Apples and Oranges—All ‘Vitamin C’ May Not Be Created Equal

Plummer, Mark P.; Lankadeva, Yugeesh R.; Bellomo, Rinaldo

doi:10.1097/ccm.0000000000006042

Critical Care Medicine

2023

DOI: 10.1097/ccm.0000000000006042

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Apples and Oranges—All ‘Vitamin C’ May Not Be Created Equal

Mark P. Plummer,

Yugeesh R. Lankadeva,

Rinaldo Bellomo

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Cited by 2 publications

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“…W e thank Plummer et al (1) for their interest in our Bayesian reanalysis of the Lessening Organ Dysfunction with Vitamin C trial (LOVIT). The authors' concerns regarding the original trial (2) and our analysis (3) include differential effects of vitamin C depending on formulation and pH, and a signal for harm due to "stopping" the administration of vitamin C.…”

mentioning

confidence: 99%

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Angriman,

Muttalib,

Lamontagne

et al. 2023

Critical Care Medicine

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mentioning

confidence: 99%

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Angriman,

Muttalib,

Lamontagne

et al. 2023

Critical Care Medicine

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Efficacy and safety of vitamin C supplementation in the treatment of community-acquired pneumonia: a systematic review and meta-analysis with trial sequential analysis

Sharma,

Sumanadasa,

Shahi

et al. 2024

Sci Rep

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Community-acquired pneumonia (CAP) poses a significant global health challenge, prompting exploration of innovative treatments. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of vitamin C supplementation in adults undergoing treatment for CAP. A comprehensive search of the MEDLINE, Embase, CINAHL, the Cochrane Central Register of Controlled Trials, and Clinical Trials.gov databases from inception to 17 November 2023 identified six randomized-controlled-trials (RCTs) meeting inclusion criteria. The primary outcome analysis revealed a non-significant trend towards reduced overall mortality in the vitamin C group compared to controls (RR 0.51; 95% CI 0.24 to 1.09; p = 0.052; I2 = 0; p = 0.65). Sensitivity analysis, excluding corona-virus-disease 2019 (COVID-19) studies and considering the route of vitamin C administration, confirmed this trend. Secondary outcomes, including hospital length-of-stay (LOS), intensive-care-unit (ICU) LOS, and mechanical ventilation, exhibited mixed results. Notably, heterogeneity and publication bias were observed in hospital LOS analysis, necessitating cautious interpretation. Adverse effects were minimal, with isolated incidents of nausea, vomiting, hypotension, and tachycardia reported. This meta-analysis suggests potential benefits of vitamin C supplementation in CAP treatment. However, inconclusive findings and methodological limitations warrants cautious interpretation, emphasising the urgency for high-quality trials to elucidate the true impact of vitamin C supplementation in CAP management.

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Apples and Oranges—All ‘Vitamin C’ May Not Be Created Equal

Cited by 2 publications

References 7 publications

The authors reply

The authors reply

Efficacy and safety of vitamin C supplementation in the treatment of community-acquired pneumonia: a systematic review and meta-analysis with trial sequential analysis

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