scholarly journals High-dose vitamin C infusion for the treatment of critically ill COVID-19

2020 ◽  
Author(s):  
Jing Zhang ◽  
Xin Rao ◽  
Yiming Li ◽  
Yuan Zhu ◽  
Fang Liu ◽  
...  
Keyword(s):  
Placebo Group ◽  
Vitamin C ◽  
Critically Ill ◽  
Day Treatment ◽  
Invasive Mechanical Ventilation ◽  
Controlled Clinical Trial ◽  
High Dose ◽  
C 50 ◽  
Intravenous Vitamin ◽  
High Dose Vitamin

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

scholarly journals Pilot Trial of High-dose vitamin C in critically ill COVID-19 patients

2020 ◽  
Author(s):  
Jing Zhang ◽  
Xin Rao ◽  
Yiming Li ◽  
Yuan Zhu ◽  
Fang Liu ◽  
...  
Keyword(s):  
Placebo Group ◽  
Vitamin C ◽  
Critically Ill ◽  
Day Treatment ◽  
Invasive Mechanical Ventilation ◽  
Pilot Trial ◽  
Controlled Clinical Trial ◽  
High Dose ◽  
C 50 ◽  
High Dose Vitamin

Abstract Background: No 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.Methods: This 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.Results: Only fifty-six critical COVID-19 patients were ultimately recruited due to the early control of the outbreak. 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 trend of reduction in 28-day mortality (P=0.06) in univariate survival analysis. IL-6 in the HDIVC) 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. Conclusion: This pilot trial showed that HDIVC might show a potential signal of benefit for critically ill patients with COVID-19, improving oxygenation even though it failed to improve IMVFD28. Clinicaltrial.gov identifer and date: NCT04264533. Registered February 14 2020.

scholarly journals Pilot trial of high-dose vitamin C in critically ill COVID-19 patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jing Zhang ◽  
Xin Rao ◽  
Yiming Li ◽  
Yuan Zhu ◽  
Fang Liu ◽  
...  
Keyword(s):  
Vitamin C ◽  
Organ Failure ◽  
Critically Ill ◽  
Day Treatment ◽  
Invasive Mechanical Ventilation ◽  
Pilot Trial ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
High Dose ◽  
High Dose Vitamin

Abstract Background Few specific medications have 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. Methods This 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 h for 7 days at a rate of 12 ml/hour, and the placebo group received bacteriostatic water for injection in the same way within 48 h of arrival to ICU. The primary outcome was invasive mechanical ventilation-free days in 28 days (IMVFD28). Secondary outcomes were 28-day mortality, organ failure (Sequential Organ Failure Assessment (SOFA) score), and inflammation progression (interleukin-6). Results Only 56 critical COVID-19 patients were ultimately recruited due to the early control of the outbreak. There was no difference in IMVFD28 between two groups (26.0 [9.0–28.0] in HDIVC vs 22.0 [8.50–28.0] in control, p = 0.57). HDIVC failed to reduce 28-day mortality (P = 0.27). 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), which was not observed in the control group. IL-6 in the HDIVC group was lower than that in the control group (19.42 vs. 158.00; 95% CI -301.72 to -29.79; P = 0.04) on day 7. Conclusion This pilot trial showed that HDIVC failed to improve IMVFD28, but might show a potential signal of benefit in oxygenation for critically ill patients with COVID-19 improving PaO2/FiO2 even though.

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

2018 ◽  
Vol 46 (9) ◽  
pp. 3640-3655 ◽  
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.

scholarly journals High-doses vitamin C improves cardiac injury through attenuating hyperinflammation in COVID-19

2021 ◽  
Author(s):  
Guozhi Xia ◽  
Di Fan ◽  
Chaoran Ma ◽  
Yanru He ◽  
Yaohu Zhu ◽  
...  
Keyword(s):  
Vitamin C ◽  
Critically Ill ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Inflammatory Markers ◽  
Troponin I ◽  
Cardiac Injury ◽  
High Dose ◽  
High Doses ◽  
Intravenous Vitamin

