What vitamins and minerals are recommended for individuals with COVID-19 (Coronavirus disease 2019)?

Vitamins and Minerals for COVID-19 Patients

For COVID-19 patients, daily allowances of vitamins A, D, B vitamins (especially B6 and B12), vitamin C, vitamin E, along with zinc, selenium, and iron should be ensured to maximize general anti-infection nutritional defense, while avoiding supraphysiologic doses that lack established evidence for improved outcomes. 1

Key Micronutrients for COVID-19 Patients

• Low levels or intakes of specific micronutrients have been associated with adverse clinical outcomes during viral infections, including COVID-19 1

• Vitamins and minerals with evidence for immune support during COVID-19 include:

  • Vitamin D - associated with reduced risk of respiratory infections; deficiency linked to various viral diseases 1, 2
  • Vitamin A - considered an "anti-infective" vitamin crucial for the body's defenses against infection 1
  • B vitamins - especially B6 and B12 for immune function 1
  • Vitamin C - has antiviral properties and may attenuate excessive inflammatory responses 3, 4
  • Vitamin E - important for immune function during viral infections 1, 5
  • Zinc - critical for immune cell function and reducing viral replication 1, 3
  • Selenium - enhances cytotoxic effector cells and T cell function 1, 3
  • Iron - important for immune cell proliferation and function 1

Dosing Considerations

• For vitamin D:

  • For individuals with confirmed deficiency, 2000 IU/day is recommended 2
  • For those with recurrent deficiency, 4000-5000 IU/day for 2 months may be needed 2
  • Daily or weekly supplementation is more effective than large bolus doses 2

• For other vitamins and minerals:

  • Standard daily allowances are generally sufficient for most patients 1
  • There is no established evidence that supraphysiologic or supratherapeutic amounts of micronutrients improve COVID-19 outcomes 1

Important Considerations

• Nutritional supplementation should focus on correcting deficiencies rather than providing excessive amounts 1

• Malnourished patients or those at risk for malnutrition should be prioritized for supplementation 1

• Blood level monitoring is recommended when using higher doses of vitamin D (>2000 IU/day) to ensure efficacy and avoid toxicity 2

• Elderly individuals and those with malabsorption conditions are at higher risk for vitamin deficiencies 2

• Combining micronutrient supplementation with adequate protein intake and regular physical activity may provide optimal immune support 1, 2

Physical Activity Considerations

• Patients in quarantine should continue regular physical activity while taking precautions 1

• Physical activity helps maintain immune competence and prevent muscle loss during COVID-19 recovery 1

• Safe home exercises include walking indoors, strength exercises, stretching, and balance activities 1

Cautions

• Vitamin toxicity can occur with excessive supplementation, particularly with fat-soluble vitamins (A, D, E) 2

• Routine empirical use of high-dose micronutrients lacks established evidence for improved COVID-19 outcomes 1

• Supplementation should be viewed as complementary to standard medical care, not as a replacement 3, 5