Effect of high-dose intravenous vitamin C on prognosis in patients with SARS-CoV-2 pneumonia

Kavurgacı, Suna; Melahat, Uzel Şener; Yıldız, Murat; Figen, Öztürk Ergür; Öztürk, Ayperi

doi:10.1016/j.medcli.2021.04.010

Cited by 23 publications

(29 citation statements)

References 18 publications

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“…The duration of treatment varied from four to 18 days. There was a low risk of bias for seven studies [8,11,14,21,22,24,25], while the risk of bias for two studies was high [13,20], as shown in Supplementary Table 2.…”

Section: Vitamin C Supplementationmentioning

confidence: 95%

“…The mean age was 61.0 ± 15.02, and 57.4% were males. These studies were conducted in China [8,14,22], Iran [13], Pakistan [20], Saudi Arabia [24], Turkey [25], and United States [11,21]. The studies provided daily doses alone [11,13,14,20e22,24,25] or daily doses after a loading dose [8].…”

Section: Vitamin C Supplementationmentioning

confidence: 99%

“…The studies provided IV [8,13,14,20e22,25] or oral [11,24] vitamin C supplementations. Daily doses used were oral 1 gm [24] and 8 gm [11] daily, and IV 50 mg/kg/day [20], 2 gm [25], 2e4 gm [22], 6 gm [8,13,21], or 24 gm [14] daily. The loading dose was 6 gm IV infusion for 12 h [8].…”

Section: Vitamin C Supplementationmentioning

confidence: 99%

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Clinical significance of micronutrient supplements in patients with coronavirus disease 2019: A comprehensive systematic review and meta-analysis

Beran

Mhanna

Srour

et al. 2022

Clinical Nutrition ESPEN

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Background and aims Micronutrient supplements such as vitamin D, vitamin C, and zinc have been used in managing viral illnesses. However, the clinical significance of these individual micronutrients in patients with Coronavirus disease 2019 (COVID-19) remains unclear. We conducted this meta-analysis to provide a quantitative assessment of the clinical significance of these individual micronutrients in COVID-19. Methods We performed a comprehensive literature search using MEDLINE, Embase, and Cochrane databases through December 5th, 2021. All individual micronutrients reported by ≥3 studies and compared with standard-of-care (SOC) were included. The primary outcome was mortality. The secondary outcomes were intubation rate and length of hospital stay (LOS). Pooled risk ratios (RR) and mean difference (MD) with corresponding 95% confidence intervals (CI) were calculated using the random-effects model. Results We identified 26 studies (10 randomized controlled trials and 16 observational studies) involving 5633 COVID-19 patients that compared three individual micronutrient supplements (vitamin C, vitamin D, and zinc) with SOC. Nine studies evaluated vitamin C in 1488 patients (605 in vitamin C and 883 in SOC). Vitamin C supplementation had no significant effect on mortality (RR 1.00, 95% CI 0.62-1.62, P=1.00), intubation rate (RR 1.77, 95% CI 0.56-5.56, P=0.33), or LOS (MD 0.64; 95% CI -1.70, 2.99; P=0.59). Fourteen studies assessed the impact of vitamin D on mortality among 3497 patients (927 in vitamin D and 2570 in SOC). Vitamin D did not reduce mortality (RR 0.75, 95% CI 0.49-1.17, P=0.21) but reduced intubation rate (RR 0.55, 95% CI 0.32-0.97, P=0.04) and LOS (MD -1.26; 95% CI -2.27, -0.25; P=0.01). Subgroup analysis showed that vitamin D supplementation was not associated with a mortality benefit in patients receiving vitamin D pre or post COVID-19 diagnosis. Five studies, including 738 patients, compared zinc intake with SOC (447 in zinc and 291 in SOC). Zinc supplementation was not associated with a significant reduction of mortality (RR 0.79, 95% CI 0.60-1.03, P=0.08). Conclusions Individual micronutrient supplementations, including vitamin C, vitamin D, and zinc, were not associated with a mortality benefit in COVID-19. Vitamin D may be associated with lower intubation rate and shorter LOS, but vitamin C did not reduce intubation rate or LOS. Further research is needed to validate our findings.

