The administration of intravenous vitamin C (IV‐VC) in treating patients with coronavirus disease 2019 (COVID‐19) is still highly controversial. There have been no previous studies on the effect of IV‐VC on the severity and mortality of COVID‐19. Hence, we conducted a systematic review and meta‐analysis to compare the disease severity and mortality in patients with COVID‐19 who promptly received IV‐VC treatment vs those who did not. We performed a comprehensive systematic search of seven health science databases, including PubMed, Embase, Cochrane Library, MEDLINE, Web of Science, China National Knowledge Infrastructure, and Wanfang Data, up to June 23, 2021. We identified a total of seven related articles, which were included in this study. This meta‐analysis showed that IV‐VC treatment did not affect disease severity compared with placebo treatment or usual care (odds ratio [OR], 0.70; 95% CI, 0.45 to 1.07; P = 0.10). In addition, no statistically significant difference in mortality was observed between patients who received IV‐VC treatment and those who did not (OR, 0.64; 95% CI, 0.41 to 1.00; P = 0.05). Moreover, the adjusted meta‐analysis revealed that the use of IV‐VC did not influence disease severity (OR, 0.67; 95% CI, 0.34 to 1.31; P = 0.242) or mortality (OR, 1.02; 95% CI, 0.75 to 1.40; P = 0.877) in comparison with a control group. The results of this meta‐analysis demonstrated that short‐term IV‐VC treatment did not reduce the risk of severity and mortality in patients with COVID‐19.

To the Editor, Recently, the associations between COVID-19 and its comorbidities including hypertension, diabetes, obesity, cardiovascular disease, chronic obstructive pulmonary disease, chronic kidney disease, immunosuppression and other diseases have been reported in the many studies. 1 However, there is no clear evidence about whether patients with asthma were at a higher risk of severe or fatal COVID-19. Respiratory viral infections are one of the most common triggers for asthma exacerbations. Some studies have provided data about the prevalence of asthma in severe or fatal COVID-19 patients. 2-5 Higher levels of evidence are required to investigate the association between severe or fatal COVID-19 and asthma. Thus, we performed this systematic review and meta-analysis.

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Background New evidence from studies on risk factors for mortality in hemodialysis (HD) patients with COVID-19 became available. We aimed to review the clinical risk factors for fatal outcomes in these patients. Methods We performed meta-analysis using the PubMed, EMBASE, and Cochrane databases. A fixed- or random-effects model was used for calculating heterogeneity. We used contour-enhanced funnel plot and Egger’s tests to assess potential publication bias. Results Twenty-one studies were included. The proportion of males was lower in the survivor group than in the non-survivor group (OR = 0.75, 95% CI [0.61, 0.94]). The proportion of respiratory diseases was significantly lower in the survivor group than in the non-survivor group (OR = 0.42, 95% CI [0.29, 0.60]). The proportion of patients with fever, cough, and dyspnea was significantly lower in the survivor group (fever: OR = 0.53, 95% CI [0.31, 0.92]; cough: OR = 0.50, 95% CI [0.38, 0.65]; dyspnea: OR = 0.25, 95% CI [0.14, 0.47]) than in the non-survivor group. Compared with the non-survivor group, the survivor group had higher albumin and platelet levels and lower leucocyte counts. Conclusions Male patients might have a higher risk of developing severe COVID-19. Comorbidities, such as respiratory diseases could also greatly influence the clinical prognosis of COVID-19. Clinical features, such as fever, dyspnea, cough, and abnormal platelet, leucocyte, and albumin levels, could imply eventual death. Our findings will help clinicians identify markers for the detection of high mortality risk in HD patients at an early stage of COVID-19.

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The influence of corticosteroid on patients with COVID-19 infection: A meta-analysis Dear Editor, Coronavirus disease 2019 (COVID-19) has rapidly spread globally in just two more months. This emerging outbreak caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has already affected a large number of people from over 100 countries in the world [1]. Currently, there is not any specific effective vaccine or anti-viral treatment for COVID-19. The pathological feature of severe COVID-19 pneumonia is an inflammation response of alveolar damage and mucinous exudate [2]. Lung injury is related to the immune responses triggered by human coronaviruses that lead to the proliferation/activation of immune cells to release excessive and uncontrolled release proinflammatory cytokines [3]. Therefore, it is crucial to strengthen the treatment to suppress the proinflammatory response and control cytokine storm at this stage. Corticosteroids are commonly given to treat severe acute respiratory infections of viral aetiology due to their anti-inflammatory effect. However, at present, there is no document from randomized clinical trials to support corticosteroids treatment for COVID-19. Although, intravenous corticosteroids were commonly used in patients with severe SARS or MERS pneumonia, their efficacy and their use to treat COVID-19 infection remain controversial [4]. Although an earlier meta-analysis evaluated the influence of corticosteroids on patients with coronavirus infection, with just two studies with COVID-19 patients included, their meta-analysis mainly evaluated the role of corticosteroids in severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle Eastern respiratory syndrome (MERS)-CoV and did not investigate the effect of corticosteroids on mortality in COVID-19 patients. With an increased number of COVID-19 literature now published, it has enabled a more robust and profound analysis of current data which is urgently needed by the international medical and scientific communities. Therefore, we aim to perform this meta-analysis to identify the roles of corticosteroids in patients with or without severe COVID-19.