Background: Cardiac injury is common and associated with worse clinical outcomes in COVID-19. Data are lacking whether high-dose intravenous vitamin C (HIVC) could help to improve cardiac injury in the pandemic. Methods: The study included severe and critically ill COVID-19 with cardiac injury. Troponin I and inflammatory markers were collected at admission and 14 days after treatment with HIVC along with symptomatic supportive treatment from the electronic medical records. Results: The patients (n = 113) were categorized into the improved cardiac injury (ICI) group (n = 70) and the non-improved cardiac injury (NICI) group (n = 43). Overall, 51 (45.1%) patients were administrated with HIVC, the percentages of patients with HIVC were higher in the ICI group than those in the NICI group. Logistic regression analysis revealed that HIVC was independently associated with improved cardiac injury. Further analysis showed that inflammatory markers levels significantly decreased at 14 days after treatment with HIVC compared to those without HIVC. Meanwhile, similar results were also observed regarding changes in inflammatory markers levels from baseline to 14 days after treatment with HIVC. Conclusions: HIVC can improve cardiac injury through attenuating hyperinflammation in severe and critically ill patients with COVID-19.

scholarly journals High dose vitamin C in sepsis (HDVCIS): study protocol for a randomized controlled trial

2021 ◽  
Author(s):  
Bing Zhao ◽  
Mengjiao Li ◽  
Jian Li ◽  
Leshan Liu ◽  
Yihui Wang ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Vitamin C ◽  
Animal Studies ◽  
Controlled Trial ◽  
Small Scale ◽  
Controlled Clinical Trial ◽  
High Dose ◽  
Clinical Trial Registry ◽  
Double Blind ◽  
High Dose Vitamin

Abstract Sepsis is an inflammatory syndrome with life-threatening organ dysfunction resulting from a dysregulated host response to infection. Although the treatment for sepsis has improved a lot in the last 30 years, sepsis related mortality remains high. In the recent 10 years, high dose intravenous injection of vitamin C, the first line antioxidant of human, has received more and more attention in the field of critical care, its beneficial effect has been demonstrated by several small scale clinical trial and animal studies, but the effect of high dose vitamin C on sepsis in a larger trial seems warranted in further study. Here we will conduct a prospective, multi-center, double-blind, adaptive sample size, randomized, placebo-controlled, clinical trial named as HDVCIS. The trial protocol has been approved by Clinical Trail Ethics Committee of Ruijin Hospital of Shanghai JiaoTong University School of Medicine. This trial has been registered in Chinese Clinical Trial Registry (ChiCTR1800017633) in August 7, 2018. Patients will be recruited from 4 medical centers in China. Its object is to testify the efficacy and safety of high dose vitamin C in the treatment of sepsis.

scholarly journals High-dose intravenous vitamin C treatment for COVID-19

2020 ◽  
Author(s):  
Adnan Erol
Keyword(s):  
Lung Injury ◽  
Vitamin C ◽  
High Dose ◽  
Immune Effector ◽  
Effector Cells ◽  
Early Stages ◽  
Immune Effector Cells ◽  
Choice Of Treatment ◽  
Intravenous Vitamin ◽  
High Dose Vitamin

COVID-19 pneumonia seems to be a lung injury caused by the hyperactivation immune effector cells. High-dose vitamin C may result in immunosuppression at the level of these effectors. Therefore, intravenous high-dose vitamin C could be safe and beneficial choice of treatment in the early stages of COVID-19.

A phase III study of comparing FOLFOX+/-bevacizumab with FOLFOX+/-bevacizumab+ high-dose intravenous vitamin C as first-line therapy in patients with advanced colorectal cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. TPS4115-TPS4115
Author(s):  
Feng Wang ◽  
Jian Xiao ◽  
Yan-Qiao Zhang ◽  
Xianglin Yuan ◽  
Weijia Fang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Vitamin C ◽  
Advanced Colorectal Cancer ◽  
Progression Free Survival ◽  
High Dose ◽  
First Line ◽  
Free Survival ◽  
First Line Therapy ◽  
Intravenous Vitamin ◽  
High Dose Vitamin

