High Dose Intravenous Vitamin C for Preventing The Disease Aggravation of Moderate COVID-19 Pneumonia. A Retrospective Propensity Matched Before-After Study

Abstract

Background: Coronavirus disease 2019 (COVID-19) pandemic is continuing to impact multiple countries worldwide and effective treatment options are still being developed. In this study, we investigate the potential of high-dose intravenous vitamin C (HDIVC) in the prevention of moderate COVID-19 disease aggravation.Methods: In this retrospective before-after case-matched clinical study, we compare the outcome and clinical courses of patients with moderate COVID-19 patients who were treated with an HDIVC protocol (intravenous injection of vitamin C, 100 mg/kg/day, 1 g/h, for 7 days from admission) during a one-month period (between March 18 and april 18, 2020, HDIVC group) with a control group treated without the HDIVC protocol during the preceding two months (January 18 to March 18, 2020). Patients in the two groups were matched in a 1:1 ratio according to age and gender.Results: The HDIVC and control groups each comprised 55 patients. For the primary outcomes, there was a significant difference in the number of patients that evolved from moderate to severe type between the two groups (HDIVC: 4/55 vs. control: 12/55, relative risk [RR] = 0.28 [0.08, 0.93], P = 0.03). Compared to the control group, there was a shorter duration of systemic inflammatory response syndrome (SIRS) (P = 0.0004) during the first week and lower SIRS occurrence (2/21 vs 10/22, P = 0.0086) on Day 7 (6–7 days after admission). In addition, HDIVC group had lower C-reactive protein levels (P = 0.005) and higher number of CD4+ T cells from Day 0 (on admission) to Day 7 (P = 0.04).” The levels of coagulation indicators, including activated partial thromboplastin time and D-dimer were also improved in the HDIVC compared to the control group on Day 7.Conclusion: HDIVC may be beneficial in limiting disease aggravation in the early stage of COVID-19 pneumonia, which may be related to its improvements on the inflammatory response, immune function and coagulation function. Further randomized controlled trials are required to augment these findings.

Therapies to Prevent Progression of COVID-19, Including Hydroxychloroquine, Azithromycin, Zinc, and Vitamin D3 With or Without Intravenous Vitamin C: An International, Multicenter, Randomized Trial

“…To date, few studies have looked into the effectiveness of early treatment of patients with COVID-19 with vitamin C/ascorbic acid [ 22 ]. One study found that high-dose intravenous vitamin C provided a 72% improvement in symptoms and reduced recovery time [ 17 ]. In contrast, a study that used an oral combination of vitamin C and zinc did not find a significant difference in the improvement of symptoms between the treatment and the control group [ 23 ].…”

“…In addition, intravenous vitamin C (IVC) has known immune-stimulating and antiviral properties [14] and had shown promise as a treatment for acute respiratory syndrome and pneumonia [15]. Recent studies reported on the benefits of IVC therapy for COVID-19 [16,17]. Furthermore, a large number of studies (n > 200) have demonstrated low vitamin D levels to be a risk factor for the severity of COVID-19 symptoms and hospitalization [18][19][20].…”

“…In addition, intravenous vitamin C (IVC) has known immune-stimulating and antiviral properties [ 14 ] and had shown promise as a treatment for acute respiratory syndrome and pneumonia [ 15 ]. Recent studies reported on the benefits of IVC therapy for COVID-19 [ 16 , 17 ].…”

Nutritional risk of vitamin D, vitamin C, zinc, and selenium deficiency on risk and clinical outcomes of COVID-19: A narrative review

“…Other observational studies with hospitalized COVID-19 patients who received high-dose intravenous vitamin C (HDIVC) also reported improvements in oxygen support status, reduced mortality [27], and improvements in the inflammatory response [28,29], and immune and coagulation function [28]. Different results were found by , in which intravenous vitamin C did not decrease the incidence of mortality, vasopressor requirements, sequential organ failure assessment score (SOFA score) or ventilator settings [30].…”

The Effects of Vitamin C on the Multiple Pathophysiological Stages of COVID-19

“…Additionally, compared to the control group, there was a shorter duration of systemic inflammatory response syndrome (SIRS, p = 0.0004) and lower SIRS occurrence (p = 0.0086) during the first week. It was concluded that in this population, a dose of 7 g for a 70-kg person may be of value in preventing progression from moderate to severe disease [39]. 8.…”