Relationship between Serum Cobalamin Levels and Disease Severity in COVID-19 Patients

Background and Objective: Vitamins play a crucial role in cellular growth, function, and evolution. Additionally, they contribute significantly to pathogen defense through cellular responses and immune enhancement. Cobalamin has been identified to play a role in suppressing virus replication, generating anti-inflammatory responses, and boosting immunity in infected patients with COVID-19. Therefore, we hypothesized that the low cobalamin levels are associated with a predisposition to severe COVID-19 infection. The present study aimed to investigate the relationship between cobalamin levels and disease severity and prognosis in COVID-19 patients. Materials and Methods: This cross-sectional study included 117 COVID-19 patients hospitalized at Sina Hospital and categorized them into three groups based on their disease severity: mild to moderate, severe, and critical. Demographic information and clinical findings of the patients were recorded. Serum cobalamin levels were assessed using biochemical methods. Logistic regression and Receiver Operating Characteristic (ROC) analyses were employed for mortality prediction based on serum cobalamin levels. Results: The results revealed that patients with low cobalamin levels are more susceptible to severe COVID-19 infections. Furthermore, with each additional day of hospitalization, the mortality rate due to COVID-19 increased by 24%. The high area under the ROC curve (0.837) indicated that mortality in COVID-19 patients can be effectively predicted based on cobalamin levels. Conclusion: It appears that cobalamin supplementation may have positive effects on COVID-19 patients’ outcomes. Additionally, serum cobalamin levels serve as a valuable indicator for predicting the mortality rate in COVID-19 patients. However, comprehensive, longer-term studies with a larger number of patients are required.