Efficacy and safety of vitamin C in the management of acute respiratory infection and disease: A rapid review

Abstract

Brief overview Current evidence from published systematic reviews indicate that oral intake of vitamin C may assist with symptoms of acute viral respiratory infections (ARI) by reducing fever and chills, relieving chest pain and assist in reducing symptoms of common cold-induced asthma. Intravenous (IV) vitamin C administration may reduce the need for vasopressor support and the duration of mechanical ventilations in critically ill patients in hospital. COVID-19 has similar signs and symptoms of ARI. Further studies involving patients with COVID-19, either through administration of oral vitamin C in mild cases or IV vitamin C in critical cases, would be advantageous to examine if it is safe and efficacious. Verdict Oral vitamin C may assist with the symptoms of acute respiratory viral infections (ARI) and common cold-induced asthma but no studies have been identified justifying oral vitamin C for the prevention or treatment of coronavirus infections including COVID-19. When taken at onset of ARI, oral vitamin C may reduce the duration of symptoms including fever, chest pain, chills and bodily aches and pains. It may also reduce the incidence of hospital admission and duration of hospital stays. For individuals admitted to hospital with community-acquired pneumonia, vitamin C may improve respiratory function in more severe cases. No major adverse events nor interactions were reported by either method of administration. However, there is an absence of high quality, contemporary clinical research examining this topic. Current evidence suggests further studies are needed to better understand the value of both oral and IV vitamin C for ARI, including COVID-19.

The Role of Herbal and Nutritional Treatments in the Fight against COVID-19 and Other Respiratory Tract Infections

“…Indeed, high bolus doses of vitamin D reduce its efficacy for non-classic effects while increasing adverse outcomes. The high efficacy of vitamin D supplements has only been detected among ARI patients with low baseline vitamin D status [65].…”

“…A review assessing both safety and efficacy of vitamin C in the management of ARI and COVID-19 showed that vitamin C does aid in relieving the symptoms and respiratory functions; however, to date, high-quality clinical trials are needed to test its safety, and whether it should be supplemented orally or intravenously [45]. COVID-19 patients are being supplemented with doses that are higher than recommended, and it still remains to be confirmed whether or not supplements only control the short-term health risks of the disease [65]. The safety of vitamin C supplements has been reported for doses up to 2 g/day, with possible adverse effects starting at levels of 3-4 g/day.…”

Perspective: Role of Micronutrients and Omega-3 Long-Chain Polyunsaturated Fatty Acids for Immune Outcomes of Relevance to Infections in Older Adults—A Narrative Review and Call for Action

“…There is also evidence for an effect in the prevention and treatment of respiratory tract infections, such as the common cold, in the general population ( 33 ). A recent review concluded that, for individuals admitted to the hospital with community-acquired pneumonia, vitamin C may improve respiratory function in more severe cases, without any adverse effects ( 34 ). On the other hand, it should be noted that a recent study reported that treatment with high-dose zinc gluconate, ascorbic acid, or a combination of the 2 supplements did not significantly decrease the duration of COVID-19 symptoms compared with standard of care ( 31 ).…”

Gambaran Penggunaan Vitamin C Sebagai Imunomodulator Pada Pasien Dewasa Dengan Covid-19: Studi Literatur

“…Limfosit serta sel T CD4+, CD8+, dan CD3+ memiliki hubungan terhadap infeksi COVID-19, jika terjadi penurunan berarti pasien mengalami infeksi yang parah. Hal ini, dikarenakan terjadi penghambatan pada pertumbuhan dan apoptosis sel hematopoietic yang memproduksi antibodi autoimun (Zhang et al, 2020) dan sitokin tertentu (Schloss et al, 2020). Pemberian vitamin C dengan dosis tinggi dapat meningkatkan CD4+ yang lebih baik pada kelompok vitamin C dosis tinggi (intravena) dibandingkan dengan kelompok kontrol.…”