Volume 30, Issue 4 (Avicenna Journal of Clinical Medicine-Winter 2024)                   Avicenna J Clin Med 2024, 30(4): 202-211 | Back to browse issues page


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Alvandi M, Hashemi S H, Shaghaghi Z, Ghasemibasir H R, Marzhoseyni Z, Mohammadian Khoshnood M et al . Relationship between Serum Cobalamin Levels and Disease Severity in COVID-19 Patients. Avicenna J Clin Med 2024; 30 (4) :202-211
URL: http://sjh.umsha.ac.ir/article-1-2866-en.html
1- Department of Nuclear Medicine and Molecular Imaging, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
2- Department of Infectious Disease, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
3- Cancer Research Center, Hamadan University of Medical Sciences, Hamadan, Iran , z.shaghaghi@umsha.ac.ir
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:   (1981 Views)
Background and Objective: Vitamins play a crucial role in cellular growth, function, and evolution. Additionally, they contribute significantly to pathogen defense through cellular responses and immune enhancement. Cobalamin has been identified to play a role in suppressing virus replication, generating anti-inflammatory responses, and boosting immunity in infected patients with COVID-19. Therefore, we hypothesized that the low cobalamin levels are associated with a predisposition to severe COVID-19 infection. The present study aimed to investigate the relationship between cobalamin levels and disease severity and prognosis in COVID-19 patients.
Materials and Methods: This cross-sectional study included 117 COVID-19 patients hospitalized at Sina Hospital and categorized them into three groups based on their disease severity: mild to moderate, severe, and critical. Demographic information and clinical findings of the patients were recorded. Serum cobalamin levels were assessed using biochemical methods. Logistic regression and Receiver Operating Characteristic (ROC) analyses were employed for mortality prediction based on serum cobalamin levels.
Results: The results revealed that patients with low cobalamin levels are more susceptible to severe COVID-19 infections. Furthermore, with each additional day of hospitalization, the mortality rate due to COVID-19 increased by 24%. The high area under the ROC curve (0.837) indicated that mortality in COVID-19 patients can be effectively predicted based on cobalamin levels.
Conclusion: It appears that cobalamin supplementation may have positive effects on COVID-19 patients’ outcomes. Additionally, serum cobalamin levels serve as a valuable indicator for predicting the mortality rate in COVID-19 patients. However, comprehensive, longer-term studies with a larger number of patients are required.
 
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Type of Study: Original | Subject: Infectious Diseases

