Potential benefit of high-dose intravenous vitamin C for coronavirus disease 2019 pneumonia

Abstract BackgroundNo specific medication has been proven effective for the treatment of patients with severe coronavirus disease 2019 (COVID-19). Here, we tested whether high-dose vitamin C infusion was effective for severe COVID-19.MethodsThis randomized, controlled clinical trial was performed at 3 hospitals in Hubei, China. Patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the ICU were randomly assigned in as 1:1 ratio to either the high-dose intravenous vitamin C (HDIVC) or the placebo. HDIVC group received 12 g of vitamin C/50 ml every 12 hours for 7 days at a rate of 12 ml/hour, and the placebo group received bacteriostatic water for injection in the same way. The primary outcome was invasive mechanical ventilation-free days in 28 days(IMVFD28). Secondary outcomes were 28-day mortality, organ failure, and inflammation progression.ResultsFifty-four critical COVID-19 patients were ultimately recruited. There was no difference in IMVFD28 between two groups. During the 7-day treatment period, patients in the HDIVC group had a steady rise in the PaO2/FiO2 (day 7: 229 vs. 151 mmHg, 95% CI 33 to 122, P = 0.01). Patients with SOFA scores ≥ 3 in the HDIVC group exhibited a significant reduction in 28-day mortality (P = 0.05) in univariate survival analysis. IL-6 in the VC group was lower than that in the placebo group (19.42 vs. 158.00; 95% CI -301.72 to -29.79; P = 0.04) on day 7.ConclusionThe addition of HDIVC may provide a protective clinical effect without any adverse events in critically ill patients with COVID-19.Clinicaltrial.gov identifer: NCT04264533

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Early high-dose vitamin C in post-cardiac arrest syndrome (VITaCCA): study protocol for a randomized, double-blind, multi-center, placebo-controlled trial

Trials ◽

10.1186/s13063-021-05483-3 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Sander Rozemeijer ◽

Harm-Jan de Grooth ◽

Paul W. G. Elbers ◽

Armand R. J. Girbes ◽

Corstiaan A. den Uil ◽

...

Keyword(s):

Cardiac Arrest ◽

Vitamin C ◽

Organ Failure ◽

Controlled Trial ◽

Lung Injury Score ◽

High Dose ◽

Double Blind ◽

Link Type ◽

Search Trial ◽

Intravenous Vitamin

Abstract Background High-dose intravenous vitamin C directly scavenges and decreases the production of harmful reactive oxygen species (ROS) generated during ischemia/reperfusion after a cardiac arrest. The aim of this study is to investigate whether short-term treatment with a supplementary or very high-dose intravenous vitamin C reduces organ failure in post-cardiac arrest patients. Methods This is a double-blind, multi-center, randomized placebo-controlled trial conducted in 7 intensive care units (ICUs) in The Netherlands. A total of 270 patients with cardiac arrest and return of spontaneous circulation will be randomly assigned to three groups of 90 patients (1:1:1 ratio, stratified by site and age). Patients will intravenously receive a placebo, a supplementation dose of 3 g of vitamin C or a pharmacological dose of 10 g of vitamin C per day for 96 h. The primary endpoint is organ failure at 96 h as measured by the Resuscitation-Sequential Organ Failure Assessment (R-SOFA) score at 96 h minus the baseline score (delta R-SOFA). Secondary endpoints are a neurological outcome, mortality, length of ICU and hospital stay, myocardial injury, vasopressor support, lung injury score, ventilator-free days, renal function, ICU-acquired weakness, delirium, oxidative stress parameters, and plasma vitamin C concentrations. Discussion Vitamin C supplementation is safe and preclinical studies have shown beneficial effects of high-dose IV vitamin C in cardiac arrest models. This is the first RCT to assess the clinical effect of intravenous vitamin C on organ dysfunction in critically ill patients after cardiac arrest. Trial registration ClinicalTrials.gov NCT03509662. Registered on April 26, 2018. https://clinicaltrials.gov/ct2/show/NCT03509662European Clinical Trials Database (EudraCT): 2017-004318-25. Registered on June 8, 2018. https://www.clinicaltrialsregister.eu/ctr-search/trial/2017-004318-25/NL

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A Pharmacokinetic Study of High‐Dose Intravenous Vitamin C in Healthy Volunteers and Oncological Patients

The FASEB Journal ◽

10.1096/fasebj.2021.35.s1.02547 ◽

2021 ◽

Vol 35 (S1) ◽

Author(s):

Ping Chen ◽

Yan Ma ◽

Gregory Reed ◽

Yu Jiang ◽

Mark Levine ◽

...

Keyword(s):

Vitamin C ◽

Healthy Volunteers ◽

Pharmacokinetic Study ◽

High Dose ◽

Oncological Patients ◽

Intravenous Vitamin

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Intravenous vitamin C in the treatment of allergies: an interim subgroup analysis of a long-term observational study

Journal of International Medical Research ◽

10.1177/0300060518777044 ◽

2018 ◽

Vol 46 (9) ◽

pp. 3640-3655 ◽

Cited By ~ 6

Author(s):

Claudia Vollbracht ◽

Martin Raithel ◽

Bianka Krick ◽

Karin Kraft ◽

Alexander F. Hagel

Keyword(s):

Vitamin C ◽

Observational Study ◽

Allergic Diseases ◽

Controlled Clinical Trial ◽

High Dose ◽

Definitive Evidence ◽

Key Factor ◽

Allergy Treatment ◽

Intravenous Vitamin ◽

Disease Specific

Objective Oxidative stress appears to be a key factor in the pathogenesis of allergic diseases and a potential therapeutic target in allergy treatment. Allergic diseases are reportedly associated with reduced plasma levels of ascorbate, which is a key physiological antioxidant. Ascorbate prevents excessive inflammation without reducing the defensive capacity of the immune system. Methods An interim analysis of a multicenter, prospective, observational study was conducted to investigate the change in disease-specific and nonspecific symptoms (fatigue, sleep disorders, depression, and lack of mental concentration) during adjuvant treatment with intravenous vitamin C (Pascorbin®; Pascoe, Giessen, Germany) in 71 patients with allergy-related respiratory or cutaneous indications. Results Between the start and end of treatment, the mean sum score of three disease-specific symptoms decreased significantly by 4.71 points and that of four nonspecific symptoms decreased significantly by 4.84 points. More than 50% of patients took no other allergy-related medication besides vitamin C. Conclusions Our observations suggest that treatment with intravenous high-dose vitamin C reduces allergy-related symptoms. Our observations form a basis for planning a randomized controlled clinical trial to obtain more definitive evidence of the clinical relevance of our findings. We also obtained evidence of ascorbate deficiency in allergy-related diseases. Trial registration: Clinical Trials NCT02422901.

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