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0 0.5 1 1.5 2+ Mortality 15% Improvement Relative Risk Vitamin C  Al Sulaiman et al.  LATE TREATMENT Is late treatment with vitamin C beneficial for COVID-19? PSM retrospective 284 patients in Saudi Arabia Lower mortality with vitamin C (not stat. sig., p=0.27) Al Sulaiman et al., Research Square, Apr 2021 Favors vitamin C Favors control

Ascorbic Acid as an Adjunctive Therapy in Critically Ill Patients with COVID-19: A Multicenter Propensity Score Matched Study

Al Sulaiman et al., Research Square, doi:10.21203/
Apr 2021  
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Vitamin C for COVID-19
7th treatment shown to reduce risk in September 2020
*, now known with p = 0.000000087 from 70 studies, recognized in 11 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,000+ studies for 60+ treatments.
Retrospective 158 critically ill patients receiving vitamin C and propensity matched controls, showing mortality OR 0.77 [0.48-1.23], and statistically significantly lower thrombosis, OR 0.42 [0.18-0.94]. 1000mg of vitamin C was given daily.
Although the 15% lower mortality is not statistically significant, it is consistent with the significant 19% lower mortality [9‑27%] from meta analysis of the 42 mortality results to date.
This is the 18th of 70 COVID-19 controlled studies for vitamin C, which collectively show efficacy with p=0.000000087 (1 in 11 million).
21 studies are RCTs, which show efficacy with p=0.0012.
risk of death, 14.9% lower, RR 0.85, p = 0.27, treatment 46 of 142 (32.4%), control 59 of 142 (41.5%), NNT 11, odds ratio converted to relative risk, PSM.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Al Sulaiman et al., 2 Apr 2021, retrospective, propensity score matching, Saudi Arabia, preprint, 12 authors.
This PaperVitamin CAll
Ascorbic Acid as an Adjunctive Therapy in Critically Ill Patients with COVID-19: A Multicenter Propensity Score Matched Study
Khalid Al Sulaiman, Ohoud Al Juhani, Khalid Bin Salah, Hisham A Badreldin, Abdullah Al Harthi, Mohammed Alenazi, Aisha Alharbi, Rahmah Algarni, Shmeylan Al Harbi, Abdullah Alhammad, Ramesh Vishwakarma, Sarah Aldekhyl
Background: Ascorbic acid represents an appealing option for clinicians to utilize in the context of a global health pandemic of COVID-19 patients due to its proposed clinical e cacy, relative safety, and low cost. Objectives: The aim of this study was to evaluate the e cacy and safety of using ascorbic acid in supplemental dose as adjunctive therapy in critically ill patients with COVID-19. Methods: This was a multi-center, non-interventional, retrospective cohort study. All critically ill adult patients admitted to ICU with a con rmed COVID-19 between March 1st to December 31 st , 2020 were included in the nal analysis. The study was conducted at two large governmental tertiary hospitals in Saudi Arabia. The purpose was to investigate the association between clinical outcomes with ascorbic acid use as an adjunctive therapy in COVID-19 after propensity score matching using baseline severity scores, systemic use of corticosteroids and study centers. Results: A 739 patients were included in this study; 296 patients were included after propensity score matching. There was no association between the administration of ascorbic acid and in-hospital mortality nor 30day ICU mortality (OR (95%CI): 0.77 (0.476, 1.234), p-value=0.2738 and OR (95%CI): 0.73 (0.438 ,1.204), p-value=0.215 respectively). Using ascorbic acid was associated with lower incidence of thrombosis compared with the non-ascorbic acid group (6.1% vs. 13% respectively); OR (95%CI): 0.42 (0.184, 0.937), p-value=0.0342). Conclusion: Supplemental dose of ascorbic acid as an adjunctive therapy in COVID19 critically ill patients was not associated with mortality bene ts; but associated with lower incidence of thrombosis. Further studies are required to con rm these ndings.
Conclusion The use of ascorbic acid was not assosiated with in-hospital nor 30-days ICU mortality reduction. Using supplemental ascorbic acid doses as an adjunctive therapy in critically ill patients with COVID-19 was associated with lower incidence of thrombosis. Further studies are warranted to con rm these ndings. Abbreviations Intensive care units (ICUs), Coronavirus disease (COVID-19), Mechanical ventilation (MV), Length of Stay (LOS). Declarations Author contributions All authors contributed to data collections, analysis, drafted, revised, and approved the nal version of the manuscript. Funding None. Ethics approval and consent to participate The study was approved November 19th, 2020, by King Abdullah International Medical Research Center (KAIMRC)-Institutional Review Board (IRB), Riyadh, Saudi Arabia (Reference No: RC20/589/R). All methods were performed in accordance with relevant guidelines and regulations. Participants' con dentiality was strictly observed throughout the study by using anonymous unique serial number for each subject and restricting data only to the investigators. KAIMRC-IRB committee waived the informed consent due to its retrospective nature. Consent for publication Not applicable. Competing interests No author has a con ict of interest in this study. This is a list of supplementary les associated with this preprint. Click to download. Additional le1DemographyandBaselinecharacteristics.docx Additional le2Coexistingillness.docx
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Late treatment
is less effective
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