Evaluation of thiamine as adjunctive therapy in COVID-19 critically ill patients: a two-center propensity score matched study

Critical Care

Ramesh Vishwakarma¹  Ghassan Al Ghamdi²  Ohoud Aljuhani³  Asma Alshahrani⁴  Mashael Al Muqrin⁵  Maram Al Dossari⁵  Nouf Al Qahtani⁵  Fahad Al Eidan⁶  Abdulkareem M. Al Bekairy⁷  Khalid Al Sulaiman⁷  Majed Al Jeraisy⁷  Shmeylan Al Harbi⁷  Abdulmalik Al Katheri⁷  Rahmah Algarni⁸  Aisha Alharbi⁸ 

[1] Biostatistics and Bioinformatics Department, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia;College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia;Intensive Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia;Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia;Department of Pharmacy Practice, Faculty of Pharmacy, King Khalid University, Abha, Saudi Arabia;Pharmaceutical Care Department, King Abdulaziz Medical City (KAMC)/King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia;Pharmaceutical Care Department, King Abdulaziz Medical City (KAMC)/King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia;College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia;Pharmaceutical Care Department, King Abdulaziz Medical City (KAMC)/King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia;College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia;Pharmaceutical Care Department, King Abdulaziz University Hospital, Jeddah, Saudi Arabia;

关键词: COVID-19;    SARS-CoV-2;    Thiamine;    Vitamin B1;    Vitamins;    Critically ill;    Intensive care units (ICUs);    30-day mortality;   

DOI  :  10.1186/s13054-021-03648-9

来源: Springer

【 摘 要 】

BackgroundThiamine is a precursor of the essential coenzyme thiamine pyrophosphate required for glucose metabolism; it improves the immune system function and has shown to reduce the risk of several diseases. The role of thiamine in critically ill septic patient has been addressed in multiple studies; however, it’s role in COVID-19 patients is still unclear. The aim of this study was to evaluate the use of thiamine as an adjunctive therapy on mortality in COVID-19 critically ill patients.MethodsThis is a two-center, non-interventional, retrospective cohort study for critically ill patients admitted to intensive care units (ICUs) with a confirmed diagnosis of COVID19. All patients aged 18 years or older admitted to ICUs between March 1, 2020, and December 31, 2020, with positive PCR COVID-19 were eligible for inclusion. We investigated thiamine use as an adjunctive therapy on the clinical outcomes in critically ill COVID-19 patients after propensity score matching.ResultsA total of 738 critically ill patients with COVID-19 who had been admitted to ICUs were included in the study. Among 166 patients matched using the propensity score method, 83 had received thiamine as adjunctive therapy. There was significant association between thiamine use with in-hospital mortality (OR = 0.39; 95% CI 0.19–0.78; P value = 0.008) as well as the 30-day mortality (OR = 0.37; 95% CI 0.18–0.78; P value = 0.009). Moreover, patients who received thiamine as an adjunctive therapy were less likely to have thrombosis during ICU stay [OR (95% CI) 0.19 (0.04–0.88), P value = 0.03].ConclusionThiamine use as adjunctive therapy may have potential survival benefits in critically ill patients with COVID-19. Additionally, it was associated with a lower incidence of thrombosis. Further interventional studies are required to confirm these findings.

【 授权许可】

CC BY