scholarly journals High Dose Intravenous Vitamin C for Preventing The Disease Aggravation of Moderate COVID-19 Pneumonia. A Retrospective Propensity Matched Before-After Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Bing Zhao ◽  
Min Liu ◽  
Ping Liu ◽  
Yibing Peng ◽  
Jun Huang ◽  
...  
Keyword(s):  
Vitamin C ◽  
Inflammatory Response ◽  
Early Stage ◽  
Treatment Options ◽  
Control Group ◽  
High Dose ◽  
Protein Levels ◽  
Number Of Patients ◽  
Significant Difference ◽  
Intravenous Vitamin

Background: Coronavirus disease 2019 (COVID-19) pandemic is continuing to impact multiple countries worldwide and effective treatment options are still being developed. In this study, we investigate the potential of high-dose intravenous vitamin C (HDIVC) in the prevention of moderate COVID-19 disease aggravation.Methods: In this retrospective before-after case-matched clinical study, we compare the outcome and clinical courses of patients with moderate COVID-19 patients who were treated with an HDIVC protocol (intravenous injection of vitamin C, 100 mg/kg/day, 1 g/h, for 7 days from admission) during a one-month period (between March 18 and april 18, 2020, HDIVC group) with a control group treated without the HDIVC protocol during the preceding two months (January 18 to March 18, 2020). Patients in the two groups were matched in a 1:1 ratio according to age and gender.Results: The HDIVC and control groups each comprised 55 patients. For the primary outcomes, there was a significant difference in the number of patients that evolved from moderate to severe type between the two groups (HDIVC: 4/55 vs. control: 12/55, relative risk [RR] = 0.28 [0.08, 0.93], P = 0.03). Compared to the control group, there was a shorter duration of systemic inflammatory response syndrome (SIRS) (P = 0.0004) during the first week and lower SIRS occurrence (2/21 vs 10/22, P = 0.0086) on Day 7 (6–7 days after admission). In addition, HDIVC group had lower C-reactive protein levels (P = 0.005) and higher number of CD4+ T cells from Day 0 (on admission) to Day 7 (P = 0.04).” The levels of coagulation indicators, including activated partial thromboplastin time and D-dimer were also improved in the HDIVC compared to the control group on Day 7.Conclusion: HDIVC may be beneficial in limiting disease aggravation in the early stage of COVID-19 pneumonia, which may be related to its improvements on the inflammatory response, immune function and coagulation function. Further randomized controlled trials are required to augment these findings.

scholarly journals Profile of Blood Glucose and Insulin after Vitamin C and Vitamin E Supplementation on Active Teenagers

2018 ◽  
Vol 7 (4.26) ◽  
pp. 136
Author(s):  
Irfiansyah Irwadi ◽  
Hayuris Kinandita ◽  
Jamaluddin Mahmud ◽  
Lilik Herawati
Keyword(s):  
Blood Glucose ◽  
Vitamin E ◽  
Vitamin C ◽  
Serum Insulin ◽  
Fasting Blood Glucose ◽  
Combination Group ◽  
Control Group ◽  
High Dose ◽  
Moderate Dose ◽  
Significant Difference

Aim: Antioxidants, such as vitamin C and vitamin E, is widely used as supplements. The aim of this study is to analyze the profile of blood glucose, serum insulin, and  HOMA in active teenagers after vitamin C and vitamin E supplementation.Methods: Subjects (14-16 y.o) consisted of 12 boys and 5 girls, divided into 3 groups: control (4 boys, 2 girls), ‘moderate dose’ of vitamin C and vitamin E combination group (5 boys, 1 girls), and ‘high dose’ of vitamin C and vitamin E combination group (3 boys, 2 girls). The treatment was given for 5 days. Vitamin C and vitamin E for ‘moderate dose’ was 500mg;  200IU, and for ‘high dose’ was 1000mg; 400IU. Fasting Blood Glucose (FGB) and 1 hour BG (1hr_BG), fasting serum insulin (FSI) and 1 hour SI (1hr_SI) was collected after treatment. We also calculated the HOMA-IR and HOMA-β.Result: There was no significant difference on FBG, 1hr_BG, FSI, 1hr_SI, HOMA-IR, and HOMA-β (p≥ 0.05). However, mean FBG and 1hr_BG tended to be higher on the treatment groups. The control group had the lowest HOMA-IR and the highest HOMA-β.Conclusions: We suggest that the supplementation of vitamin C and vitamin E in active teenagers is not essential on glucose homeostasis.  