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Section: Vitamin C Supplementationmentioning

confidence: 95%

Section: Vitamin C Supplementationmentioning

confidence: 99%

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Clinical significance of micronutrient supplements in patients with coronavirus disease 2019: A comprehensive systematic review and meta-analysis

Beran

Mhanna

Srour

et al. 2022

Clinical Nutrition ESPEN

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“…Although a few observational research and preliminary clinical studies on vitamin C in patients with COVID-19 corroborate their findings by noting a reduction in hyper inflammation (43,44,47), improvement in the oxygen support status (39,41,46,47), lower incidence of thrombosis (42), and also the reduced disease aggravation in the early stage of COVID-19 pneumonia (43), the mortality rate is still controversial among the studies. Some authors found a reduction in mortality (46) whereas other studies with vitamin C did not observe a difference in mortality when compared to patients in the control group (40,42,45). Controversial research with vitamin C also demonstrated failure to ameliorate the mechanical ventilation of patients with COVID-19 (39,40) and did not find a substantial decrease in the duration of symptoms (37).…”

Section: Vitamin Cmentioning

confidence: 99%

“…Among 108 coronavirus-associated melatonin articles extracted and assessed for eligibility, three studies with a melatonin approach were included (33)(34)(35). Moreover, among the 399 coronavirus-associated zinc studies extracted and evaluated for eligibility, three studies entered the inclusion criteria (36)(37)(38), whereas among 344 coronavirus-associated vitamin C (or ascorbic acid) papers initially extracted and analyzed for eligibility, a total of 10 papers were also included as RCTs or observational research (37,(39)(40)(41)(42)(43)(44)(45)(46)(47).…”

Section: Characterization Of Included Studiesmentioning

confidence: 99%

Melatonin, Zinc, and Vitamin C: Potential Adjuvant Treatment for COVID-19 Patients

et al. 2022

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The use of nutraceutical approaches may regulate the immune system, performing a potential strategy to contain the worst outcomes of COVID-19. We reviewed the current evidence surrounding nutritional/nutraceutical approaches for the therapy in patients with COVID-19. We searched the PubMed database to report randomized controlled trials (RCTs) and observational research that used melatonin, zinc, or vitamin C supplementation as an intervention for COVID-19 treatment. To date, we found only three concluded studies that assessed zinc supplementation and melatonin therapy in patients with COVID-19, but with inconclusive data, relatively small sample size, and early termination of the trial. On the other hand, vitamin C therapy appears to reduce hyperinflammation and improve the oxygen support status of patients with COVID-19. However, a large part of this research involves pilot trials, and there are still conflicting data regarding mortality rate, mechanical ventilation, and duration of symptoms of patients with COVID-19. Melatonin, zinc, and vitamin C supplementation should be investigated further on the nutritional status-immune response, and data from ongoing trials are needed to understand these molecules as a therapy strategy in patients COVID-19.

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Impact of high‐dose vitamin C on the mortality, severity, and duration of hospital stay in COVID‐19 patients: A meta‐analysis

Bhowmik

Barek

Aziz

et al. 2022

Health Science Reports

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Background and Aims Vitamin C has been predicted to be effective as an antioxidant in treating various ailments, including viral infections such as pervasive coronavirus disease (COVID‐19). With this meta‐analysis, we looked to ascertain the relationship between high‐dose vitamin C administration and mortality, severity, and length of hospitalization of COVID‐19 patients. Methods We collected articles from PubMed, Google Scholar, ScienceDirect, SAGE, and Cochrane databases between January 1, 2020, and May 30, 2022. Odds ratio (ORs) with corresponding 95% confidence interval (CI) and p value were calculated to assess the connection of high‐dose vitamin C in COVID‐19 patients' mortality and severity. The length of hospitalization was calculated and pooled with the mean difference (MD), 95% CI, and p value. Review manager 5.3 was used to carry out this meta‐analysis. Results This meta‐analysis included 15 complete studies involving 2125 COVID‐19 patients. Our study demonstrated a significant correlation between vitamin C consumption and death. Vitamin C consumption significantly reduces mortality risk with COVID‐19 patients (OR = 0.54, 95% CI = 0.42–0.69, p < 0.00001). Furthermore, there was a link between the severity of COVID‐19 and the intake of vitamin C. Patients who consumed vitamin C showed 0.63 times less severity than those who did not take vitamin C (OR = 0.63, 95% CI = 0.43–0.94, p = 0.02). Patients taking vitamin C spent slightly more time in hospital than those who did not take vitamin C (MD = 0.19, 95% CI = −1.57 to 1.96, p = 0.83). Conclusions During COVID‐19, there was a substantial advantage in taking supplementary vitamin C, at least in terms of severity and mortality.

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Effect of high-dose intravenous vitamin C on prognosis in patients with SARS-CoV-2 pneumonia

Cited by 23 publications

References 18 publications

Clinical significance of micronutrient supplements in patients with coronavirus disease 2019: A comprehensive systematic review and meta-analysis

Clinical significance of micronutrient supplements in patients with coronavirus disease 2019: A comprehensive systematic review and meta-analysis

Melatonin, Zinc, and Vitamin C: Potential Adjuvant Treatment for COVID-19 Patients

Impact of high‐dose vitamin C on the mortality, severity, and duration of hospital stay in COVID‐19 patients: A meta‐analysis

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