References
1. Cassiano LM, Cavalcante-Silva V, Oliveira MS, Prado BV, Cardoso CG, Salim A, Franco GR, D’Almeida V, Francisco SC, Coimbra RS. Vitamin B12 attenuates leukocyte inflammatory signature in COVID-19 via methyl-dependent changes in epigenetic markings. Frontiers in Immunology. 2023;14:1048790. DOI: 10.3389/fimmu.2023.1048790
2. Manzanares W, Hardy G. Vitamin B12 pharmaconutrition for COVID-19. Revista de Nutrición Clínica y Metabolismo. 2021;4(1). DOI: 10.35454/rncm.v4n1.187
3. Yazdi A, Alvandi M, Shaghaghi Z, Hashemi SH, Inanloo SO, Hashemi S, Mohammadi T, Akbari S. Coronavirus Disease in Cardiovascular Patients: Clinical Characteristics and Final Prognosis.Avicenna J Clin Microbiol Infect.2023; 10(1): 20-26. DOI: 10.34172/ajcmi.2023.3421
4. Batista KS, Cintra VM, Lucena PAF, Manhães-de-Castro R, Toscano AE, Costa LP, et al. The role of vitamin B12 in viral infections: a comprehensive review of its relationship with the muscle-gut-brain axis and implications for SARS-CoV-2 infection. Nutr Rev. 2022;80(3):561-78. PMID: 34791425 DOI: 10.1093/nutrit/nuab092
5. 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
6. Aslaner H, İnanç N, Gökçek MB, Aykemat Y, Aslaner HA, Benli AR. The effect of vitamin b12 levels on prognosis in covid-19 patients. J Contemp Med. 2022;12(2):359-63. DOI: 10.16899/jcm.1035078
7. Manzanares W, Hardy G. Vitamin B12: the forgotten micronutrient for critical care. Curr Opin Clin Nutr Metab Care. 2010;13(6):662-8. PMID:20717016 DOI: 10.1097/MCO.0b013e32833dfaec
8. Lagana A.S, Rizzo G. A review of vitamin B12, Molecular Nutrition, Vitamin.2019:105-129.
9. Mikkelsen K, Stojanovska L, Prakash M, Apostolopoulos V. The effects of vitamin B on the immune/cytokine network and their involvement in depression. Maturitas. 2017;96:58-71. PMID: 28041597 DOI: 10.1016/j.maturitas.2016.11.012
10. Pandya M, Shah S, Dhanalakshmi M, Juneja T, Patel A, Gadnayak A, Dave S, Das K, Das J. Unravelling Vitamin B12 as a potential inhibitor against SARS-CoV-2: A computational approach. Informatics in medicine unlocked. 2022;30:100951. DOI: 10.1016/j.imu.2022.100951
11. World Health Organization. WHO R&D Blueprint: novel Coronavirus: outline of trial designs for experimental therapeutics, January 27, 2020, Geneva, Switzerland. World Health Organization. 2020.
12. Narayanan N, Nair DT. Vitamin B12 may inhibit RNA-dependent-RNA polymerase activity of nsp12 from the SARS-CoV-2 virus. IUBMB Life. 2020;72(10):2112-20. PMID: 32812340 DOI: 10.1002/iub.2359
13. Baldewicz TT, Goodkin K, Blaney NT, Shor-Posner G, Kumar M, et al. Cobalamin level is related to self-reported and clinically rated mood and to syndromal depression in bereaved HIV-1(+) and HIV-1(-) homosexual men. J Psychosom Res. 2000;48(2):177-85. PMID: 10719135 DOI: 10.1016/s0022-3999(99)00108-7
14. Iwarson S, Lindberg J. Coenzyme-B12 therapy in acute viral hepatitis. Scand J Infect Dis. 1977;9(2):157-8. PMID: 897571 DOI: 10.3109/inf.1977.9.issue-2.22
15. Sugihara T, Koda M, Okamoto T, Miyoshi K, Matono T, Oyama K, et al. Falsely Elevated Serum Vitamin B12 Levels Were Associated with the Severity and Prognosis of Chronic Viral Liver Disease. Yonago Acta Med. 2017;60(1):31-9. PMID: 28331419
16. Sezgin Y. Evaluation of serum vitamin B12 levels in patients with COVID-19 infection: A case-control study. J Med Biochem. 2023;42(3):524-29. PMID: 37790208 DOI: 10.5937/jomb0-42357
17. Hemdan DI. Level of vitamins and minerals for people with coronavirus (Covid-19) in Taif, Kingdom of Saudi Arabia. Materials Express. 2022;12(3):518-26. DOI: 10.1166/mex.2022.2168
18. Michele CA, Angel B, Valeria L, Teresa M, Giuseppe C, Giovanni M, Ernestina P, Mario B. Vitamin supplements in the Era of SARS-Cov2 pandemic. GSC Biological and Pharmaceutical Sciences. 2020;11(2):007-19. DOI: 10.30574/gscbps.2020.11.2.0114
19. Shakeri H, Azimian A, Ghasemzadeh-Moghaddam H, Safdari M, Haresabadi M, Daneshmand T, Namdar Ahmadabad H. Evaluation of the relationship between serum levels of zinc, vitamin B12, vitamin D, and clinical outcomes in patients with COVID-19. J Med Virol. 2022;94(1):141-6. PMID:34406674 DOI: 10.1002/jmv.27277
20. Corcoran TB, O'Neill MA, Webb SA, Ho KM. Prevalence of vitamin deficiencies on admission: relationship to hospital mortality in critically ill patients. Anaesthesia and intensive care. 2009;37(2):254-60. DOI: 10.1177/0310057X0903700215
21. Tan CW, Ho LP, Kalimuddin S, Cherng BPZ, Teh YE, Thien SY, Wong HM, etal. 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). Nutrition. 2020;79-80:111017. PMID:33039952 DOI: 10.1016/j.nut.2020.111017
22. Elsayad OA, Abdou SM. Relation between Vitamin B12 Levels and Smell Affection in COVID-19 Patients. Int Arch Otorhinolaryngol. 2022;26(4):e533-e537. PMID: 36405468 DOI: 10.1055/s-0042-1755311
23. Mubaraki AA, Alrbaiai GT, Sibyani AK, Alhulayfi RM, Alzaidi RS, Almalki HS. Prevalence of anosmia among COVID-19 patients in Taif City, Kingdom of Saudi Arabia. Saudi Med J. 2021;42(1):38-43. PMID: 33399169 DOI: 10.15537/smj.2021.1.25588
24. Sampaio Rocha-Filho PA, Albuquerque PM, Carvalho LC, Dandara Pereira Gama M, Magalhães JE. Headache, anosmia, ageusia and other neurological symptoms in COVID-19: a cross-sectional study. J Headache Pain. 2022;23(1):1. DOI: 10.1186/s10194-021-01367-8
25. Gupta PK, Garg RK, Gupta RK, Malhotra HS, Paliwal VK, Rathore RK, Verma R, Singh MK, Rai Y, Pandey CM. Diffusion tensor tractography and neuro-psychological assessment in patients with vitamin B12 deficiency. Neuroradiology. 2014;56:97-106. DOI: 10.1007/s00234-013-1306-y
26. Kandeel M, Al-Nazawi M. Virtual screening and repurposing of FDA approved drugs against COVID-19 main protease. Life Sci. 2020;251:117627. PMID: 32251634 DOI: 10.1016/j.lfs.2020.117627
27. Li Y, Chen G, Ma L, Ohms SJ, Sun C, Shannon MF, Fan JY. Plasticity of DNA methylation in mouse T cell activation and differentiation. BMC Molecular Biol. 2012;13(1):1-9. DOI: 10.1186/1471-2199-13-16
28. de Queiroz KB, Cavalcante-Silva V, Lopes FL, Rocha GA, D’Almeida V, Coimbra RS. Vitamin B 12 is neuroprotective in experimental pneumococcal meningitis through modulation of hippocampal DNA methylation. J Neuroinflammation. 2020;17:1-2. DOI: 10.1186/s12974-020-01763-y
29. Vianello A, Braccioni F. Geographical Overlap Between Alpha-1 Antitrypsin Deficiency and COVID-19 Infection in Italy: Casual or Causal? Arch Bronconeumol. 2020;56(9):609–10. DOI: 10.1016/j.arbres.2020.05.015

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