scholarly journals Safety and Effectiveness of High-Dose Vitamin C in Patients with COVID-19; A Randomized Controlled open-label Clinical Trial ‎

2021 ◽  
Author(s):  
Saeidreza JamaliMoghadamSiahkali ◽  
Besharat Zarezade ◽  
Sogol Koolaji ◽  
Seyed Ahmad Seyed Alinaghi ◽  
Abolfazl Zendehdel ◽  
...  
Keyword(s):  
Vitamin C ◽  
Controlled Trial ◽  
Control Treatment ◽  
Control Group ◽  
P Value ◽  
Case Group ◽  
High Dose ◽  
Open Label ◽  
Significant Difference ◽  
High Dose Vitamin

Abstract Background: To assess the effectiveness of vitamin C treatment against coronavirus disease 2019 (COVID-19)Methods: An open-label, randomized, and controlled trial was conducted on patients with severe COVID-19 infection. The case and control treatment groups each consisted of 30 patients. The control group received lopinavir/ritonavir and hydroxychloroquine and the case group received high-dose of vitamin C (six gr daily) added to the same regimen. Results: There were no statistically significant differences between two groups with respect to age and gender, laboratory results, and underlying diseases. On the 3rd day of hospitalization, the mean core body temperatures was significantly lower and SpO2 was higher In the case group (p value = 0.001, and 0.014, respectively). The median length of hospitalization in case group which was significantly longer than the control group (8.5 days vs. 6.5 days) (p value = 0.0280). There was no significant difference in SpO2 levels at discharge time, the length of ICU stay, and mortality between the two groups.Conclusions: We did not find significantly better outcomes in the group who were treated with high-dose vitamin C in addition to the main treatment regimen at discharge.Trial registration: The project was registered by Iranian Registry of Clinical Trials.IRCT20200411047025N1

scholarly journals De-escalation Antibiotic Therapy Alleviates Organ Injury through Modulation of NET Formation during Sepsis

2020 ◽  
Author(s):  
Tian Xie ◽  
Chengnan Chu ◽  
Shilong Sun ◽  
Xinyu Wang ◽  
Zehua Duan ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Late Stage ◽  
Early Stage ◽  
Neutrophil Extracellular Trap ◽  
Organ Injury ◽  
Control Group ◽  
Histopathological Analysis ◽  
Escalation Therapy ◽  
Significant Difference

Empiric broad-spectrum antimicrobials therapy is suggested to be started immediately for sepsis patients. Empiric antimicrobial therapy should be narrowed once pathogen identification and sensitivities are established. However, the detail mechanisms of de-escalation strategy are still unclear. Here we hypothesized neutrophil extracellular trap (NETs) played an essential role and de-escalation strategy might alleviate organs injury through regulation of NETs formation in sepsis. We evaluated the effect of imipenem and ceftriaxone on NETs formation in vitro and examined the role of reactive oxygen species (ROS). Next, we designed de-escalation and escalation strategy based on their effects on NETs formation in CLP model. Organ injury, inflammatory cytokines, NETs levels were compared and evaluated. The in vitro study showed that imipenem and ceftriaxone had opposite effects on NETs formation in activated neutrophils. De-escalation therapy resulted in an evaluated MPO-DNA during early stage and decreased MPO-DNA during late stage, which exerted the reverse effects in escalation therapy sepsis animal model. Inflammatory response and organ injury exacerbated when eliminated NETs with DNAseI during early stage of sepsis (p<0.01). Histopathological analysis showed decreased injury in lung, liver and intestine in de-escalation therapy compared with escalation therapy (p<0.01). De-escalation therapy results in the highest 6-day survival rate compared with the control group (p<0.01), however, no significant difference was found between de-escalation and escalation group (p=0.051). We demonstrate that de-escalation, not escalation, therapy reduces organ injury, decreases inflammatory response by promoting NETs formation in the early stage and inhibiting NETs formation in the late stage of sepsis.

