scholarly journals Vitamin C Intervention for Critical COVID-19: A Pragmatic Review of the Current Level of Evidence

Life ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 1166
Author(s):  
Patrick Holford ◽  
Anitra C. Carr ◽  
Masuma Zawari ◽  
Marcela P. Vizcaychipi
Keyword(s):  
Vitamin C ◽  
Respiratory Infections ◽  
Current Level ◽  
Vitamin Supplementation ◽  
Level Of Evidence ◽  
Vitamin C Supplementation ◽  
Retrospective Cohort Studies ◽  
High Doses ◽  
Intravenous Vitamin ◽  
Randomised Controlled

Severe respiratory infections are characterized by elevated inflammation and generation of reactive oxygen species (ROS) which may lead to a decrease in antioxidants such as vitamin C and a higher requirement for the vitamin. Administration of intravenous vitamin C to patients with pneumonia and sepsis appears to decrease the severity of the disease and potentially improve survival rate. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes pneumonia, sepsis and acute respiratory distress syndrome (ARDS) in severe cases, and is referred to as coronavirus disease 2019 (COVID-19). Patients with COVID-19 infection also appear to have depleted vitamin C status and require additional supplementation of vitamin C during the acute phase of the disease. To date there have been 12 vitamin C and COVID-19 trials published, including five randomised controlled trials (RCTs) and seven retrospective cohort studies. The current level of evidence from the RCTs suggests that intravenous vitamin C intervention may improve oxygenation parameters, reduce inflammatory markers, decrease days in hospital and reduce mortality, particularly in the more severely ill patients. High doses of oral vitamin C supplementation may also improve the rate of recovery in less severe cases. No adverse events have been reported in published vitamin C clinical trials in COVID-19 patients. Upcoming findings from larger RCTs will provide additional evidence on vitamin supplementation in COVID-19 patients.

scholarly journals Vitamin C in the Treatment of COVID-19

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1172
Author(s):  
Gregorio Paolo Milani ◽  
Marina Macchi ◽  
Anat Guz-Mark
Keyword(s):  
Clinical Trials ◽  
Vitamin C ◽  
Respiratory Infections ◽  
Medical Condition ◽  
Case Reports ◽  
Case Series ◽  
Theoretical Background ◽  
Current Evidence ◽  
Vitamin C Supplementation ◽  
Essential Nutrient

Vitamin C is an essential nutrient that serves as antioxidant and plays a major role as co-factor and modulator of various pathways of the immune system. Its therapeutic effect during infections has been a matter of debate, with conflicting results in studies of respiratory infections and in critically ill patients. This comprehensive review aimed to summarize the current evidence regarding the use of vitamin C in the prevention or treatment of patients with SARS-CoV2 infection, based on available publications between January 2020 and February 2021. Overall, 21 publications were included in this review, consisting of case-reports and case-series, observational studies, and some clinical trials. In many of the publications, data were incomplete, and in most clinical trials the results are still pending. No studies regarding prevention of COVID-19 with vitamin C supplementation were found. Although some clinical observations reported improved medical condition of patients with COVID-19 treated with vitamin C, available data from controlled studies are scarce and inconclusive. Based on the theoretical background presented in this article, and some preliminary encouraging studies, the role of vitamin C in the treatment of patients with SARS-CoV-2 infection should be further investigated.

scholarly journals Effects of vitamin C supplementation on acute phase Chagas disease in experimentally infected mice with Trypanosoma cruzi QM1 strain

2012 ◽  
Vol 54 (6) ◽  
pp. 319-323 ◽  
Author(s):  
Ricardo Guimarães Marim ◽  
Alex Silva de Gusmão ◽  
Roberto Esteves Pires Castanho ◽  
Rafael Deminice ◽  
Altino Luiz Silva Therezo ◽  
...  
Keyword(s):  
Lipid Peroxidation ◽  
Vitamin C ◽  
Chagas Disease ◽  
Acute Phase ◽  
Immune Reaction ◽  
Parasite Clearance ◽  
Vitamin C Supplementation ◽  
Affected Tissue ◽  
Tissue Changes ◽  
High Doses

