Supplementary Data — Vitamin C reduces COVID-19 risk: real-time meta-analysis of 72 studies

October 2026

Vitamin C COVID-19 outcomes

StudyImprovementRR · 95% CIOutcomeTreatmentControlRelative Risk
Su−135%2.35 · 0.67–8.27progressionn/an/a Su−34%1.34 · 1.02–1.73no improv.n/an/a Thomas (RCT)−204%3.04 · 0.13–72.89death1/480/50COVIDAtoZ Thomas (RCT)31%0.69 · 0.12–3.98hosp.2/483/50COVIDAtoZ Thomas (RCT)18%0.82 · 0.63–1.07recov. time48 (n)50 (n)COVIDAtoZ Zhao (PSM)72%0.28 · 0.08–0.93progression4/5512/55 Zhao (PSM)−8%1.08 · 0.64–1.80viral time55 (n)55 (n) Ried (RCT)31%0.69 · 0.54–0.89no recov.69/16246/75 Usanma Koban33%0.67 · 0.07–5.38viral+31 (n)95 (n) Rahman40%0.60 · 0.47–0.76hosp.128/47656/124 Krishnan31%0.69 · 0.47–0.92death40/7952/73 Zhang (RCT)50%0.50 · 0.20–1.50death6/2711/29ICU patients Zhang (RCT)80%0.20 · 0.10–0.90death5/2711/29ICU patients Zhang (RCT)50%0.50 · 0.20–1.80death6/2710/29ICU patients Zhang (RCT)70%0.30 · 0.21–1.10death5/2710/29ICU patients Yüksel (ICU)19%0.81 · 0.66–0.99death31/4240/44ICU patients Patel29%0.71 · 0.43–1.14death22/9626/80 Patel16%0.84 · 0.52–1.36death15/3016/27 Kumari (RCT)36%0.64 · 0.26–1.55death7/7511/75 Kumari (RCT)20%0.80 · 0.40–1.59ventilation12/7515/75 Kumari (RCT)26%0.74 · 0.64–0.86recov. time75 (n)75 (n) Kumari (RCT)24%0.76 · 0.66–0.87hosp. time75 (n)75 (n) Jang51%0.49 · 0.23–1.01no recov.5/126/7ECMO patients JamaliMo.. (RCT)0%1.00 · 0.22–4.56death3/303/30 JamaliMo.. (RCT)−25%1.25 · 0.37–4.21ventilation5/304/30 JamaliMo.. (RCT)−31%1.31 · 1.03–1.66hosp. time30 (n)30 (n) Gao86%0.14 · 0.03–0.72death1/465/30 Hamidi-A.. (RCT)44%0.56 · 0.20–1.51death5/409/40CT2 Hamidi-A.. (RCT)38%0.62 · 0.45–0.86hosp. time40 (n)40 (n)CT2 Al Sulaiman (PSM)15%0.85 · 0.61–1.12death46/14259/142 Mulhem−32%1.32 · 1.07–1.62death157/794359/2,425 Gadhiya−1%1.01 · 0.48–1.91death19/5536/226 Hakamifard (RCT)46%0.54 · 0.14–2.08ICU3/385/34CT2 Hakamifard (RCT)1%0.99 · 0.91–1.07hosp. time38 (n)34 (n)CT2 Elhadi (ICU)−12%1.12 · 0.96–1.31death175/277106/188ICU patients Suna21%0.79 · 0.44–1.41death17/15324/170 Suna−2%1.02 · 0.46–2.24ICU11/15312/170 Pourhoseingholi13%0.87 · 0.63–1.19death54/199285/2,269 Li (ICU)−11%1.11 · 0.79–1.54death7/819/24ICU patients Vishnuram54%0.46 · 0.24–0.86death164/8,63410/241 Özgünay (ICU)9%0.91 · 0.63–1.30death17/3275/128ICU patients Özgünay (ICU)−1%1.01 · 0.79–1.29ventilation23/3291/128ICU patients Tan25%0.75 · 0.10–2.98death/int.1/4614/115CT2 Tan73%0.27 · 0.09–0.61ARDS7/4641/115CT2 Zheng (PSM)−157%2.57 · 0.39–16.79death12/707/327 Zheng−169%2.69 · 0.91–7.89death12/707/327 Zheng (PSM)−35%1.35 · 0.88–2.08no improv.18/7016/327 Zheng−32%1.32 · 0.93–1.82no improv.18/7016/327 Simsek44%0.56 · 0.23–1.35death6/5815/81 Simsek10%0.90 · 0.55–1.46ICU18/5828/81 Tehrani (RCT)87%0.13 · 0.01–2.25death0/184/26 Tehrani (RCT)18%0.82 · 0.60–1.13hosp. time18 (n)26 (n) Majidi (DB RCT)14%0.86 · 0.74–1.01death26/3167/69ICU patients Baguma−48%1.48 · 0.41–4.70death385 (n)96 (n) Tu83%0.17 · 0.08–0.35death8/11626/64 Yang (RCT)33%0.67 · 0.55–0.81recov. time10 (n)10 (n)CT2 Yang (RCT)45%0.55 · 0.44–0.71recov. time10 (n)10 (n)CT2 Yang (RCT)24%0.76 · 0.63–0.93recov. time10 (n)10 (n)CT2 Yang (RCT)28%0.72 · 0.58–0.89recov. time10 (n)10 (n)CT2 Yang (RCT)27%0.73 · 0.60–0.89recov. time10 (n)10 (n)CT2 Yang (RCT)23%0.77 · 0.66–0.89recov. time10 (n)10 (n)CT2 Yang (RCT)15%0.85 · 0.68–1.06recov. time10 (n)10 (n)CT2 Yang (RCT)15%0.85 · 0.75–0.97recov. time10 (n)10 (n)CT2 Gavrielatou (ICU)58%0.42 · 0.12–1.48death2/1049/103ICU patients Salehi (ICU)10%0.90 · 0.65–1.25death22/4052/85ICU patients Coppock (RCT)5%0.95 · 0.16–7.84progression4/442/22 Coppock (RCT)50%0.50 · 0.16–1.33no improv.6/446/22 Coppock (RCT)22%0.78 · 0.61–0.98no disch.31/4420/22 Hess (PSW)20%0.80 · 0.40–1.60death10/2537/75 Hess (PSW)40%0.60 · 0.28–1.00ventilation18/2554/75 Hess (PSW)50%0.50 · 0.20–0.90ventilation18/2554/75 Hess (PSW)27%0.73 · 0.41–1.04ICU22/2563/75 Hess (PSW)30%0.70 · 0.40–1.20ICU22/2563/75 Izzo41%0.59 · 0.50–0.69recovery869 (n)521 (n)LINCOLNLONG COVID OT1 CT2 Izzo68%0.33 · 0.19–0.57recovery869 (n)521 (n)LINCOLNLONG COVID OT1 CT2 Fogleman (DB RCT)4%0.96 · 0.65–1.40recovery32 (n)34 (n) Kumar (DB RCT)23%0.77 · 0.40–1.47death10/3013/30ICU patients Kumar (DB RCT)21%0.79 · 0.43–1.44ventilation11/3014/30ICU patients Özgülteki̇n (ICU)−5%1.05 · 0.81–1.36death18/2118/22ICU patients Doocy63%0.37 · 0.08–1.82death2/6422/80 Labbani-.. (DB RCT)33%0.67 · 0.20–2.17death4/376/37 Labbani-.. (DB RCT)−13%1.13 · 0.81–1.58hosp. time37 (n)37 (n) Labbani-.. (DB RCT)16%0.84 · 0.68–1.05progression37 (n)37 (n) Labbani-.. (DB RCT)−9%1.09 · 0.86–1.39progression37 (n)37 (n) Labbani-.. (DB RCT)−6%1.06 · 0.93–1.20progression37 (n)37 (n) Labbani-.. (DB RCT)60%0.40 · 0.14–1.16progression4/3710/37 Coskun (ICU)25%0.75 · 0.48–1.15death17/3824/40ICU patients Coskun (ICU)2%0.98 · 0.76–1.28ventilation28/3830/40ICU patients Coskun (ICU)28%0.72 · 0.57–0.90sofa38 (n)40 (n)ICU patients Kyagambiddwa50%0.50 · 0.24–1.04death246 (all patients) Rana (DB RCT)55%0.45 · 0.16–1.27death5/13911/139ICU patients Rana (DB RCT)44%0.56 · 0.19–1.62ventilation5/1399/139ICU patients Rana (DB RCT)37%0.63 · 0.00–1358hosp. time139 (n)139 (n)ICU patients Mousaviasl (DB RCT)20%0.80 · 0.32–1.98death8/20110/200 Mousaviasl (DB RCT)−99%1.99 · 0.18–21.77death2/2011/200 Mousaviasl (DB RCT)−200%3.00 · 0.12–73.09ventilation1/2010/200 Mousaviasl (DB RCT)−33%1.33 · 0.47–3.75ICU8/2016/200 Seely (DB RCT)48%0.52 · 0.10–2.71progression2/424/44CT2 Seely (DB RCT)14%0.86 · 0.61–1.22no recov.34 (n)24 (n)CT2 Seely (DB RCT)29%0.71 · 0.28–1.75no recov.7/347/24CT2 Seely (DB RCT)29%0.71 · 0.31–1.65no recov.32 (n)31 (n)CT2 Seely (DB RCT)14%0.86 · 0.37–1.97no recov.33 (n)30 (n)CT2 Seely (DB RCT)50%0.50 · 0.19–1.34no recov.32 (n)33 (n)CT2 Seely (DB RCT)−12%1.12 · 0.82–1.54no recov.30 (n)25 (n)CT2 Seely (DB RCT)−4%1.04 · 0.77–1.40recov. time34 (n)24 (n)CT2 Seely (DB RCT)12%0.88 · 0.19–4.02PASC3/333/29CT2 Seely (DB RCT)36%0.64 · 0.16–2.65PASC3/354/30CT2 Seely (DB RCT)1%0.99 · 0.34–2.93PASC6/355/29CT2 Adhikari (RCT)−19%1.19 · 0.98–1.46death1,303 (n)903 (n)REMAP-CAP Adhikari (RCT)−16%1.16 · 0.91–1.47death953 (n)434 (n)REMAP-CAP Adhikari (RCT)−27%1.27 · 0.92–1.85death350 (n)469 (n)REMAP-CAP Adhikari (DB RCT)28%0.72 · 0.45–1.17death190 (n)194 (n)LOVIT-COVID Adhikari (DB RCT)28%0.72 · 0.36–1.33death84 (n)97 (n)LOVIT-COVID Adhikari (DB RCT)28%0.72 · 0.35–1.45death106 (n)97 (n)LOVIT-COVID Fowler (DB RCT)19%0.81 · 0.30–2.19death5/227/25SAFE EVICT CORONA-ALIICU patients Fowler (DB RCT)−2%1.02 · 0.99–1.05misc.21 (n)23 (n)SAFE EVICT CORONA-ALIICU patients Corrao39%0.61 · 0.23–1.60death9/1046/42 Corrao19%0.81 · 0.56–1.12death/ICU104 (n)42 (n) Corrao−102%2.02 · 0.46–8.83ICU10/1042/42 Corrao25%0.75 · 0.50–1.12hosp. time104 (n)42 (n) Uz84%0.16 · 0.02–0.97death41 (n)46 (n) Uz90%0.10 · 0.02–0.49death183 (n)46 (n) Dinoi−32%1.32 · 0.79–2.20deathcase-control study Bepouka76%0.24 · 0.08–0.72death185 (n)225 (n) Behera18%0.82 · 0.45–1.57casescase-control study Behera29%0.71 · 0.40–1.26casescase-control study Louca0%1.00 · 0.97–1.04casespopulation-based cohort Mahto−26%1.26 · 0.63–2.28IgG+34/14059/549 Bejan34%0.66 · 0.29–1.53death569 (n)8,637 (n) Bejan25%0.75 · 0.35–1.62ventilation572 (n)8,657 (n) Bejan15%0.85 · 0.43–1.69ICU577 (n)8,690 (n) Bejan0%1.00 · 0.67–1.49hosp.626 (n)9,122 (n) Holt−3%1.03 · 0.77–1.39cases49/1,580397/13,647COVIDENCE UK Abdulateef19%0.81 · 0.37–1.78hosp.8/13222/295 Aldwihi36%0.64 · 0.45–0.86hosp.142/50595/233 Mohseni−44%1.44 · 1.22–1.71cases34/43307/560 Nimer25%0.75 · 0.54–1.04hosp.52/651167/1,497 Nimer17%0.83 · 0.62–1.09severe case66/651194/1,497 Shehab4%0.96 · 0.46–1.99severe case14/13912/114 Loucera28%0.72 · 0.58–0.88death840 (n)15,128 (n) Guldemir31%0.69 · 0.48–0.99hosp.33/17384/304 Sharif46%0.54 · 0.01–0.92severe casen/an/a Asoudeh69%0.31 · 0.14–0.65severe case250 (all patients) Vaisi38%0.62 · 0.31–1.23hosp.2,818 (n)1,137 (n) Vaisi10%0.90 · 0.69–1.29symp. case2,818 (n)1,137 (n) Akbar14%0.86 · 0.65–1.14cases665 (n)9,335 (n) Guan31%0.69 · 0.50–0.86symp. case28/462,017/2,454 Guan18%0.82 · 0.68–0.94symp. case55/792,017/2,454 Guan7%0.93 · 0.84–1.01symp. case129/1672,017/2,454
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1 OT: comparison with other treatment
2 CT: study uses combined treatment
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← Vitamin C
reduces risk
Vitamin C
increases risk →
Fig. S1. All outcomes.
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Fig. S2. Comparison of results for RCTs versus observational studies. For COVID-19 treatments, there is no significant difference between the results of RCTs and observational studies. Observational studies do not systematically over or underestimate efficacy. For high-cost treatments, there is a non-significant trend towards RCTs showing greater efficacy.