotsiou OS. The Role of Folic Acid in SARS-CoV-2 Infection: An Intriguing Linkage under Investigation. J Pers Med. 2023;13(3):561. PMID: 36983742 DOI: 10.3390/jpm13030561
7. Kumar P, Kumar M, Bedi O, Gupta M, Kumar S, Jaiswal G, Rahi V, Yedke NG, Bijalwan A, Sharma S, Jamwal S. Role of vitamins and minerals as immunity boosters in COVID-19. Inflammopharmacology. 2021 ;29(4):1001-1016. PMID: 34110533 DOI: 10.1007/s10787-021-00826-7
8. Prajapat M, Shekhar N, Sarma P, Avti P, Singh S, Kaur H, Bhattacharyya A, Kumar S, Sharma S, Prakash A, Medhi B. Virtual screening and molecular dynamics study of approved drugs as inhibitors of spike protein S1 domain and ACE2 interaction in SARS-CoV-2. J Mol Graph Model. 2020; 101:107716. PMID: 32866780 DOI: 10.1016/j.jmgm.2020.107716
9. Z. Sheybani, M.H. Dokoohaki, M. Negahdaripour, M. Dehdashti, H. Zolghadr, M. Moghadami, S.M. Masoompour, A.R. Zolghadr, The role of folic acid in the management of respiratory disease caused by COVID-19.2020. DOI:10.26434/chemrxiv. 12034980
10. Im JH, Je YS, Baek J, Chung MH, Kwon HY, Lee JS. Nutritional status of patients with COVID-19. Int J Infect Dis. 2020; 100:390-393. PMID: 32795605 DOI: 10.1016/j.ijid.2020.08.018
11. Clinical management of COVID-19: interim guidance, 27 May 2020. World Health Organization, 2020. Link
12. Strand TA, Taneja S, Bhandari N, Refsum H, Ueland PM, Gjessing HK, Bahl R, Schneede J, Bhan MK, Sommerfelt H. Folate, but not vitamin B-12 status, predicts respiratory morbidity in north Indian children. Am J Clin Nutr. 2007;86(1):139-44. PMID: 17616773 DOI: 10.1093/ajcn/86.1.139 .
13. Meisel E, Efros O, Bleier J, Beit Halevi T, Segal G, Rahav G, Leibowitz A, Grossman E. Folate Levels in Patients Hospitalized with Coronavirus Disease 2019. Nutrients. 2021;13(3):812. PMID: 33801194 DOI: 10.3390/nu13030812
14. [14] Doğan A, Anaç İ, Gezer Y, Timur B. Folate, B12 and Iron Levels in COVID 19 Patients Observational Case-Control Study. Sağlık Akademisi Kastamonu. 2022;7(Covid-19 Ek Sayısı):91-9. DOI: 10.25279/sak.1102076
15. Itelman E, Wasserstrum Y, Segev A, Avaky C, Negru L, Cohen D, et al. Clinical Characterization of 162 COVID-19 patients in Israel: Preliminary Report from a Large Tertiary Center. Isr Med Assoc J. 2020;22(5):271-274. PMID: 32378815
16. Acosta-Elias J, Espinosa-Tanguma R. The Folate Concentration and/or Folic Acid Metabolites in Plasma as Factor for COVID-19 Infection. Front Pharmacol. 2020;11:1062. PMID: 32765270 DOI: 10.3389/fphar.2020.01062
17. Eloranta JJ, Zaïr ZM, Hiller C, Häusler S, Stieger B, Kullak-Ublick GA. Vitamin D3 and its nuclear receptor increase the expression and activity of the human proton-coupled folate transporter. Mol Pharmacol. 2009;76(5):1062-71. PMID: 19666701 DOI: 10.1124/mol.109.055392
18. Ilie PC, Stefanescu S, Smith L. The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality. Aging Clin Exp Res. 2020;32(7):1195-98. PMID: 32377965 DOI: 10.1007/s40520-020-01570-8
19. Calder PC, Carr AC, Gombart AF, Eggersdorfer M. Optimal Nutritional Status for a Well-Functioning Immune System Is an Important Factor to Protect against Viral Infections. Nutrients. 2020;12(4):1181. PMID: 32340216 DOI: 10.3390/nu12041181
20. Shakoor H, Feehan J, Mikkelsen K, Al Dhaheri AS, Ali HI, Platat C, Ismail LC, Stojanovska L, Apostolopoulos V. Be well: A potential role for vitamin B in COVID-19. Maturitas. 2021; 144:108-111. PMID: 32829981 DOI: 10.1016/j.maturitas.2020.08.007
21. Kumar V, Kancharla S, Jena MK. In silico virtual screening-based study of nutraceuticals predicts the therapeutic potentials of folic acid and its derivatives against COVID-19. Virusdisease. 2021;32(1):29-37. PMID: 33532517 DOI: 10.1007/s13337-020-00643-6
22. Elmadfa I, Meyer AL. The Role of the Status of Selected Micronutrients in Shaping the Immune Function. Endocr Metab Immune Disord Drug Targets. 2019;19(8):1100-1115. PMID: 31142256 DOI: 10.2174/1871530319666190529101816
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