The tissue changes that occur in Chagas disease are related to the degree of oxidative stress and antioxidant capacity of affected tissue. Studies with vitamin C supplementation did not develop oxidative damage caused by Chagas disease in the host, but other studies cite the use of peroxiredoxins ascorbate - dependent on T. cruzi to offer protection against immune reaction. Based on these propositions, thirty "Swiss" mice were infected with T. cruzi QM1 strain and treated with two different vitamin C doses in order to study the parasitemia evolution, histopathological changes and lipid peroxidation biomarkers during the acute phase of Chagas disease. The results showed that the parasite clearance was greater in animals fed with vitamin C overdose. There were no significant differences regarding the biomarkers of lipid peroxidation and inflammatory process or the increase of myocardium in animals treated with the recommended dosage. The largest amount of parasite growth towards the end of the acute phase suggests the benefit of high doses of vitamin C for trypomastigotes. The supplementation doesn't influence the production of free radicals or the number of amastigote nests in the acute phase of Chagas disease.

scholarly journals Vitamin C—An Adjunctive Therapy for Respiratory Infection, Sepsis and COVID-19

2020 ◽  
Author(s):  
Patrick Holford ◽  
Anitra Carr ◽  
Thomas H. Jovic ◽  
Stephen R. Ali ◽  
Iain S. Whitaker ◽  
...  
Keyword(s):  
Vitamin C ◽  
Adjunctive Therapy ◽  
Respiratory Infections ◽  
Low Cost ◽  
Vitamin C Deficiency ◽  
Favourable Safety ◽  
Favourable Safety Profile ◽  
Hospital Stays ◽  
Anti Inflammatory ◽  
Intravenous Vitamin

There are limited proven therapies for the treatment of COVID-19. Vitamin C’s antioxidant, anti-inflammatory and immunomodulating effects, make it a potential therapeutic candidate, both for the prevention and amelioration of COVID-19 infection, and as an adjunctive therapy in the critical care of COVID-19, supporting anti-inflammatory treatment. This literature review focuses on vitamin C deficiency in respiratory infections including COVID-19; the mechanism of action in infectious disease and adrenal function supporting the anti-inflammatory actions of glucocorticosteroids: its role in preventing and treating colds and pneumonia and its role in treating sepsis and COVID-19. The evidence to date indicates that oral vitamin C (2-8g/d) may reduce incidence and duration of respiratory infections and intravenous vitamin C (2-24g/d) has been shown to reduce mortality, Intensive Care Unit and hospital stays, time on mechanical ventilation in severe respiratory infections. Further trials are urgently warranted. Given the favourable safety profile and low cost of vitamin C, and frequency of vitamin C deficiency in respiratory infections it may be worthwhile testing patients’ vitamin C status and treating accordingly with intravenous use within ICUs and orally with doses between 2 and 8g/day in hospitalised and infected persons.

scholarly journals Vitamin C—An Adjunctive Therapy for Respiratory Infection, Sepsis and COVID-19

Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3760 ◽  
Author(s):  
Patrick Holford ◽  
Anitra C. Carr ◽  
Thomas H. Jovic ◽  
Stephen R. Ali ◽  
Iain S. Whitaker ◽  
...  
Keyword(s):  
Vitamin C ◽  
Adjunctive Therapy ◽  
Respiratory Infections ◽  
Low Cost ◽  
Oral Vitamin ◽  
Vitamin C Deficiency ◽  
Favourable Safety ◽  
Favourable Safety Profile ◽  
Hospital Stays ◽  
Intravenous Vitamin