scholarly journals De-escalation antibiotic therapy alleviates organ injury through modulation of NETs formation during sepsis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Zehua Duan ◽  
Tian Xie ◽  
Chengnan Chu ◽  
Fang Chen ◽  
Xinyu Wang ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Late Stage ◽  
Early Stage ◽  
Organ Injury ◽  
Control Group ◽  
Histopathological Analysis ◽  
Dependent Manner ◽  
Escalation Therapy ◽  
Significant Difference

AbstractEmpiric broad-spectrum antimicrobials therapy is suggested to be started immediately for sepsis patients. Empiric antimicrobial therapy should be narrowed once pathogen identification and sensitivities are established. However, the detailed mechanisms of de-escalation strategy are still unclear. Here we hypothesized neutrophil extracellular traps (NETs) played an essential role and de-escalation strategy might alleviate organs injury through regulation of NETs formation in sepsis. We evaluated the effect of imipenem and ceftriaxone on NETs formation in vitro and examined the role of reactive oxygen species (ROS). Next, we designed de-escalation and escalation strategy in cecum ligation and puncture (CLP) models. Organ injury, inflammatory cytokines, NETs levels were compared and evaluated. In CLP models, de-escalation therapy resulted in an increased serum MPO-DNA level during the early stage and decreased MPO-DNA level during late stage, which exerted the reverse effects in escalation therapy. Inflammatory response and organ injury exacerbated when eliminated NETs with DNAse I during the early stage of sepsis (p < 0.01). Histopathological analysis showed decreased injury in lung, liver, and intestine in de-escalation therapy compared with escalation therapy (p < 0.01). De-escalation therapy results in the highest 6-day survival rate compared with the control group (p < 0.01), however, no significant difference was found between de-escalation and escalation group (p = 0.051). The in vitro study showed that the imipenem could promote, while the ceftriaxone could inhibit the formation of NETs in PMA-activated PMNs through a ROS-dependent manner. We firstly demonstrate that de-escalation, not escalation, therapy reduces organ injury, decreases inflammatory response by promoting NETs formation in the early stage, and inhibiting NETs formation in the late stage of sepsis.

scholarly journals The relationship between COVID-19 and blood vitamin C; a systematic review study

2021 ◽  
Vol 6 (2) ◽  
pp. e31-e31
Author(s):  
Sadeq Hosseinpour ◽  
Nasrin Moradi ◽  
Reyhane Izadi ◽  
Shahrzad Shadabi ◽  
Raheleh Behzadi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mechanical Ventilation ◽  
Vitamin C ◽  
Inflammatory Response ◽  
High Dose ◽  
Organ Function ◽  
Health Crisis ◽  
Icu Stay ◽  
Intravenous Vitamin ◽  
The Relationship

