Role of high dose IV vitamin C and zinc in coronavirus

Abstract

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome- related coronavirus 2 (SARS-CoV- 2), is now considered as an ongoing global pandemic. Common symptoms include pyrexia, cough, dyspnea, fatigue, sore throat, and loss of sense of taste and smell. Complications that can result from more severe insult on lung tissue is pneumonia and acute respiratory distress syndrome (ARDS), which can further lead to septic shock. It is also not uncommon to find neurological symptoms in patients suffering from COVID-19. The primary treatment for COVID-19 is symptomatic treatment and supportive care. As there is no known vaccination and antiviral therapy for this disease, there is a desperate need to find an alternative to control and stop the spread of disease. Maintaining adequate micronutrient balance might enhance the immunity and protect from viral infections as well. Vitamin C and zinc helps in improving symptoms and shortening the duration of the common cold. Vitamin C (L-ascorbic acid) possesses pleiotropic physiological activity. High dose Vitamin C has shown to be effective against the common flu, rhinovirus, avian virus, chikungunya, Zika, ARDS, and influenza, and there is evidence that supports the protective effect of high dose IV vitamin C during sepsis-induced ARDS due to COVID-19. Zinc has a profound impact on the replication of viruses. Increasing intracellular zinc concentration along with pyrithione (zinc ionophore) has been shown to impair the replication of several RNA viruses efficiently, including poliovirus, influenza virus and several picornaviruses. A combination of zinc and can also inhibit the replication of SARS-coronavirus in cell culture.

Methemoglobinemia and acute hemolysis induced by high intravenous doses of vitamin C in a COVID-19 patient with unrecognized glucose-6- phosphate-dehydrogenase deficiency

“…This is the first reported case of vitamin C-induced methemoglobinemia and hemolytic anemia in a COVID-19 patient with unrecognized G6PD deficiency. 10 Considering the possible therapeutic use of vitamin C in COVID-19, 2,[4][5][6] clinicians should be alert to this possible complication. A screening for G6PD deficiency appears advisable before treatment with very high vitamin C doses (>6 gr daily) or for long period.…”

“…1 There is no resolutive treatment of severe COVID-19, even though some drugs (such as corticosteroids, tocilizumab, baricitinib, and anakinra) may help counteracting the cytokine storm of hospitalized COVID-19 patients with critical illness. 2 Very high (>10 gr per day) intravenous doses of ascorbic acid (vitamin C) have been found to improve the outcome of non-COVID-19 patients with severe sepsis, a benefit due to the recognized antiinflammatory and antioxidant properties of vitamin C. 3,4 Very high intravenous doses of vitamin C are currently studied also in critically ill COVID-19 patients and are often used in clinical practice. 4,5 In a small randomized controlled trial, vitamin C proved effective in ameliorating arterial oxygenation in critical COVID-19 patients.…”

“…2 Very high (>10 gr per day) intravenous doses of ascorbic acid (vitamin C) have been found to improve the outcome of non-COVID-19 patients with severe sepsis, a benefit due to the recognized antiinflammatory and antioxidant properties of vitamin C. 3,4 Very high intravenous doses of vitamin C are currently studied also in critically ill COVID-19 patients and are often used in clinical practice. 4,5 In a small randomized controlled trial, vitamin C proved effective in ameliorating arterial oxygenation in critical COVID-19 patients. 6 We applied a therapeutic protocol based on the off-label intravenous administration of very-high doses of vitamin C (starting from 6 gr per day) in patients admitted for COVID-19 pneumonia to our COVID Unit of Geriatrics of the Azienda Ospedaliera di Cosenza, Italy.…”