Should Vitamin C/Ascorbic Acid infusion be used in the treatment of COVID-19?

2020 ◽  
Vol 54 ◽  
Author(s):  
Marc Evans M. Abat ◽  
Cristina Larracas ◽  
Ian Theodore G. Cabaluna
Keyword(s):  
Mechanical Ventilation ◽  
Vitamin C ◽  
Treatment Guidelines ◽  
Indirect Evidence ◽  
Adjunctive Treatment ◽  
Small Subset ◽  
High Dose ◽  
Icu Stay ◽  
Intravenous Vitamin ◽  
Vit C

KEY FINDINGS There is no direct evidence available as of this point for efficacy of intravenous vitamin C as an adjunctive treatment in preventing mortality or shortening disease course among adults suspected of, or positive for COVID-19. • Vitamin C is currently not mentioned in the treatment guidelines for COVID. • Currently, there are 3 ongoing trials registered in clinicaltrials.gov studying intravenous vitamin C in COVID-19. No other ongoing or planned trials were registered in the other trial registries. • Most of the available data are from studies on disease populations which may be considered as COVID-19 suspects:  Conflicting results on mortality from indirect evidence among patients with sepsis with or without ARDS with significant reduction in mortality found in only a small subset of patients (n-40) with severe sepsis given high dose Vitamin C infusion.  Strong evidence supporting no mortality benefit from 5 meta-analyses on critically ill patients due to conditions other than or in combination with sepsis who were given Vit C infusion alone or in combinations with other medications. One meta-analysis showed benefit in decreasing duration of ICU stay and mechanical ventilation but sample size is small. Most showed no benefit on and other key endpoints such as acute kidney injury, duration of hospital stay/ ICU stay/ duration of vasopressor use or duration of mechanical ventilation. • The use of Vit C infusion is not mentioned in the treatment guidelines for COVID-19 or ARDS. • The risks or adverse events with short term use of Vitamin C infusion in the general population is negligible or minimal. It should be avoided in patients with G6PD insufficiency. The dose should be carefully adjusted for patients with renal insufficiency.

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.

Liver Histological Improvement After Administration of High-Dose Vitamin C in Guinea Pig with Nonalcoholic Steatohepatitis

2018 ◽  
Vol 88 (5-6) ◽  
pp. 263-269
Author(s):  
Seong-Hoon Park ◽  
A Lum Han ◽  
Na-Hyung Kim ◽  
Sae-Ron Shin
Keyword(s):  
Liver Biopsy ◽  
Vitamin C ◽  
Nonalcoholic Steatohepatitis ◽  
Guinea Pigs ◽  
Normal Diet ◽  
High Dose ◽  
Biochemical Tests ◽  
Deficient Diet ◽  
Histological Improvement ◽  
Vit C

Abstract. Background: Vitamin C is a strong antioxidant, and the health effects of vitamin C megadoses have not been validated despite the apparent health benefits. Therefore, the present study sought to confirm the effects of vitamin C megadoses. Materials and Methods : Four groups of six guinea pigs were used. Each group was fed one of the following diets for three weeks: normal diet, methionine choline-deficient diet, methionine choline-deficient diet + vitamin C megadose (MCD + vit C 2.5 g/kg/day), and methionine-choline deficient diet + ursodeoxycholic acid (MCD + UDCA 30 mg/kg/day). The MCD diet was given to induce nonalcoholic steatohepatitis, and UDCA was used to treat nonalcoholic steatohepatitis. Three weeks after initial diet administration, the results of biochemical tests and liver biopsy were compared between the groups. Results: The cytoplasm state was similar in the MCD + vit C and MCD + UDCA groups, exhibiting clearing of the cytoplasm and ballooning degeneration. However, macrovesicular steatosis was not observed in the MCD + vit C group. Aspartate transaminase and alanine transaminase were elevated significantly following vitamin C administration. Conclusions: The present study confirmed that alone vitamin C megadoses are potential remedies for nonalcoholic steatohepatitis, based on the liver biopsy results of guinea pigs that were unable to synthesize vitamin C.

scholarly journals Effect of High-dose Intravenous Vitamin C on Prognosis in Patients with SARS-CoV-2 Pneumonia

2021 ◽  
Author(s):  
Kavurgacı Suna ◽  
Şener Uzel Melahat ◽  
Yıldız Murat ◽  
Öztürk Ergür Figen ◽  
Öztürk Ayperi
Keyword(s):  
Vitamin C ◽  
High Dose ◽  
Intravenous Vitamin

scholarly journals High-Dose Intravenous Vitamin C Treatment of a Child with Neurofibromatosis Type 1 and Optic Pathway Glioma: A Case Report

2016 ◽  
Vol 17 ◽  
pp. 774-781 ◽  
Author(s):  
Nina Mikirova ◽  
Ronald Hunnunghake ◽  
Ruth C. Scimeca ◽  
Charles Chinshaw ◽  
Faryal Ali ◽  
...  
Keyword(s):  
Case Report ◽  
Vitamin C ◽  
Neurofibromatosis Type 1 ◽  
Neurofibromatosis Type ◽  
Optic Pathway Glioma ◽  
High Dose ◽  
Optic Pathway ◽  
Intravenous Vitamin

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

Trials ◽  
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

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

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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