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

  1. Chuen Wen Tan
  2. Liam Pock Ho
  3. Shirin Kalimuddin
  4. Benjamin Pei Zhi Cherng
  5. Yii Ean Teh
  6. Siew Yee Thien
  7. Hei Man Wong
  8. Paul Jie Wen Tern
  9. Manju Chandran
  10. Jason Wai Mun Chay
  11. Chandramouli Nagarajan
  12. Rehena Sultana
  13. Jenny Guek Hong Low
  14. Heng Joo Ng
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Abstract

Objective

To determine the clinical outcomes of older COVID-19 patients who received DMB compared to those who did not. We hypothesized that fewer patients administered DMB would require oxygen therapy and/or intensive care support than those who did not.

Methodology

Cohort observational study of all consecutive hospitalized COVID-19 patients aged 50 and above in a tertiary academic hospital who received DMB compared to a recent cohort who did not. Patients were administered oral vitamin D3 1000 IU OD, magnesium 150mg OD and vitamin B12 500mcg OD (DMB) upon admission if they did not require oxygen therapy. Primary outcome was deterioration post-DMB administration 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 DMB and 26 patients did not. Baseline demographic characteristics between the two groups was significantly different in age. In univariate analysis, age and hypertension showed significant influence on outcome while DMB retained protective significance after adjusting for age or hypertension separately in multivariate analysis. Fewer DMB patients than controls required initiation of oxygen therapy during their hospitalization (17.6% vs 61.5%, P=0.006). DMB 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

DMB combination in older COVID-19 patients was associated with a significant reduction in proportion of patients with clinical deterioration requiring oxygen support and/or intensive care support. This study supports further larger randomized control trials to ascertain the full benefit of DMB in ameliorating COVID-19 severity.

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