Original Articles

Supplement Usage Pattern in a Group of COVID- 19 Patients in Tehran


Objective: The coronavirus disease 19 (COVID-19) is a highly transmittable and pathogenic viral infection, causes severe acute respiratory syndrome and was spread throughout the world in early 2020. The effects of vitamin and micronutrient supplements on the prevention and treatment of COVID- 19 seems challenging in scientific considerations. On the other side generally, experts warn against over-consumption of these supplements.
Materials and Methods: This study aimed to investigate the vitamin and micronutrient supplementation usage pattern in past history of patients with COVID-19 via a cross-sectional inquiry. Totally 510 patients referring to the infectious disease clinic of Imam Khomeini Hospital in Tehran from March 2020 to May 2020 were recruited. The inclusion criterion was suspected patients for COVID-19 based on clinical findings and CT scans of the lung. The infected patients included both inpatients (171) and outpatients (339). Demographic information, clinical signs, and the supplement pattern use were collected through a questionnaire and the data were statistically analyzed.
Results: Vitamin D3 intake was reported in 30% (103 patients) of outpatients and 16.5% (28 patients) of hospitalized patients, which is statistically significant (P=0.001). It shows that, the frequency of vitamin D3 consumption in the outpatient group was higher than inpatient group. This significant difference has also been shown in zinc consumption, in 29 patients (9%) outpatients versus 4 patients (2%) inpatients were reported (P=0.007). Multi nominal regression showed that vitamin D3 intake has a supportive effect and reduces the risk of exacerbation and worsening of the disease. (OR=0.291; 95% CI 0.102-.0834, P=0.022).
Conclusion: According to the results of the present study and the findings of other studies, considering the supportive effect of vitamin D3 in reducing the severity of infectious diseases; Clinical trials with an appropriate sample size are recommended to investigate the functional role of this vitamin in improving viral diseases of the respiratory tract


