Do vitamins halt the COVID-19-evoked pro-inflammatory cytokines involved in the development of neuropathic pain?

Abstract

Neuropathic pain (NP), a disease affecting the somatosensory nervous system, causes a high socioeconomic burden on healthcare systems and society; yet, its management has not been fully solved. Post COVID-19, with sequelae of the somatosensory system, further increases the number of individuals with chronic pain, thus further exacerbating the social burden related to NP. The pro-inflammatory mediators, such as TNF-α, IL-1β, and IL-6, are massively released in patients with COVID-19 and are known to be involved in the pathomechanisms of NP, particularly in relation to neuronal sensitization. Specifically, the release of large amounts of these pro-inflammatory cytokines from immune and non-immune effector cells during the acute and post COVID-19 phases prone to have substantial involvement in the development of post COVID-19 NP. Several preclinical and clinical studies have shown that vitamins’ supplementation, namely vitamins A, B1, B2, B3, B5, B6, B7, B9, B12, C, D, E, and K can attenuate the enhanced release of TNF-α, IL-1β, and IL-6. The early supplementation of these vitamins may mitigate the neuronal sensitization evoked by cytokine storm due to COVID-19 or other viruses. This strategy may provide a novel approach to prevent the development of post COVID-19 NP. This review highlights the mechanisms by which COVID-19 can induce NP and how vitamins may help to alleviate these post COVID-19 sequelae.