TPS4115 Background: Previous studies showed that high dose vitamin C especially when administered intravenously might have anti-cancer effect. A recent preclinical study found that human colorectal cancer cells harboring KRAS or BRAF mutations are selectively killed by high dose vitamin C. Our phase I dose-escalation and expansion study has shown that high dose (up to 1.5g/kg) intravenous vitamin C with FOLFOX or FOLFIRI is well tolerated in patients with colorectal or gastric cancer. This trial is a randomized, multicenter, phase Ⅲ study of high dose vitamin C infusion combined with FOLFOX +/- bevacizumab versus FOLFOX +/- bevacizumab as first-line therapy in patients with advanced colorectal cancer. Methods: This study has enrolled patients with histologically confirmed metastatic adenocarcinoma of colorectum, normal G6PD status and no prior treatment for metastatic disease. 432 patients are randomized 1:1 into one of two groups. Patients in the control group are treated with mFOLFOX6 (oxaliplatin 85 mg/m² d1 concurrent with leucovorin 400 mg/m², followed by bolus 5FU 400 mg/m² d1, followed by infusional 5FU 2400 mg/m² over 46 hours) with or without bevacizumab (5mg/kg, d1) every 2 weeks. Patients in the experimental group are treated with vitamin C intravenously (1.5g/kg/day, d1-3) in combination with mFOLFOX6 with or without bevacizumab every 2 weeks. Randomization is stratified by the location of primary site (left-sided or right-sided) and treatment with bevacizumab (with or without). The primary endpoint is progression free survival (assessed by investigator per RECIST v1.1). Secondary endpoints are overall survival, response rate, assessment of treatment-related adverse events, progression free survival and overall survival in RAS or BRAF mutant patients. Genome, microbiome and metabolome are also assessed. Clinical trial information: NCT02969681 .

scholarly journals Effect of High-Dose Intravenous Vitamin C on Postpartum Oxidative Stress in Severe Preeclampsia

2020 ◽  
Vol 1 (2) ◽  
pp. 122-131
Author(s):  
Monika Korenc ◽  
Joško Osredkar ◽  
Ksenija Gersak ◽  
Kristina Kumer ◽  
Teja Fabjan ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Placebo Group ◽  
Vitamin C ◽  
Controlled Trial ◽  
Study Groups ◽  
Severe Preeclampsia ◽  
High Dose ◽  
Oxidative Stress Biomarkers ◽  
Intravenous Vitamin ◽  
Singleton Pregnancies

Purpose: To determine whether high-dose intravenous vitamin C reduces oxidative stress in patients with severe preeclampsia in the first days postpartum. Methods: Biomarkers of oxidative stress were assessed as secondary outcomes of a single-center, randomized, placebo-controlled trial. Thirty-four patients with singleton pregnancies complicated by severe features of preeclampsia were randomized into two groups: intravenous vitamin C (1.5 g/6 h) (n = 17) or placebo (n = 17). Urinary concentrations of dityrosine, 8-hydroxy-2-deoxyguanosine (8-OHdg), 8-isoprostane, and N epsilon-(hexanoyl) lysine (HEL) were measured at days one and three after delivery and normalized for urinary creatinine in 22 of patients included (12 in vitamin C and 10 in placebo group). The Mann–Whitney U-test was used to compare values of oxidative stress biomarkers at days one and three after delivery in vitamin C vs. placebo groups (p ≤ 0.05 significant). Results: Dityrosine and 8-OHdg values did not differ significantly between the two study groups at day one after delivery (p = 0.23 and p = 0.77, respectively), but were significantly lower in the vitamin C group compared to the placebo group at day three after delivery (p = 0.04 and p = 0.03, respectively). Values of 8-isoprostane and HEL did not differ significantly between the two study groups at day one (p = 0.41 and p = 0.42, respectively), as well as at day three, after delivery (p = 0.25 and p = 0.24, respectively). Conclusion: High-dose intravenous vitamin C treatments in patients with severe preeclampsia reduced urinary levels of dityrosine and 8-OHdg (markers of protein and DNA oxidative damage, respectively) on day three after delivery. Vitamin C treatment had no significant effect on lipid peroxidation biomarkers, i.e., 8-isoprostane and HEL.

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