1. Shereen MA, Khan S, Kazmi A, Bashir N, Siddigue R. COVID-19 infection: Origin, transmission, and characteristics of human coronaviruses. J Adv Res 2020; 24: 91-8.
2. Li JY, You Zh, Wang Q, Zhou ZJ, Qiu Y, Luo R, et al. The epidemic of 2019-novel-coronavirus (2019-nCoV) pneumonia and insights for emerging infectious diseases in the future. Microbes Infect 2020; 22: 80–5.
3. National Institutes of Health State-of-the-Science Panel . National Institutes of Health State-of-the-Science Conference Statement: multivitamin/mineral supplements and chronic disease prevention. Am J Clin Nutr 2007; 85: 257S-64S.
4. Huang HY, Caballero B, Chang S, Alberg A, Semba RD, Schneyer CR, et al. The Efficacy and Safety of Multivitamin and Mineral Supplement Use To Prevent Cancer and Chronic Disease in Adults: A Systematic Review for National Institutes of Health State-of-the-Science Conference. Ann Intern Med 2006; 145: 372-85.
5. Rautiainen S, Manson JE, Lichtenstein AH, Sesso H. Dietary supplements and disease prevention - a global overview. Nat Rev Endocrinology 2016; 12:407-20.
6. Grant WB, Lahore H, McDonnell SL, Baggerly CA, French CB, Aliano JL, et al. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza
and COVID-19 Infections and Deaths. Nutrients 2020; 12: 988.
7. Lee J, Hecke OV, Roberts N. Vitamin D: A rapid review of the evidence for treatment or prevention in COVID-19. CEBM, The Centre for Evidence-Based Medicine develops, promotes and disseminates better evidence for healthcare 2020.
8. Bergman P, Lindh AU, Björkhem-Bergman L, Lindh JD. Vitamin D and Respiratory Tract Infections: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PLoS One 2013; 8: e65835.
9. Calder PC, Carr AC, Gombart AF, Eggersdorfer M. Optimal Nutritional Status for a Well-Functioning Immune System Is an Important Factor to Protect against Viral Infections. Nutrients 2020; 12: 1181.
10. Elmadfa I, Meyer AL. The Role of the Status of Selected Micronutrients in Shaping the Immune Function. Endocr Metab Immune Disord Drug Targets 2019; 19:1100-15.
11. 11.Li XW, Geng M, Peng Y, Meng L, Lu Sh. Molecular immune pathogenesis and diagnosis of COVID-19 . J Pharm Anal 2020; 10: 102-8.
12. Tu H, Tu Sh, GAO S, Shao A, Sheng J. Current epidemiological and clinical features of COVID-19 ; a global perspective from China. J Infect 2020; 81: 1-9.
13. 13.Skalny AV, Rink L, Ajsuvakova OP, Aschner M, Gritsenko VA, Alekseenko SI, et al. Zinc and respiratory tract infections: Perspectives for COVID-19 (Review). Int J Mol Med 2020; 46: 17-26.
14. Te Velthuis AJW, Van den Worm SHE, Sims AC, Baric RS, Snijder EJ, Van Hemert MJ. Zn2+ inhibits coronavirus and arterivirus RNA polymerase activity in vitro and zinc ionophores block the replication of these viruses in cell culture. PLoS Pathog 2010; 6: e1001176.
15. Read SA, Obeid S, Ahlenstiel Ch, Ahlenstiel G. The Role of Zinc in Antiviral Immunity. Adv Nutr 2019; 10: 696–710.
16. Bartley J. Vitamin D, innate immunity and upper respiratory tract infection. J Laryngol Otol 2010; 124: 465-9.
17. Laaksi I. Vitamin D and respiratory infection in adults. Proc Nutr Soc 2012; 71:90-7.
18. Beard JA, Bearden A, Striker R. Vitamin D and the anti-viral state. J Clin Virol 2011; 50: 194–200.
19. Martineau AR, Jollie DA, Hooper RL, et al. Vitamin D supplementation to prevent acute respiratorytract infections: Systematic review and meta-analysis of individual participant data. BMJ 2017; 356: i6583.
20. Vasarhelyi B, Satori A, Olajos F, Szabo A, Beko G. Low vitamin D levels among patients at Semmelweis University: Retrospective analysis during a one-year period. Orv Hetil 2011; 152: 1272–7.
21. Epidemiology Working Group for NCIP Epidemic Response, Chinese Center for Disease Control and Prevention.The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19 ) in China. Zhonghua Liu Xing Bing Xue Za Zhi 2020; 41:145–51.
22. MacLaughlin J, Holick MF. Aging decreases the capacity of human skin to produce vitamin D3. J Clin Invest 1985; 76: 1536–8.
23. Grober U, Kisters K. Influence of drugs on vitamin D and calcium metabolism. Dermatoendocrinol 2012; 4:
24. Wimalawansa S J. Global epidemic of coronavirus–COVID-19 : What we can do to minimze risks. Eur J Biomed Pharm Sci 2020; 7: 432–8.
25. Annweiler C. COVID-19 and Vitamin D Supplementation: a Multicenter Randomized Controlled Trial of High Dose Versus Standard Dose Vitamin D3 in High-risk COVID-19 Patients (CoVitTrial) 2020. [Internet]. Available from:https://clinicaltrials.gov/ct2/show/record/NCT04344041.
26. Gombart AF, Pierre A, Maggini S. A Review of Micronutrients and the Immune System-Working in Harmony to Reduce the Risk of Infection. Nutrients 2020; 12: 236.
IssueVol 14, No 3 (September 2020) QRcode
SectionOriginal Articles
DOI https://doi.org/10.18502/jfrh.v14i3.4668
Supplement COVID-19 Vitamins Micronutrients

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How to Cite
Bagheri M, Haghollahi F, Shariat M, Jafarabadi M, Aryamloo P, Rezayof E. Supplement Usage Pattern in a Group of COVID- 19 Patients in Tehran. J Fam Reprod Health. 14(3):158-165.