Vitamin C supplementation for prevention and treatment of pneumonia

Padhani, Zahra Ali; Moazzam, Zorays; Ashraf, Alina; Bilal, Hasana; Salam, Rehana A; Bhutta, Zulfiqar Ahmed

doi:10.1002/14651858.cd013134.pub3

Cited by 10 publications

(6 citation statements)

References 53 publications

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“…First, we intend to summarise evidence relevant to patients who have a greater severity of pneumonia that warrants hospital admission. This is in contrast to recent reviews14 29 on vitamin C which have focused on prevention and treatment of pneumonia in general. Second, we attempt to include recent clinical trials that have been published recently resulting in an updated review.…”

Section: Ethics and Disseminationmentioning

confidence: 71%

“…Previous randomised controlled trials (RCTs) evaluating the benefits of vitamin C supplementation among patients with pneumonia have yielded varied results. A systematic review 14 in 2021 included five RCTs of oral and parenteral vitamin C supplementation for prevention and treatment of pneumonia. This review found a reduction in the number of days before improvement in oxygen saturation (1.03±0.16 days vs 1.14 days±1.0 days) and respiratory rate (3.61±1.50 days vs 4.04±1.62 days) in the vitamin C-treated group compared with the control group, but the certainty of evidence was limited by the small number of trials.…”

Section: Introductionmentioning

confidence: 99%

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Role of vitamin C in treatment of community-acquired pneumonia in adult patients requiring hospitalisation: a systematic review protocol

Sharma,

Sumanadasa,

Shahi

et al. 2024

BMJ Open

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IntroductionCommunity-acquired pneumonia (CAP) is a leading cause of hospitalisation and is associated with a high mortality. Vitamin C is a powerful antioxidant and has been used in treatment of infections; however, its role as an adjunctive treatment in CAP is unclear. This review aims to assess the efficacy and safety of vitamin C in adults who require hospitalisation for CAP.Methods and analysesSearches will be conducted from inception to November 2023 on Ovid MEDLINE Daily and MEDLINE, Embase CINAHL, the Cochrane Central Register of Controlled Trials, Scopus, Web of Science and ClinicalTrials.gov databases with the aid of a medical librarian. We will include data from randomised controlled trials reporting vitamin C supplementation in patients with CAP requiring hospitalisation. Two independent reviewers will select studies, extract data and will assess the risk of bias by use of the Risk of Bias tool. The overall certainty of evidence will be assessed by use of the Grading of Recommendations Assessment, Development and Evaluation framework. Random-effects meta-analyses will be conducted, and effect measures will be reported as relative risks with 95% CIs.Ethics and disseminationNo previous ethical approval is required for this review. The findings of this review will be submitted to a scientific journal and presented at an international medical conference.PROSPERO registration number483860.

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Section: Ethics and Disseminationmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Role of vitamin C in treatment of community-acquired pneumonia in adult patients requiring hospitalisation: a systematic review protocol

Sharma,

Sumanadasa,

Shahi

et al. 2024

BMJ Open

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“…Nine peer‐reviewed academic journal publications on pneumonia prevention were identified for inclusion in this review. Three were Cochrane reviews (Cao et al, 2022; Moberley et al, 2013; Padhani et al, 2021); one was an update of a previous Cochrane review (Schiffner‐Rohe et al, 2016); three were systematic reviews (Kraicer‐Melamed et al, 2016; Prina et al, 2015; Torres et al, 2013); one was a narrative review (Breen & File, 2015); and the final paper was a prospective multicentre cohort study (Hama et al, 2022). The geographical spread of the papers was wide and international.…”

Section: Resultsmentioning

confidence: 99%

Strategies to prevent or reduce inequalities in specific avoidable causes of death for adults with intellectual disability: A systematic review

