Relation between Vitamin B12 Levels and Smell Affection in COVID-19 Patients

Elsayad, Osama A.; Abdou, Said Mohammed

doi:10.1055/s-0042-1755311

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International Archives of Otorhinolaryngology

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Original Research • iao 26 (4) • Oct-Dec 2022 • https://doi.org/10.1055/s-0042-1755311 copy

Relation between Vitamin B12 Levels and Smell Affection in COVID-19 Patients

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction

Olfactory and gustative alterations are frequent in the initial stages of the COVID-19 infection. Vitamin B12 deficiency has been linked to olfactory dysfunction.

Objective

The present study aimed to assess the relationship between vitamin B12 levels and smell affection in COVID-19 patients.

Methods

The present study included 201 laboratory-confirmed COVID-19 patients. Smell affection was assessed using self-rated olfactory function. Serum vitamin B12 levels were assessed using commercial enzyme-linked immunosorbent assay (ELISA) kits.

Results

According to the smell function assessment, the patients were classified into three categories: normal osmesis (n = 77), hyposmia (n = 49), and anosmia (n = 75) (►Fig. 1). Four weeks later, 195 patients (97.0%) had their normal smell function restored. The remainder 6 patients included 4 anosmic and 2 hyposmic patients. Patients with hyposmia or anosmia had significantly lower vitamin B12 levels when compared with patients with normal osmesis (median [IQR]: 363.0 [198.0–539.0] versus 337.0 [175.0–467.0] and 491.0 [364.5–584.5] pg/ml, respectively, p < 0.001).

Conclusion

Vitamin B12 appears to have some contribution to smell affection in patients with COVID-19 infection.

Keywords
COVID-19; vitamin B12; olfactory dysfunction

	All patients N = 201	Normal osmesis N = 77	Hyposmia N = 49	Anosmia N = 75	P-value
Age (years) median (IQR)	31.0(27.0-36.0)	33.0 (28.0–39.0)	32.0 (28.5–38.0)	30.0 (26.0–33.0)	0.003
Male/female n	132/69	47/30	35/14	50/25	0.48
Covid-19 severity n (%)
Mild	30 (14.9)	65 (84.4)	38 (77.6)	68 (90.7)	0.13
Severe	171 (85.1)	12 (15.6)	11 (22.4)	7 (9.3)	0.13
Laboratory findings median (IQR)
Hb (gm/dL)	13.0 (12.0–14.0)	12.8 (11.8–14.0)	13.0 (11.5–14.2)	13.2 (12.0–14.0)	0.27
WBCs (× 103/mL)	6.5 (4.5-10.0)	6.5 (4.0–10.0)	6.0 (4.6–10.7)	7.0 (4.5–10.0)	0.44
Platelets (× 103/mL)	212.0 (162.5-260.0)	200.0 (139.5–250.0)	200.0 (160.0–239.5)	215.0 (180.0–259.0)	0.17
CRP (mg/dL)	88.0 (44.5-126.5)	91.0 (41.0–145.5)	93.0 (50.5–122.5)	75.0 (41.0–118.0)	0.42
Procalcitonin (μg/L)	0.1 (0.08-0.2)	0.1 (0.1–0.2)	0.15 (0.08–0.2)	0.1 (0.08–0.2)	0.96
LDH (U/L)	614.0 (414.0-908.0)	527.0 (385.5–922.5)	621.0 (454.5–911.5)	618.0 (431.0–831.0)	0.38
Ferritin (μg/L)	663.0 (442.0-1,456.5)	648.0 (408.5–1,549.0)	800.0 (416.0–1,598.5)	713.0 (507.0–1,324.0)	0.65
PT (sec.)	13.9 (13.0–15.8)	14.3 (13.2–15.8)	14.8 (13.3–16.7)	14.5 (13.0–16.0)	0.36
APTT (sec.)	34.0 (30.0–42.0)	35.0 (31.0–40.5)	36.0 (32.0–45.5)	33.0 (30.0–44.0)	0.27
D-dimer (ng/mL)	1162.0 (746.5-2,122.0)	978.0 (732.0–2, 122.0)	1290.0 (810.0–2,549.0)	980.0 (750.0–1,750.0)	0.35
Fibrinogen (gm/dL)	3.7 (3.0-4.8)	3.7 (3.1–4.7)	4.1 (3.0–5.2)	3.5 (3.0–4.5)	0.23
Creatinine (mg/dL)	1.1 (0.8-1.3)	1.0 (0.9–1.3)	0.9 (0.9–1.25)	0.9 (0.8–1.3)	0.1
Urea (mg/dL)	50.0 (38.0–76.0)	51.0 (38.0–76.5)	56.0 (41.0–80.0)	45.0 (37.0–72.0)	0.42
Albumin (gm/dL)	3.2 (3.0-4.0)	3.5 (3.0–3.9)	3.5 (3.1–3.8)	3.5 (3.1–4.0)	0.88
AST (U/L)	45.0 (29.0–72.5)	47.0 (34.5–76.0)	41.0 (28.0–76.0)	42.0 (27.0–67.0)	0.19
ALT (U/L)	51.0 (34.0-80.0)	59.0 (37.0–81.0)	48.0 (33.0–80.0)	44.0 (26.0–76.0)	0.08
O2 saturation (%)	90.0 (80.0- 95.0)	92.0 (80.0–95.0)	90.0 (80.0–94.0)	92.0 (85.0–95.0)	0.07
Vitamin B12 (pg/mL)	403.0 (212.0-544.5)	491.0 (364.5–584.5)	363.0(198.0–539.0)	337.0 (175.0–467.0)	< 0.001

	Vitamin B12
Age	0.12	0.17
Hb	0.04	0.61
WBCs	-0.07	0.35
Platelets	0.09	0.19
CRP	0.04	0.56
Procalcitonin	0.03	0.71
LDH	–0.03	0.67
Ferritin	–0.04	0.6
PT	–0.04	0.58
APTT	0.02	0.82
D-dimer	–0.03	0.7
Fibrinogen	0.11	0.06
Creatinine	0.14	0.056
Urea	0.06	0.41
Albumin	0.1	0.08
AST	–0.08	0.26
ALT	0.11	0.07
O2 saturation	–0.07	0.27

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[1] Address for correspondence Osama A. Elsayad, Benha University Faculty of Medicine, Tanta University Faculty of Medicine, El Bahr St. 'Tanta Qism 2, Tanta, Gharbia Governorate 31111, Egypt (e-mail: drsayado@yahoo.com).