Vitamin B12 Pharmaconutrition for COVID-19

William Manzanares; Gil Hardy

doi:10.35454/rncm.v4n1.187

Authors

William Manzanares Facultad de Medicina, Universidad de la República http://orcid.org/0000-0002-6060-0329
Gil Hardy

DOI:

https://doi.org/10.35454/rncm.v4n1.187

Keywords:

Pharmaconutrition, COVID-19, Vitamin B12, ARDS, Critical Care

Abstract

Mortality from COVID-19 disease is much greater in the elderly, many of whom succumb to acute respiratory distress syndrome (ARDS) triggered by the viral infection. High dose parenteral vitamin B12 offers a promising novel therapy for those COVID-19 patients with ARDS from sepsis/ septic shock. The anti-inflammatory and antioxidant properties of vitamin B12 and transcobalamins can modulate the systemic inflammation contributing to the cytokine cascade that leads to ARDS. Clinical studies are now required to establish an appropriate regimen for administering vitamin B12 as pharmaconutrient for critically ill COVID-19 patients.

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Author Biography

Gil Hardy

Auckland, Nueva Zelanda

References

World Health Organization. https://www.who.int/emergencies/diseases/novelcoronavirus-2019. [Accessed 28 June 2020]

Krautler B. Vitamin B12: chemistry and biochemistry. Biochem Soc Trans. 2005; 33(Pt 4): 806-10. doi: https://doi.org/10.1042/BST0330806.

Birch CS, Brasch NE, McCaddon A, Williams JHH. A novel role for vitamin B(12): Cobalamins are intracellular antioxidants in vitro. Free Radic Biol Med. 2009; 47(2): 184–8. doi: https://doi.org/10.1016/j.freeradbiomed.2009.04.023.

Manzanares W, Hardy G. Vitamin B12: The Forgotten Micronutrient for Critical Care. Curr Opin Clin Nutr Metab Care. 2010;13(6):662-8. doi: https://doi.org/10.1097/MCO.0b013e32833dfaec.

Romain M, Sviri S, Linton DM, Stav I, van Heerden PV. The role of vitamin B12 in the critically ill—a review. Anaesth Intensive Care. 2016:44(4); 447-52. doi: https://doi.org/10.1177/0310057X1604400410.

Corcoran TB, O’Neill MA, Webb SAR, Ho KM. Prevalence of vitamin deficiencies on admission: relationship to hospital mortality in critically ill patients. Anaesth Intensive Care. 2009; 37(2):254-60. doi: https://doi.org/10.1177/0310057X0903700215.

Corcoran TB, O’Neill MP, Webb SAR, Ho KM. Inflammation, vitamin deficiencies and organ failure in critically ill patients. Anaesth Intensive Care. 2009; 37(5): 740-7. doi: https://doi.org/10.1177/0310057X0903700510.

Racca V, Castiglioni P, Ripamonti V, Bertoli S, Calvo MG, Ferratini M. Nutrition markers in patients after heart surgery. JPEN J Parenter Enteral Nutr. 2010; 34(2): 143-50. doi: https://doi.org/10.1177/0148607109357627.

Abilés J, Pérez AR, Moratalla G, Castaño J, Rodríguez EM, Pérez de la CA et al. High prevalence of hyperhomocysteinemia in critically ill patients: Vascular damage and adequate vitamin intake. e-SPEN. 2008; 3: e240-e245. doi: https://doi.org/10.1016/j.eclnm.2008.06.011.

Ploder M, Kurz K, Spittler A, Neurauter G, Roth E, Fuchs D. Early increase of plasma homocysteine in sepsis patients with poor outcome. Mol Med. 2010: 16(11-12): 498-504. doi: https://doi.org/10.2119/molmed.2010.00008.

Wheatley C. A scarlet pimpernel for the resolution of inflammation? The role of supra-therapeutic doses of cobalamin, in the treatment of systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis, and septic or traumatic shock. Med Hypotheses. 2006; 67:124–42. doi: https://doi.org/10.1016/j.mehy.2006.01.036.

Wheatley C. The return of the Scarlet Pimpernel: cobalamin in inflammation II—cobalamins can both selectively promote all three nitric oxide synthases (NOS), particularly iNOS and eNOS, and, as needed, selectively inhibit iNOS and nNOS. J Nutr Environ Med. 2007; 16(3-4):181–211. doi: https://doi.org/10.1080/10520290701791839.

Weinberg JB, Chen Y, Jiang N, Beasley BE, Salerno JC, Ghosh DK. Inhibition of nitric oxide synthase by cobalamins and cobinamides. Free Radic Biol Med. 2009; 46(12): 1626-32. doi: https://doi.org/10.1016/j.freeradbiomed.2009.03.017.

Manzanares W, Biestro A, Galusso F, Torre MH, Mañáy N, Facchin G, et al. High dose selenium for critically ill patients with systemic inflammation. Pharmacokinetics and pharmacodynamics of selenious acid: A pilot study. Nutrition. 2010; 26(6): 634-40. doi: https://doi.org/10.1016/j.nut.2009.06.022.

Vanek VW, Borum P, Buchman A, Fessler TA, Howard L, Jeejeebhoy K et al. ASPEN position paper: recommendations for changes in commercially available parenteral multivitamin and multi-trace element products. Nutr Clin Pract 2012; 27:440-491.

Joint Formulary Committee. British National Formulary (Ed.57) London: BMJ Group and Pharmaceutical Press 2009. http://www.medicinescomplete.com. [Accessed on 20.7.20].

Hoey L, Strain JJ, McNul H. Studies of biomarker responses to intervention with vitamin B-12: a systematic review of randomized controlled trials. Am J Clin Nutr. 2009; 89(6):1981S–96S. doi: https://doi.org/10.3945/ajcn.2009.27230C.