The Role of Thiamine in the Management of Refractory Hy-poxemia, Refractory Hypotension and Shock in Critically Ill Covid-19 Patients



Dear editor, we would like to share you our experience regarding the management of re-fractory hypoxemia, refractory hypotension and shock in critically ill Covid-19 patients. We believe that, one of the main causes of the deterioration of Covid-19 patients could be malnutrition with vitamins depletion from the body. Many of these patients presented with loss of appetite and taste accompanied with poor oral intake for several days or even weeks. This will deplete the body resources from Macro-& micro-nutrients especially thi-amine, which can be deficient in 3-14 days particularly if the patient is already malnour-ished, taking anti-thiamine products (as coffee, tea), receiving Total Parenteral Nutrition (TPN), on Continuous Renal Replacement Therapy (CRRT), or had a bariatric surgery. From the daily practice, we have noticed that refractory hypoxemia, refractory hypoten-sion, or septic shock is exaggerated by Thiamine deficiency.