Introduction: The rapid worldwide spread of COVID-19 has caused a global health crisis. Unfortunately, no vaccine or special antiviral drug has been developed against COVID-19 to date, symptomatic supportive care has been the most common treatment. Objectives: the purpose of this systematic review aims to provide a timely, rigorous, and continuously updated summary of the available evidence on the role of vitamin C in treating patients with COVID-19. Methods: In this review, we identified studies published in 2020 that describe on the relationship between COVID-19 and vitamin C. We searched PubMed, Google Scholar, Scopus, Magiran, SID and Web of Science for research articles published up to 23 December 2020 using the keywords of vitamin C, COVID-19, SARS-COV-2 and coronavirus 2. Results: At the initial stage of screening, 181articles were excluded after reviewing the title and removing irrelevant and duplicate titles, 52 articles were selected to review the abstract. After reviewing the abstract (or in articles without abstracts after reviewing the original text), nine articles were finally considered suitable for this purpose and were reviewed and finalized. Vitamin C is a pivotal component of the immune system, with proven antioxidant, cytokine storm suppressor and anti-inflammatory properties and has been tested in numerous studies for its role in severe sepsis and ICU care, especially when used as a continuous high-dose intravenous infusion. In addition, some studies indicated high-dose intravenous vitamin C treatment was associated with fewer days on mechanical ventilation, shorter ICU stay, and earlier recovery compared to the average length of mechanical ventilation, disease duration, and ICU stay in critical COVID-19 patients. Conclusion: Vitamin C can significantly improve clinical symptoms, inflammatory response, immune and organ function in COVID-19 patients. In patients affected with COVID-19, high-dose intravenous vitamin C is expected to improve pulmonary function and reduce mortality for patients with COVID-19 and can be beneficial in aspects of inflammatory response, immune and organ function for aggravation of COVID-19 patients, however further clinical trials are necessary.

scholarly journals Safety and effectiveness of high-dose vitamin C in patients with COVID-19: a randomized open-label clinical trial

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Saeidreza JamaliMoghadamSiahkali ◽  
Besharat Zarezade ◽  
Sogol Koolaji ◽  
SeyedAhmad SeyedAlinaghi ◽  
Abolfazl Zendehdel ◽  
...  
Keyword(s):  
Vitamin C ◽  
Controlled Trial ◽  
Water Soluble ◽  
Control Treatment ◽  
Control Group ◽  
Case Group ◽  
High Dose ◽  
Open Label ◽  
Mean Body Temperature ◽  
Significant Difference

Abstract Background Vitamin C is an essential water-soluble nutrient that functions as a key antioxidant and has been proven to be effective for boosting immunity. In this study, we aimed to assess the efficacy of adding high-dose intravenous vitamin C (HDIVC) to the regimens for patients with severe COVID-19 disease. Methods An open-label, randomized, and controlled trial was conducted on patients with severe COVID-19 infection. The case and control treatment groups each consisted of 30 patients. The control group received lopinavir/ritonavir and hydroxychloroquine and the case group received HDIVC (6 g daily) added to the same regimen. Results There were no statistically significant differences between two groups with respect to age and gender, laboratory results, and underlying diseases. The mean body temperature was significantly lower in the case group on the 3rd day of hospitalization (p = 0.001). Peripheral capillary oxygen saturations (SpO2) measured at the 3rd day of hospitalization was also higher in the case group receiving HDIVC (p = 0.014). The median length of hospitalization in the case group was significantly longer than the control group (8.5 days vs. 6.5 days) (p = 0.028). There was no significant difference in SpO2 levels at discharge time, the length of intensive care unit (ICU) stay, and mortality between the two groups. Conclusions We did not find significantly better outcomes in the group who were treated with HDIVC in addition to the main treatment regimen at discharge. Trial registration irct.ir (IRCT20200411047025N1), April 14, 2020

scholarly journals Feasibility of Vitamin C in the Treatment of Post Viral Fatigue with Focus on Long COVID, Based on a Systematic Review of IV Vitamin C on Fatigue

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1154
Author(s):  
Claudia Vollbracht ◽  
Karin Kraft
Keyword(s):  
Vitamin C ◽  
Sleep Disturbances ◽  
Positive Impact ◽  
Treatment Options ◽  
Present Knowledge ◽  
Control Group ◽  
High Dose ◽  
Immunomodulatory Effects ◽  
Before And After ◽  
Suitable Treatment

