A cohort study to evaluate the effect of combination Vitamin D, Magnesium and Vitamin B12 on progression to severe outcome in older COVID-19 patients

Abstract Objective To determine the clinical outcomes of older COVID-19 patients who received vitamin D/magnesium/vitamin B12 compared to those who did not. We hypothesized that fewer patients administered this combination would require oxygen therapy and/or intensive care support than those who did not. Methodology This is a cohort observational study of all consecutive hospitalized COVID-19 patients aged 50 and above in a tertiary academic hospital. Prior to 6 April 2020, no patients received the vitamin D/magnesium/vitamin B12 combination. After this date, patients were administered oral vitamin D3 1000 IU OD, magnesium 150mg OD and vitamin B12 500mcg OD upon admission if they did not require oxygen therapy. Primary outcome was deterioration leading to any form of oxygen therapy and/or intensive care support. Results Between 15 January and 15 April 2020, 43 consecutive COVID-19 patients aged ≥50 were identified. 17 patients received vitamin D/magnesium/vitamin B12 before onset of primary outcome and 26 patients did not. Baseline demographic characteristics between the two groups was significantly different for age. In univariate analysis, age and hypertension showed significant influence on outcome. After adjusting for age or hypertension separately in multivariate analysis, the interventional group retained protective significance. Fewer treated patients than controls required initiation of oxygen therapy during their hospitalization (17.6% vs 61.5%, P=0.006). Vitamin D/magnesium/vitamin B12 exposure was associated with odds ratios of 0.13 (95% CI: 0.03 – 0.59) and 0.20 (95% CI: 0.04 – 0.93) for oxygen therapy and/or intensive care support on univariate and multivariate analyses respectively. Conclusions Vitamin D/magnesium/vitamin B12 combination in older COVID-19 patients was associated with a significant reduction in the proportion of patients with clinical deterioration requiring oxygen support and/or intensive care support. This study supports further larger randomized controlled trials to ascertain the full benefit of vitamin D/magnesium/vitamin B12 in ameliorating COVID-19 severity.