Nutritional supplements potentially beneficial in COVID-19

7th December 2020

During the COVID-19 pandemic, sales of nutritional supplements known to have an important role in immune function such as vitamins C, D and the mineral, zinc, increased substantially. However, to date, no trials have shown evidence for a beneficial role of these supplements in COVID-19.

Given this lack of evidence on the possible value of nutritional supplements in either preventing or reducing the severity of infection with COVID-19, researchers from Kings’ College, London, wondered if they could examine the association between supplement use and self-reported infection with the virus, from data collected as part of the COVID Symptom study app. The app allows users to self-report a vast amount of data including demographics, core risk factors, COVID-19 symptoms and test results. In fact, data collected from the app has already led to the acceptance of anosmia and skin rashes as important symptoms of COVID-19 infection. Using a yes/no question, the app enquires as to whether an individual uses any nutritional supplements on a regular basis, defined as more than three times a week. The app has a list of various supplements including probiotics, garlic, omega-3 fish oils, multivitamins as well as vitamins C, D separately and the mineral, zinc. For the present analysis, the team included a subset of participants who reported being tested for COVID-19 using either the PCR test or via serology and who reported that they used nutritional supplements. The primary outcome was the report of a positive test for COVID-19.

Findings
A total of 175,652 individuals self-reported using nutritional supplements regularly since the beginning of the pandemic. Analysis of their data showed a significant 13% reduced risk of testing positive for COVID-19 and regular use of multivitamins (odds ratio, OR = 0.87), supplementing with vitamin D (OR = 0.91), probiotics (OR = 0.86) and omega fish oils (OR = 0.88). In contrast, there was no statistically significant association for either zinc, vitamin C or garlic. Interestingly, these protective effects were only significant for females and this was seen across all age groups and body mass indices. No protective effect was seen for males although for males aged > 60 years, there was a positive association between use of zinc and vitamin C and testing positive for COVID-19.

Although the associations were not huge, the researchers called for trials to test the protective effects of these nutrients before making any specific supplement recommendations.

Citation
Louca P et al. Dietary supplements during the COVID-19 pandemic: insights from 1.4M users of the COVID Symptom Study app – a longitudinal app-based community survey. MedRxiv preprint doi: https://doi.org/10.1101/2020.11.27.20239087