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A recent two-center, retrospective study investigated the effect of administration of thiamine as adjunctive therapy in 738 critically ill patients admitted to ICUs with a confirmed diagnosis of COVID-19.
The study published in Critical Care this June, found that the 30-day mortality rate was significantly lower in the group that received thiamine and this group had a lower overall risk of thrombosis.
“Additionally, thiamine use was associated significantly with a lower in-hospital mortality rate by 61%”
The study also found that administration of thiamine to ICU patients was associated with an 81% reduced risk of thrombosis.
“Critically ill patients who received thiamine as an adjunctive therapy were less likely to have thrombosis during ICU stay by 81% [OR (95% CI) 0.19 (0.04, 0.88), P value = 0.03]”
Study authors Khalid Al Sulaiman et al mentioned that the benefit of the use of thiamine had been noted in previous studies of non Covid-19 patients, but not in Covid patients till now.
They suggested that it could be perhaps the effect of Covid infection prior to admission that led to the nutritional deficit that thiamine corrected, or it could be a local dietary deficiency in zinc and selenium that made the patients present with thiamine-correctable thrombosis and mortality risk as Covid-19 ICU patients.
The study also cited,
“Additionally, an in-vitro study found that high-dose thiamine lowers the T-helper cells (Th-17) cell pro-inflammatory response believed to be associated with the COVID-19 cytokine storm [17].”
The study was conducted at to large tertiary governmental hospitals; King Abdulaziz Medical City, Riyadh (KAMC-RD) and King Abdulaziz University Hospital, Jeddah (KAUH-JD).
“The median (Q1, Q3) dose of thiamine given per day was 100 mg (50, 200) with a median duration of seven days. The majority of patients received thiamine by intravenous administration (57%).”
Thiamine is also known as Vitamin B1, is found in many foods including yeast, cereals, whole grains, beans, nuts, and meat and has been known to be used as an immune boost, for treating diabetic pain and heart disease and other native applications. In an unrelated article, Jeffery Lubell suggested that thiamine being a carbonic anhydrase inhibitor may have benefit in ‘HAPE‘ and Covid.
Khalid Al Sulaiman et al concluded:
“Thiamine use as adjunctive therapy may have potential survival benefits in critically ill patients with COVID-19. Additionally, it was associated with a lower incidence of thrombosis. Systemic thiamine administration could be considered as a part of COVID-19 management upon ICU admission.”
Related
A related study published in Maturitas made related suggestions on the use of Thiamine:
“Thiamine is able to improve immune system function and has been shown to reduce the risk of type-2 diabetes, cardiovascular disease, aging-related disorders, kidney disease, cancer, mental disorders and neurodegenerative disorders [[6]]. Thiamine deficiency affects the cardiovascular system, causes neuroinflammation, increases inflammation and leads to aberrant antibody responses [[6]]. As antibodies, and importantly T-cells, are required to eliminate the SARS-CoV-2 virus, thiamine deficiency can potentially result in inadequate antibody responses, and subsequently more severe symptoms. Hence, adequate thiamine levels are likely to aid in the proper immune responses during SARS-CoV-2 infection. In addition, the symptoms of COVID-19 are very similar to altitude sickness and high-altitude pulmonary edema. Acetazolamide is commonly prescribed to prevent high-altitude sickness and pulmonary edema through inhibition of the carbonic anhydrase isoenzymes and subsequently increases oxygen levels. Thiamine also functions as a carbonic anhydrase isoenzyme inhibitor [[9]]; hence, high-doses of thiamine given to people at early stages of COVID-19 could potentially limit hypoxia and decrease hospitalization. Further research is required to determine whether administration of high thiamine doses could contribute to the treatment of patients with COVID-19.”
https://www.maturitas.org/article/S0378-5122(20)30348-0/fulltext#%20