Heslop,

Lauer

2024

Brit J Learn Disabil

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BackgroundWe now have sufficient evidence demonstrating inequalities in specific avoidable causes of death for adults with intellectual disability compared to their peers without intellectual disability. Apart from covid‐19, the largest differentials that disadvantage people with intellectual disability are in relation to pneumonia, aspiration pneumonia, epilepsy, cerebrovascular disease, ischaemic heart disease, deep vein thrombosis, diabetes and sepsis. The aim of this systematic review is to report on strategies at the individual, population or policy levels aimed at preventing these conditions that are applicable to adults with intellectual disability and that have been based on or recommended by research.MethodsSystematic review of PUBMED, EMBASE, CINAHL, PsychInfo, Social Care Online, International Bibliography of the Social Sciences (IBSS), Web of Science, Scopus, Overton, the Cochrane Library and Google Scholar databases was carried out. Searches were completed on 30 June 2023. Quantitative, qualitative and mixed‐methods research; systematic, scoping or evidence‐based reviews; and audit and reports of mortality reviews were included. Publications included in the review were about preventing the eight potentially avoidable causes of death.FindingsNinety‐four papers were included in the review (9 in relation to pneumonia; 11 for aspiration pneumonia; 18 for sudden unexpected death in epilepsy; 7 for cerebrovascular disease; 8 for ischaemic heart disease; 4 for deep vein thrombosis; 31 for diabetes; 6 for sepsis). The eight most frequently occurring potentially avoidable causes of death in people with intellectual disability are very different medical conditions, but they shared striking similarities in how they could be prevented. The literature overwhelmingly implicated the need to make lifestyle changes to address obesity, lack of exercise and poor nutrition, and to have regular medical reviews. In addition, ‘whole‐population’ approaches are required that look beyond the individual to the social determinants of health.ConclusionsWe found little peer‐reviewed evidence specifically about preventing these conditions in people with intellectual disability. However, most of the literature about preventative strategies pertaining to the general population was applicable to people with intellectual disability, albeit that some ‘reasonable adjustments’ would be required.

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“…Interestingly, we found no associations between genetically predicted circulating iron, zinc, beta-carotene, vitamin B12, and vitamin C and the risk of gastrointestinal infections, pneumonia, or urinary tract infection. Systematic reviews of RCTs have found limited evidence of micronutrient supplementation on the risk of infections but have also underscored the paucity of studies [54][55][56][57]. Among those reviews, one reported no difference in the incidence of diarrhea and lower respiratory tract infection in infants with zinc supplementation [54].…”

Section: Discussionmentioning

confidence: 99%

“…Among those reviews, one reported no difference in the incidence of diarrhea and lower respiratory tract infection in infants with zinc supplementation [54]. Another review found uncertain and limited evidence for vitamin C supplementation in preventing pneumonia [55]. Two reviews found no clear evidence that emerged in favor of selenium supplementation for developing infections [56] and the incidence of new infections [57] among critically ill patients.…”

Section: Discussionmentioning

confidence: 99%

Circulating levels of micronutrients and risk of infections: a Mendelian randomization study

Flatby

Ravi²,

Damås³

et al. 2023

BMC Med

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Background Micronutrients play an essential role at every stage of the immune response, and deficiencies can therefore lead to increased susceptibility to infections. Previous observational studies and randomized controlled trials of micronutrients and infections are limited. We performed Mendelian randomization (MR) analyses to evaluate the effect of blood levels of eight micronutrients (copper, iron, selenium, zinc, beta-carotene, vitamin B12, vitamin C, and vitamin D) on the risk of three infections (gastrointestinal infections, pneumonia, and urinary tract infections). Methods Two-sample MR was conducted using publicly available summary statistics from independent cohorts of European ancestry. For the three infections, we used data from UK Biobank and FinnGen. Inverse variance-weighted MR analyses were performed, together with a range of sensitivity analyses. The threshold for statistical significance was set at P < 2.08E−03. Results We found a significant association between circulating levels of copper and risk of gastrointestinal infections, where a one standard deviation increase in blood levels of copper was associated with an odds ratio of gastrointestinal infections of 0.91 (95% confidence interval 0.87 to 0.97, P = 1.38E−03). This finding was robust in extensive sensitivity analyses. There was no clear association between the other micronutrients and the risk of infection. Conclusions Our results strongly support a role of copper in the susceptibility to gastrointestinal infections.

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Vitamin C supplementation for prevention and treatment of pneumonia

Cited by 10 publications

References 53 publications

Role of vitamin C in treatment of community-acquired pneumonia in adult patients requiring hospitalisation: a systematic review protocol

Role of vitamin C in treatment of community-acquired pneumonia in adult patients requiring hospitalisation: a systematic review protocol

Strategies to prevent or reduce inequalities in specific avoidable causes of death for adults with intellectual disability: A systematic review

Circulating levels of micronutrients and risk of infections: a Mendelian randomization study

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