Effect of folic acid in patients with lung damage caused by coronavirus SARS-CoV-2

ABSTRACT

Aim of study. To evaluate the influence exerted by additional use of a fixed combination of folic acid with pyridoxine hydrochloride and cyanocobalamin in complex therapy for hospitalised patients with COVID-19-associated lung damage on parameters of inflammation and clinical outcomes. Material and methods. A comparative prospective interventional study included 117 patients with a lung lesion volume caused by the SARS-CoV-2 coronavi-rus corresponding to CT-1 and CT-2. The study group included 78 patients who additionally received a fixed combination of 5mg folic acid, 4mg pyridoxine hydrochloride, and 6mug cyanocobalamin three times a day in combination with standard therapy. The comparison group included 39 patients. Results. By days 14-21 of hospitalisation, the main group showed a decrease in the proportion of patients with CT symptoms of "cobblestone appearance" by 26% (p = 0.005) and an increase in the proportion of patients with transformation of viral lung lesions into areas of consolidation of the pulmonary parenchyma by 23% (p <0.001). The effect of a fixed combination of folic acid with vitamins B6, B12 on the achievement of the level of C-reactive protein <20 mg / l by day 7 depending on the red blood parameters and the number of platelets was established (likelihood ratio test in the logistic regression model 13.925;P = 0.084) as well as the shortening of the time period required to reach the first negative result of the SARS-CoV-2 RNA test (in the linear regression model, R = 0.437;R2 = 0.191;F = 4.552;p = 0.006). Conclusion. The use of a fixed combination of folic acid with vitamins B6, B12 for patients with COVID-19 is associated with earlier achievement of positive dynamics in CT symptoms of lung damage. The additional use of these micronutrients in combination with restoration of red blood count and platelet count improves the odds ratio of an early decrease in serum C-reactive protein, negative result of the SARS-CoV-2 RNA test.Copyright © 2021, Krasnoyarsk State Medical University. All rights reserved.