Pharmacologic Ascorbic Acid as Early Therapy for Hospitalized Patients with COVID-19: A Randomized Clinical Trial
Coppock et al.,
Pharmacologic Ascorbic Acid as Early Therapy for Hospitalized Patients with COVID-19: A Randomized Clinical..,
Life, doi:10.3390/life12030453
RCT with 66 very late stage (8 days from symptom onset) hospitalized patients, 44 treated with vitamin C and 22 control patients, showing no significant differences with treatment.
risk of progression, 5.0% lower, HR 0.95, p = 0.64, treatment 4 of 44 (9.1%), control 2 of 22 (9.1%), adjusted per study, within 36 hours.
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risk of no improvement, 49.7% better, RR 0.50, p = 0.16, treatment 6 of 44 (13.6%), control 6 of 22 (27.3%), NNT 7.3, adjusted per study, inverted to make RR<1 favor treatment, odds ratio converted to relative risk, within 36 hours.
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risk of no hospital discharge, 22.5% lower, RR 0.78, p = 0.07, treatment 31 of 44 (70.5%), control 20 of 22 (90.9%), NNT 4.9, within 36 hours.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Coppock et al., 19 Mar 2022, Randomized Controlled Trial, USA, peer-reviewed, 14 authors, average treatment delay 8.1 days.
Abstract: life
Article
Pharmacologic Ascorbic Acid as Early Therapy for Hospitalized
Patients with COVID-19: A Randomized Clinical Trial
Dagan Coppock 1, * , Pierre-Christian Violet 2 , Gustavo Vasquez 1 , Katherine Belden 1 , Michael Foster 3 ,
Bret Mullin 3 , Devon Magee 3 , Isabelle Mikell 4 , Lokesh Shah 4 , Victoria Powers 4 , Brian Curcio 5 ,
Constantine Daskalakis 5 , Daniel Monti 6 and Mark Levine 2, *
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Citation: Coppock, D.; Violet, P.-C.;
Vasquez, G.; Belden, K.; Foster, M.;
Mullin, B.; Magee, D.; Mikell, I.; Shah,
L.; Powers, V.; et al. Pharmacologic
Ascorbic Acid as Early Therapy for
Hospitalized Patients with
COVID-19: A Randomized Clinical
Trial. Life 2022, 12, 453. https://
doi.org/10.3390/life12030453
Academic Editor: Ramón Cacabelos
Received: 29 January 2022
Accepted: 15 March 2022
Published: 19 March 2022
Publisher’s Note: MDPI stays neutral
with regard to jurisdictional claims in
*
Division of Infectious Diseases, Department of Medicine, Sidney Kimmel Medical College,
Thomas Jefferson University, 1015 Chestnut Street, Philadelphia, PA 19107, USA;
gvasquezmd@gmail.com (G.V.); katherine.belden@jefferson.edu (K.B.)
Molecular and Clinical Nutrition Section, National Institute of Diabetes and Digestive and Kidney Diseases,
National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA; pierre-christian.violet@nih.gov
Jefferson Clinical Research Institute, Thomas Jefferson University, 833 Chestnut Street,
Philadelphia, PA 19107, USA; mfoster610@gmail.com (M.F.); bret.mullin@jefferson.edu (B.M.);
devon.magee@jefferson.edu (D.M.)
Sidney Kimmel Medical College, Thomas Jefferson University, 1015 Walnut Street,
Philadelphia, PA 19107, USA; isabelle.mikell@students.jefferson.edu (I.M.);
lokesh.shah@students.jefferson.edu (L.S.); tori.powers@students.jefferson.edu (V.P.)
Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Sidney Kimmel
Medical College, Thomas Jefferson University, 1015 Chestnut Street, Philadelphia, PA 19107, USA;
curciob@arcadia.edu (B.C.); constantine.daskalakis@jefferson.edu (C.D.)
Department of Integrative Medicine and Nutritional Sciences, Sidney Kimmel Medical College,
Thomas Jefferson University, 925 Chestnut Street, Philadelphia, PA 19107, USA; daniel.monti@jefferson.edu
Correspondence: dagan.coppock@jefferson.edu (D.C.); markl@bdg8.niddk.nih.gov (M.L.)
Abstract: Despite the widespread availability of effective vaccines, new cases of infection with
severe acute respiratory syndrome coronavirus-2, the cause of coronavirus disease 2019 (COVID-19),
remain a concern in the settings of vaccine hesitancy and vaccine breakthrough. In this randomized,
controlled, phase 2 trial, we hypothesized that high-dose ascorbic acid delivered intravenously to
achieve pharmacologic concentrations may target the high viral phase of COVID-19 and thus improve
early clinical outcomes. Sixty-six patients admitted with COVID-19 and requiring supplemental
oxygen were randomized to receive either escalating doses of intravenous ascorbic acid plus standard
of care or standard of care alone. The demographic and clinical characteristics were well-balanced
between the two study arms. The primary outcome evaluated in this study was clinical improvement
at 72 h after randomization. While the primary outcome was not achieved, point estimates for
the composite outcome and its individual components of decreased use of supplemental oxygen,
decreased use of bronchodilators,..
Late treatment
is less effective
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