Fatigue is common not only in cancer patients but also after viral and other infections. Effective treatment options are still very rare. Therefore, the present knowledge on the pathophysiology of fatigue and the potential positive impact of treatment with vitamin C is illustrated. Additionally, the effectiveness of high-dose IV vitamin C in fatigue resulting from various diseases was assessed by a systematic literature review in order to assess the feasibility of vitamin C in post-viral, especially in long COVID, fatigue. Nine clinical studies with 720 participants were identified. Three of the four controlled trials observed a significant decrease in fatigue scores in the vitamin C group compared to the control group. Four of the five observational or before-and-after studies observed a significant reduction in pre–post levels of fatigue. Attendant symptoms of fatigue such as sleep disturbances, lack of concentration, depression, and pain were also frequently alleviated. Oxidative stress, inflammation, and circulatory disorders, which are important contributors to fatigue, are also discussed in long COVID fatigue. Thus, the antioxidant, anti-inflammatory, endothelial-restoring, and immunomodulatory effects of high-dose IV vitamin C might be a suitable treatment option.

Relapse After Early-Stage, Favorable Hodgkin Lymphoma: Disease Characteristics and Outcomes With Conventional or High-Dose Chemotherapy

2021 ◽  
Vol 39 (2) ◽  
pp. 107-115
Author(s):  
Paul J. Bröckelmann ◽  
Horst Müller ◽  
Teresa Guhl ◽  
Karolin Behringer ◽  
Michael Fuchs ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Early Stage ◽  
High Dose Chemotherapy ◽  
Sensitivity Analyses ◽  
High Dose ◽  
Second Line ◽  
Second Line Therapy ◽  
Line Therapy ◽  
Significant Difference ◽  
First Diagnosis

PURPOSE We evaluated disease and treatment characteristics of patients with relapse after risk-adapted first-line treatment of early-stage, favorable, classic Hodgkin lymphoma (ES-HL). We compared second-line therapy with high-dose chemotherapy and autologous stem cell transplantation (ASCT) or conventional chemotherapy (CTx). METHODS We analyzed patients with relapse after ES-HL treated within the German Hodgkin Study Group HD10+HD13 trials. We compared, by Cox proportional hazards regression, progression-free survival (PFS) after relapse (second PFS) treated with either ASCT or CTx and performed sensitivity analyses with overall survival (OS) from relapse and Kaplan-Meier statistics. RESULTS A total of 174 patients’ disease relapsed after treatment in the HD10 (n = 53) and HD13 (n = 121) trials. Relapse mostly occurred > 12 months after first diagnosis, predominantly with stage I-II disease. Of 172 patients with known second-line therapy, 85 received CTx (49%); 70, ASCT (41%); 11, radiotherapy only (6%); and 4, palliative single agent therapies (2%). CTx was predominantly bleomycin, etoposide, doxorubicin cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP [68%]), followed by the combination regimen of doxorubicin, bleomycin, vinblastine, and dacarbazine (19%), or other regimens (13%). Patients aged > 60 years at relapse had shorter second PFS (hazard ratio [HR], 3.0; P = .0029) and were mostly treated with CTx (n = 33 of 49; 67%) and rarely with ASCT (n = 8; 16%). After adjustment for age and a disadvantage of ASCT after the more historic HD10 trial, we did not observe a significant difference in the efficacy of CTx versus ASCT for second PFS (HR, 0.7; 95% CI, 0.3 to 1.6; P = .39). In patients in the HD13 trial who were aged ≤ 60 years, the 2-year, second PFS rate was 94.0% with CTx (95% CI, 85.7% to 100%) versus 83.3% with ASCT (95% CI, 71.8% to 94.8%). Additional sensitivity analyses including OS confirmed these observations. CONCLUSION After contemporary treatment of ES-HL, relapse mostly occurred > 12 months after first diagnosis. Polychemotherapy regimens such as BEACOPP are frequently administered and may constitute a reasonable treatment option for selected patients with relapse after ES-HL.

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