Folate Levels in Patients Hospitalized with Coronavirus Disease 2019

Nutrients
Q1
Mar 2021
Citations:26
Influential Citations:2
Observational Studies (Human)
80
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Enhanced Details

Methods
Retrospective cohort at Sheba Medical Center, Israel. Included 333 adults (≥18 years) hospitalized with PCR-confirmed COVID-19 (Jan 27, 2020 to Nov 23, 2020) who had at least one serum folate level measured; the lowest value was used if multiple measurements. Folate measured by Beckman-Coulter DxI 800 chemiluminescent immunoassay. Primary outcomes: mortality and a composite of invasive ventilation and mortality; secondary outcomes included AKI, hypoxemia, and length of stay. Analyses included logistic regression and Cox proportional hazards, adjusting for age, sex, BMI, comorbidities, low systolic BP, creatinine, and folic acid therapy.
Results
Folate deficiency (<5.9 ng/mL) occurred in 11.4% (38/333). No significant differences in AKI, hypoxemia, invasive ventilation within 30 days, mortality within 60 days, or length of stay between decreased and normal folate groups, nor across folate quartiles. Multivariable analyses showed no significant association between low folate and mortality or the composite outcome. Folic acid therapy showed no significant effect on outcomes. Conclusion: Decreased serum folate is common among hospitalized COVID-19 patients but not linked to worse outcomes; monitor folate status and consider supplementation to prevent deficiency; more studies needed.
Limitations
Retrospective, single-center design; folate levels measured in only a subset (333/1020 hospitalized patients); potential selection bias; no red blood cell folate or homocysteine measurements; possible underestimation of AKI; observational design limits causal inference.

Abstract

We aimed to investigate the prevalence of decreased folate levels in patients hospitalized with Coronavirus Disease 2019 (COVID-19) and evaluate their outcome and the prognostic signifi-cance associated with its different levels. In this retrospectiv...