There are limited proven therapies for COVID-19. Vitamin C’s antioxidant, anti-inflammatory and immunomodulating effects make it a potential therapeutic candidate, both for the prevention and amelioration of COVID-19 infection, and as an adjunctive therapy in the critical care of COVID-19. This literature review focuses on vitamin C deficiency in respiratory infections, including COVID-19, and the mechanisms of action in infectious disease, including support of the stress response, its role in preventing and treating colds and pneumonia, and its role in treating sepsis and COVID-19. The evidence to date indicates that oral vitamin C (2–8 g/day) may reduce the incidence and duration of respiratory infections and intravenous vitamin C (6–24 g/day) has been shown to reduce mortality, intensive care unit (ICU) and hospital stays, and time on mechanical ventilation for severe respiratory infections. Further trials are urgently warranted. Given the favourable safety profile and low cost of vitamin C, and the frequency of vitamin C deficiency in respiratory infections, it may be worthwhile testing patients’ vitamin C status and treating them accordingly with intravenous administration within ICUs and oral administration in hospitalised persons with COVID-19.

scholarly journals Intravenous Vitamin C Administered as Adjunctive Therapy for Recurrent Acute Respiratory Distress Syndrome

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Amit Bharara ◽  
Catherine Grossman ◽  
Daniel Grinnan ◽  
Aamer Syed ◽  
Bernard Fisher ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Vitamin C ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Venous Catheter ◽  
Young Female ◽  
Gastrointestinal Polyposis ◽  
High Doses ◽  
Intravenous Vitamin

This case report summarizes the first use of intravenous vitamin C employed as an adjunctive interventional agent in the therapy of recurrent acute respiratory distress syndrome (ARDS). The two episodes of ARDS occurred in a young female patient with Cronkhite-Canada syndrome, a rare, sporadically occurring, noninherited disorder that is characterized by extensive gastrointestinal polyposis and malabsorption. Prior to the episodes of sepsis, the patient was receiving nutrition via chronic hyperalimentation administered through a long-standing central venous catheter. The patient became recurrently septic with Gram positive cocci which led to two instances of ARDS. This report describes the broad-based general critical care of a septic patient with acute respiratory failure that includes fluid resuscitation, broad-spectrum antibiotics, and vasopressor support. Intravenous vitamin C infused at 50 mg per kilogram body weight every 6 hours for 96 hours was incorporated as an adjunctive agent in the care of this patient. Vitamin C when used as a parenteral agent in high doses acts “pleiotropically” to attenuate proinflammatory mediator expression, to improve alveolar fluid clearance, and to act as an antioxidant.

scholarly journals Influence of Vitamin C Supplementation on Oxidative Stress and Neutrophil Inflammatory Response in Acute and Regular Exercise

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Ljiljana M. Popovic ◽  
Nebojsa R. Mitic ◽  
Dijana Miric ◽  
Boban Bisevac ◽  
Mirjana Miric ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Lipid Peroxidation ◽  
Vitamin C ◽  
Inflammatory Response ◽  
Acute Exercise ◽  
Exercise Group ◽  
Vitamin Supplementation ◽  
Regular Exercise ◽  
Biological Macromolecules ◽  
Vitamin C Supplementation

Exercise induces a multitude of physiological and biochemical changes in blood affecting its redox status. Tissue damage resulting from exercise induces activation of inflammatory cells followed by the increased activity of myeloperoxidase (MPO) in circulation. Vitamin C readily scavenges free radicals and may thereby prevent oxidative damage of important biological macromolecules. The aim of this study was to examine the effect of vitamin C supplementation on oxidative stress and neutrophil inflammatory response induced by acute and regular exercise. Experiment was conducted on acute exercise group (performing Bruce Treadmill Protocol (BTP)) and regular training group. Markers of lipid peroxidation, malondialdehyde (MDA), MPO activity, and vitamin C status were estimated at rest and after BTP (acute exercise group) and before and after vitamin C supplementation in both groups. Our results showed increased postexercise Asc in serum independently of vitamin supplementation. They also showed that vitamin C can significantly decrease postexercise MDA level in both experimental groups. Increased postexercise MPO activity has been found in both groups and was not affected by vitamin C supplementation. We concluded that vitamin C supplementation can suppress lipid peroxidation process during exercise but cannot affect neutrophil inflammatory response in either exercise group.

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.

Sign in / Sign up

Export Citation Format

Share Document