Vitamin C for the treatment of COVID-19: A living systematic review

Abstract

Objective This living systematic review aims to provide a timely, rigorous and continuously updated summary of the evidence available on the role of vitamin C in the treatment of patients with COVID-19. Data sources We will conduct searches in PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), grey literature and in a centralised repository in L OVE (Living OVerview of Evidence). L OVE is a platform that maps PICO questions to evidence from Epistemonikos database. In response to the COVID-19 emergency, L OVE was adapted to expand the range of evidence it covers and customised to group all COVID-19 evidence in one place. The search will cover the period until the day before submission to a journal. Eligibility criteria for selecting studies and methods We adapted an already published common protocol for multiple parallel systematic reviews to the specificities of this question. We will include randomised trials evaluating the effect of vitamin C, as monotherapy or in combination with other drugs, versus placebo or no treatment in patients with COVID-19. Randomised trials evaluating vitamin C in infections caused by other coronaviruses, such as MERS-CoV and SARS-CoV, and non-randomised studies in COVID-19 will be searched in case no direct evidence from randomised trials is found, or if the direct evidence provides low- or very low-certainty for critical outcomes. Two reviewers will independently screen each study for eligibility, extract data, and assess the risk of bias. We will pool the results using meta-analysis and will apply the GRADE system to assess the certainty of the evidence for each outcome. A living, web-based version of this review will be openly available during the COVID-19 pandemic. We will resubmit it every time the conclusions change or whenever there are substantial updates. Ethics and dissemination No ethics approval is considered necessary. The results of this review will be widely disseminated via peer-reviewed publications, social networks and traditional media. PROSPERO Registration Submitted to PROSPERO (awaiting ID allocation). Keywords COVID-19, severe acute respiratory syndrome coronavirus 2, Coronavirus Infections, Systematic review, vitamin c, ascorbic acid.

Effects of Immune System-Related Medications on COVID-19 Outcome in a Cohort of Iranian Patients: Preliminary Report of a Data Mining Study

“…Regression wise, there was no association with death but an increased in LOS was seen. Vitamin C has potentially antiviral effects through producing free radicals and rising antiviral cytokines; however, putting study design problems aside, not enough evidence for routine use of vitamin C in COVID-19 patients was found [ 25 , 26 ]. Our association rule mining showed that its administration was usually along with favipiravir, interferon, and acetaminophen.…”

Unravelling Vitamins as Wonder Molecules for Covid-19 Management via Structure-based Virtual Screening

“…including B1, C (Ascorbic acid), D, E and Omega-3, minerals such as magnesium and manganese and herb like thyme play an important role on the innate system under the virus infection [15]. The study suggests the need to diet with the higher content of Vitamin C [16] and Vitamin B-Complex micro-nutrients to manage this pandemic successfully [17]. Due to anti-inflammatory properties, zinc has been suggested to limit the cytokine storm [18].…”

Role of vitamins and minerals as immunity boosters in COVID-19

“…There is some indirect and direct evidence that reveals vitamin C's effectiveness in treating patients with COVID-19. One Cochrane review and a randomized controlled trial showed a significant reduction in the common cold symptoms by oral administration of 0.2 g/day vitamin C. One trial on adult patients showed a dose-dependent decrease in the duration of pneumonia with two vitamin C doses (Baladia et al 2020). Therefore, research addressing vitamin C's role specifically for COVID-19 would add helpful information (Carr 2020).…”