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The Effect of High-dose Vitamin C Treatment for Acute Respiratory Failure due to Coronavirus Disease Pneumonia on Mortality and Length of Intensive Care Stay: A Retrospective Cohort Study

Coskun et al., SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital, doi:10.14744/SEMB.2022.66742, NCT04710329 (history)

Coskun et al., The Effect of High-dose Vitamin C Treatment for Acute Respiratory Failure due to Coronavirus Disease Pneumonia.., SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital, doi:10.14744/SEMB.2022.66742, NCT04710329

Mar 2023 Source PDF

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Retrospective 78 ICU patients in Turkey, showing lower mortality with high-dose vitamin C treatment, without statistical significance. The SOFA score was significantly better with treatment at day 4.

Authors incorrectly state that "HDVC treatment did not reduce the short-term mortality...". Mortality was lower with treatment, although not statistically significant given the sample size.

6g of vitamin C daily in 4 equal doses every 6h, for a total of 96h.

This is the 58th of 61 COVID-19 controlled studies for vitamin C, which collectively show efficacy with p=0.00000098. 15 studies are RCTs, which show efficacy with p=0.00013.

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risk of death, 25.4% lower, RR 0.75, p = 0.26, treatment 17 of 38 (44.7%), control 24 of 40 (60.0%), NNT 6.6.

risk of mechanical ventilation, 1.8% lower, RR 0.98, p = 1.00, treatment 28 of 38 (73.7%), control 30 of 40 (75.0%), NNT 76.

ICU time, no change, relative time 1.00, treatment 38, control 40.

relative SOFA score, 28.4% better, RR 0.72, p = 0.005, treatment 38, control 40, mean SOFA score, day 4.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates

Coskun et al., 21 Mar 2023, retrospective, Turkey, peer-reviewed, 1 author, study period March 2020 - June 2020, trial NCT04710329 (history).

Contact: hacersebnem@yahoo.com.tr.

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AI generated summary. Current AI models can provide useful summaries for non-experts, but may be inaccurate and have limited ability to analyze larger context such as the entire evidence base for vitamin C.

A retrospective cohort study of 78 ICU patients with acute respiratory failure due to COVID-19 pneumonia found that high-dose vitamin C therapy did not significantly reduce mortality.

This article is a retrospective cohort study that investigated the effect of high-dose vitamin C treatment on short-term mortality and length of intensive care unit (ICU) stay in patients with coronavirus disease (COVID-19) followed up in the ICU. The study included 78 patients, 38 of whom received high-dose vitamin C and 40 of whom did not. The primary outcomes were length of ICU stay and short-term mortality, while the secondary outcomes were vasopressor and invasive mechanical ventilation requirements and change in sequential organ failure assessment score from the 0 to the 96th hour.

The results showed that there was no significant difference in mortality rates between the two groups (44% vs. 60%). The median length of ICU stay was also similar in both groups (10 days). There were also no significant differences in the invasive mechanical ventilation and vasopressor requirements between the two groups.

The mean SOFA score was significantly lower in the vitamin C group at 96 hours (5.3 vs. 7.4).

Limitations of this study include:

The study was retrospective, which means that the researchers looked back at medical records after the fact. This type of study design can be more prone to bias than a prospective study, in which the researchers collect data from patients before they know the outcome.
The study had a small sample size. This means that the results of the study may not be generalizable to a larger population of patients with COVID-19.

The Effect of High-dose Vitamin C Treatment for Acute Respiratory Failure due to Coronavirus Disease Pneumonia on Mortality and Length of Intensive Care Stay: A Retrospective Cohort Study

Nurcan Coskun, Hacer Musta Altinay, Sebnem Turk, Nebia Peker, Serkan Islamoglu, Surhan Ayse, Melis Turkel Cinar, Ozkan, Etfal Sisli, Hospital, Sebnem Hacer, MD. Sisli Hamidiye Turk, Egitim Etfal, Arastirma Ve, Saglik Bilimleri Hastanesi, Universitesi, Türkiye İstanbul

SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital, doi:10.14744/semb.2022.66742

S evere acute respiratory syndrome coronavirus 2 (SARS- CoV-2) causes tissue damage in the endothelium and epithelium, increasing vascular permeability and the risk of lung edema. The expressions of interleukin (IL) 6, IL-2, IL-7, IL-10, interferon gamma, and tumor necrosis factor α are thought to induce an interstitial fibrosis in the lung by causing an abnormal increase (cytokine storm) in plasma levels. [1] [2] [3] When these pathogenic factors are taken into account, a table with high mortality from acute respiratory failure and severe acute respiratory distress syndrome (ARDS) emerges in patients with coronavirus disease (CO-VID-19) followed up in the intensive care unit (ICU). The low Objectives: In our study, we aimed to determine the effect of vitamin C on short-term mortality and length of intensive care unit (ICU) stay in patients with coronavirus disease (COVID-19) followed up in the ICU. Methods: The patients who received and those who did not receive the high-dose intravenous vitamin C protocol were assigned to the treatment and control groups, respectively. The primary study findings in both groups were length of ICU stay and shortterm mortality, while the secondary findings were vasopressor and invasive mechanical ventilation requirements and change in sequential organ failure assessment score from the 0 to the 96th hour. Results: Thirty-eight patients were included in the treatment group and 40 were included in the control group. The mortality rates were 44% and 60% in the treatment and control groups, respectively; however, the difference between the groups was not statistically significant (p>0.05). The median length of ICU stay in both groups was 10 days (p>0.05). No significant differences in the invasive mechanical ventilation and vasopressor requirements were found between the groups (p>0.05). Conclusion: Consequently, the high-dose vitamin C therapy in the patients with acute respiratory failure due to COVID-19 pneumonia did not reduce the length of ICU stay, mortality, and invasive mechanical ventilation and vasopressor reqirements.

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Late treatment
is less effective

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