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Multicenter Study
. 2021 Jun 30;25(1):223.
doi: 10.1186/s13054-021-03648-9.

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

Khalid Al Sulaiman  1   2 , Ohoud Aljuhani  3 , Maram Al Dossari  4 , Asma Alshahrani  5 , Aisha Alharbi  6 , Rahmah Algarni  6 , Majed Al Jeraisy  4   7 , Shmeylan Al Harbi  4   7 , Abdulmalik Al Katheri  4   7 , Fahad Al Eidan  4   8 , Abdulkareem M Al Bekairy  4   7 , Nouf Al Qahtani  4 , Mashael Al Muqrin  4 , Ramesh Vishwakarma  9 , Ghassan Al Ghamdi  8   10
Affiliations
Multicenter Study

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

Khalid Al Sulaiman et al. Crit Care. .

Abstract

Background: Thiamine 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.

Methods: This 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.

Results: A 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].

Conclusion: Thiamine 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.

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

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Conflict of interest statement

No author has a conflict of interest in this study.

Figures

Fig. 1
Fig. 1
a Overall survival plot during the hospital stay comparing patients who received thiamine (88 patients) as adjunctive therapy versus the control group (650 patients)—before PS matching. b Overall survival plot during the hospital stay comparing patients who received thiamine (83 patients) as adjunctive therapy versus the control group (83 patients)—after PS matching
See this image and copyright information in PMC

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