Impact of supplemental vitamins and natural honey for treatment of COVID-19: A review

Abstract The main aim of the paper is to assess whether vitamin C, vitamin D, and natural honey can be administered in the course of the COVID-19 pandemic for promising in line methods with recent evidence. Both systematic literature and clinical trial identification were conducted by searching various databases. A total 58 articles and 29 clinical trials were selected wherein 11 for vitamin C, 16 for vitamin D, and 2 for natural honey were identified for analysis. The high doses of vitamin C (i.e. ‘200 mg/kg body weight/day, divided into 4 doses’) has been found to reduce COVID-19 lung damage, various flu infections. Additionally, the high doses of vitamin C can shorten around 7.8% stay in the intensive care unit. At the same time, vitamin D can effectively protect from lung injury and acute respiratory infections whereas vitamin D deficiency severely affects 75% of the institutionalized people (serum 25(OH) D < 25 nmol/L). Meanwhile, natural honey which contains proteins (0.1-0.4%); ash (0.2%); water (15-17%) has potential antiviral effects and the ability to improve immunity. Therefore, the administration of vitamins and honey is the promising evidence-based approach for reducing fatalities, saving lives, and bringing the COVID-19 pandemic to a rapid end. It is believed that the utilization of vitamin C, vitamin D, and natural honey with the current treatment may be effective in treating COVID-19-caused fatal complications such as pneumonia. Therefore, high-level clinical studies are required on COVID-19 to administrate the effects of vitamins and natural honey.摘要 本研究旨在评估在新冠（COVID-19）大流行期间，维生素C（vitamin C）、维生素D（vitamin D）及天然蜂蜜（natural honey）是否可作为契合现有研究证据的可靠干预手段。研究通过检索多个数据库开展系统文献梳理与临床试验筛选，最终纳入58篇文献及29项临床试验，其中纳入分析的研究包括：维生素C相关研究11项、维生素D相关研究16项、天然蜂蜜相关研究2项。研究结果显示，高剂量维生素C（即"每日200mg/kg体重，分4次给药"）可减轻新冠肺损伤及各类流感感染；此外，高剂量维生素C可使重症监护病房（Intensive Care Unit, ICU）停留时长缩短约7.8%。与此同时，维生素D可有效预防肺损伤与急性呼吸道感染，而维生素D缺乏会影响75%的机构照护人群（血清25(OH)D <25nmol/L）。天然蜂蜜含有0.1%~0.4%的蛋白质、0.2%的灰分及15%~17%的水分，具备潜在抗病毒活性与免疫改善能力。综上，补充维生素与天然蜂蜜是一种基于证据的可靠方案，可降低新冠死亡率、挽救生命并加速结束新冠大流行。现有治疗方案联合维生素C、维生素D及天然蜂蜜，或可有效治疗新冠引发的致命并发症（如肺炎）。因此，亟需开展高质量临床研究，以评估维生素与天然蜂蜜在新冠治疗中的应用效果。