Vitamin C deficiency in critically ill COVID-19 patients admitted to intensive care unit
Luis Chiscano-Camón, Juan Carlos Ruiz-Rodriguez, Erika P Plata-Menchaca, Laura Martin, Ivan Bajaña, Cristina Martin-Rodríguez, Clara Palmada, Roser Ferrer-Costa, Silvia Camos, Yolanda Villena-Ortiz, Vicent Ribas, Adolf Ruiz-Sanmartin, Marcos Pérez-Carrasco, Ricard Ferrer
Frontiers in Medicine, doi:10.3389/fmed.2023.1301001
Objectives: To determine vitamin C plasma kinetics, through the measurement of vitamin C plasma concentrations, in critically ill Coronavirus infectious disease 2019 (COVID-19) patients, identifying eventually the onset of vitamin C deficiency.
Ethics statement The studies involving humans were approved by Clinical Research Ethics Committee (CEIm) of Vall d'Hebron University Hospital [PR(AG)687/2020]. The studies were conducted in accordance with the local legislation and institutional requirements. The ethics committee/ institutional review board waived the requirement of written informed consent for participation from the participants or the participants' legal guardians/next of kin because the informed consent was waived due to epimediological situation, in between COVID-19 outbreak.
Author contributions
Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Publisher's note All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
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doi:10.1016/j.jpba.2021.113927{ 'indexed': { 'date-parts': [[2023, 12, 21]],
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'abstract': '<jats:sec><jats:title>Objectives</jats:title><jats:p>To determine vitamin C plasma kinetics, '
'through the measurement of vitamin C plasma concentrations, in critically ill Coronavirus '
'infectious disease 2019 (COVID-19) patients, identifying eventually the onset of vitamin C '
'deficiency.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>Prospective, '
'observational, single-center '
'study.</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>Intensive Care '
'Unit (ICU), Vall d’Hebron University Hospital, Barcelona. Study period from November 12th, '
'2020, to February 24th, '
'2021.</jats:p></jats:sec><jats:sec><jats:title>Patients</jats:title><jats:p>Patients who had '
'a severe hypoxemic acute respiratory failure due to COVID-19 were '
'included.</jats:p></jats:sec><jats:sec><jats:title>Interventions</jats:title><jats:p>Plasma '
'vitamin C concentrations were measured on days 1, 5, and 10 of ICU admission. There were no '
'vitamin C enteral nor parenteral supplementation. The supportive treatment was performed '
'following the standard of care or acute respiratory distress syndrome (ARDS) '
'patients.</jats:p></jats:sec><jats:sec><jats:title>Measurement</jats:title><jats:p>Plasma '
'vitamin C concentrations were analyzed using an ultra-performance liquid chromatography '
'(UPLC) system with a photodiode array detector (wavelength set to 245\u2009nm). We '
'categorized plasmatic levels of vitamin C as follows: undetectable: &lt; 1,5 mg/L, '
'deficiency: &lt;2\u2009mg/L. Low plasma concentrations: 2–5\u2009mg/L; (normal plasma '
'concentration: &gt; 5\u2009mg/L).</jats:p></jats:sec><jats:sec><jats:title>Main '
'results</jats:title><jats:p>Forty-three patients were included (65% men; mean age 62 ±\u2009'
'10\u2009years). The median Sequential Organ Failure Assessment (SOFA) score was 3 (1–4), and '
'the Acute Physiology and Chronic Health disease Classification System (APACHE II) score was '
'13 (10–22). Five patients had shock. Bacterial coinfection was documented in 7 patients '
'(16%). Initially all patients required high-flow oxygen therapy, and 23 (53%) further needed '
'invasive mechanical ventilation during 21 (± 10) days. The worst '
'PaO<jats:sub>2</jats:sub>/F<jats:sub>I</jats:sub>O<jats:sub>2</jats:sub> registered was 93 (± '
'29). ICU and hospital survival were 77 and 74%, respectively. Low or undetectable levels '
'remained constant throughout the study period in the vast majority of '
'patients.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>This '
'observational study showed vitamin C plasma levels were undetectable on ICU admission in 86% '
'of patients with acute respiratory failure due to COVID-19 pneumonia requiring respiratory '
'support. This finding remained consistent throughout the study period.</jats:p></jats:sec>',
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