High-dose vitamin C ameliorates cardiac injury in COVID-19 pandemic: a retrospective cohort study

Xia, Guozhi; Qin, Bowen; Ma, Chaoran; Zhu, Yaowu; Zheng, Qiangsun

doi:10.18632/aging.203503

Cited by 10 publications

(12 citation statements)

References 19 publications

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“…Furthermore, C-reactive protein (CRP), procalcitonin (PCT) and interleukin-8 (IL-8) concentrations were reduced in the patients with COVID-19 who received IVC. Other retrospective cohort studies from Wuhan, China, also reported reductions in inflammatory markers (CRP, IL-6, TNF-α) and ameliorated cardiac injury in patients with severe COVID-19 who had received a loading dose of 100 mg/kg bodyweight 6 hourly on the first day followed by 100 mg/kg 12 hourly for the following 5 days, relative to those who received standard therapy only [33,34]. Severe COVID-19 is mainly characterized by deteriorating respiratory function and rapid progression of radiological lesions, while the critical type requires mechanical ventilation and is accompanied by shock or multiple organ failure.…”

Section: Retrospective Cohort Studies With Intravenous Vitamin Cmentioning

confidence: 91%

Vitamin C Intervention for Critical COVID-19: A Pragmatic Review of the Current Level of Evidence

Holford¹,

Carr

Zawari

et al. 2021

Life

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Severe respiratory infections are characterized by elevated inflammation and generation of reactive oxygen species (ROS) which may lead to a decrease in antioxidants such as vitamin C and a higher requirement for the vitamin. Administration of intravenous vitamin C to patients with pneumonia and sepsis appears to decrease the severity of the disease and potentially improve survival rate. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes pneumonia, sepsis and acute respiratory distress syndrome (ARDS) in severe cases, and is referred to as coronavirus disease 2019 (COVID-19). Patients with COVID-19 infection also appear to have depleted vitamin C status and require additional supplementation of vitamin C during the acute phase of the disease. To date there have been 12 vitamin C and COVID-19 trials published, including five randomised controlled trials (RCTs) and seven retrospective cohort studies. The current level of evidence from the RCTs suggests that intravenous vitamin C intervention may improve oxygenation parameters, reduce inflammatory markers, decrease days in hospital and reduce mortality, particularly in the more severely ill patients. High doses of oral vitamin C supplementation may also improve the rate of recovery in less severe cases. No adverse events have been reported in published vitamin C clinical trials in COVID-19 patients. Upcoming findings from larger RCTs will provide additional evidence on vitamin supplementation in COVID-19 patients.

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Section: Retrospective Cohort Studies With Intravenous Vitamin Cmentioning

confidence: 91%

Vitamin C Intervention for Critical COVID-19: A Pragmatic Review of the Current Level of Evidence

Holford¹,

Carr

Zawari

et al. 2021

Life

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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).…”

Section: Vitamin Cmentioning

confidence: 87%

“…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%

“…Among the research that used vitamin C therapy, there appears to be an agreement in observing a reduction in hyperinflammation (39,43,44,47) and improvement in the oxygen support status of patients with COVID-19 (39,41,46,47). However, there are still conflicting data regarding mortality rate, mechanical ventilation, and duration of the symptoms of patients with COVID-19.…”

Section: Final Considerationsmentioning

confidence: 99%

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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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“…In the sub-group of patients with SOFA scores ≥ 3, the differences in ICU and hospital mortality were statistically significant while the 28-day mortality approached, but did not reach statistical significance (21.7% vs. 52.4%, P = 0.06) [ 81 ]. To date, there is only one small RCT involving IVAA demonstrating improved mortality in those patients with an SOFA score ≥ 3, and there has been accumulating evidence that IVAA improves inflammatory markers, coagulopathic parameters, ameliorates cardiac injury, decreases incidence of systemic inflammatory response syndrome (SIRS) and shortens the duration of SIRS ( Table 3 ) [ 81 - 89 ].…”

Section: Aa and Covid-19mentioning

confidence: 99%

“MATH+” Multi-Modal Hospital Treatment Protocol for COVID-19 Infection: Clinical and Scientific Rationale

Kory¹,

Meduri

Iglesias

et al. 2022

J Clin Med Res

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In December 2019, coronavirus disease 2019 (COVID-19), a severe respiratory illness caused by the new coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China. The greatest impact that COVID-19 had was on intensive care units (ICUs), given that approximately 20% of hospitalized cases developed acute respiratory failure (ARF) requiring ICU admission. Based on the assumption that COVID-19 represented a viral pneumonia and no anti-coronaviral therapy existed, nearly all national and international health care societies recommended "supportive care only" avoiding other therapies outside of randomized controlled trials, with a specific prohibition against the use of corticosteroids in treatment. However, early studies of COVID-19-associated ARF reported inexplicably high mortality rates, with frequent prolonged durations of mechanical ventilation (MV), even from centers expert in such supportive care strategies. These reports led the authors to form a clinical expert panel called the Front-Line COVID-19 Critical Care Alliance (www.flccc.net). The panel collaboratively reviewed the emerging clinical, radiographic, and pathological reports of COVID-19 while initiating multiple discussions among a wide clinical network of front-line clinical ICU experts from initial outbreak areas in China, Italy, and New York. Based on the shared early impressions of "what was working and what wasn't working", the increasing medical journal publications and the rapidly accumulating personal clinical experiences with COVID-19 patients, a treatment protocol was created for the hospitalized patients based on the core therapies of methylprednisolone, ascorbic acid, thiamine, heparin and non-antiviral co-interventions (MATH+). This manuscript reviews the scientific and clinical rationale behind MATH+ based on published in-vitro, pre-clinical, and clinical data in support of each medicine, with a special emphasis of studies supporting their use in the treatment of patients with viral syndromes and COVID-19 specifically.

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High-dose vitamin C ameliorates cardiac injury in COVID-19 pandemic: a retrospective cohort study

Cited by 10 publications

References 19 publications

Vitamin C Intervention for Critical COVID-19: A Pragmatic Review of the Current Level of Evidence

Vitamin C Intervention for Critical COVID-19: A Pragmatic Review of the Current Level of Evidence

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

“MATH+” Multi-Modal Hospital Treatment Protocol for COVID-19 Infection: Clinical and Scientific Rationale

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