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0 0.5 1 1.5 2+ Mortality 63% Improvement Relative Risk Vitamin C for COVID-19  Doocy et al.  LATE TREATMENT Is late treatment with vitamin C beneficial for COVID-19? Prospective study of 144 patients in multiple countries (Dec 2020 - Jun 2021) Lower mortality with vitamin C (not stat. sig., p=0.22) Doocy et al., PLOS Global Public Health, Oct 2022 Favors vitamin C Favors control

Clinical progression and outcomes of patients hospitalized with COVID-19 in humanitarian settings: A prospective cohort study in South Sudan and Eastern Democratic Republic of the Congo

Doocy et al., PLOS Global Public Health, doi:10.1371/journal.pgph.0000924, NCT04568499
Oct 2022  
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Vitamin C for COVID-19
7th treatment shown to reduce risk in September 2020
*, now known with p = 0.000000098 from 67 studies, recognized in 10 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,800+ studies for 60+ treatments.
Prospective study of 144 hospitalized COVID-19 patients in the DRC and South Sudan, showing lower mortality with vitamin C treatment.
This is the 54th of 67 COVID-19 controlled studies for vitamin C, which collectively show efficacy with p=0.000000098 (1 in 10 million). 18 studies are RCTs, which show efficacy with p=0.00088.
Study covers vitamin A, zinc, and vitamin C.
risk of death, 62.8% lower, RR 0.37, p = 0.22, treatment 2 of 64 (3.1%), control 22 of 80 (27.5%), NNT 4.1, adjusted per study, inverted to make RR<1 favor treatment, multivariable.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Doocy et al., 19 Oct 2022, prospective, multiple countries, peer-reviewed, 6 authors, study period December 2020 - June 2021, trial NCT04568499 (history). Contact:
This PaperVitamin CAll
Clinical progression and outcomes of patients hospitalized with COVID-19 in humanitarian settings: A prospective cohort study in South Sudan and Eastern Democratic Republic of the Congo
Shannon Doocy, Iris Bollemeijer, Eva Leidman, Abdou Sebushishe, Eta Ngole Mbong, Kathleen Page
PLOS Global Public Health, doi:10.1371/journal.pgph.0000924
Little information is available on COVID-19 in Africa and virtually none is from humanitarian and more resource-constrained settings. This study characterizes hospitalized patients in the African humanitarian contexts of Juba, South Sudan and North and South Kivu in Eastern Democratic Republic of the Congo. This observational cohort was conducted between December 2020 and June 2021. Patients presenting for care at five facilities or referred from home-based care by mobile medical teams were eligible for enrollment and followed until death or recovery. Disease progression was characterized for hospitalized patients using survival analysis and mixed effects regression model to estimate survival odds for patient characteristics and treatments received. 144 COVID-19 cases enrolled as hospitalized patients were followed to recovery/death. The observed mortality proportion among hospitalized patients was 16.7% (CI: 11.2-23.3%); mortality was three times higher in South Sudan, where patients presented later after symptom onset and in worse conditions. Age and diabetes history were the only patient characteristics associated with decreased survival; clinical status indicators associated with decreased survival included fever, low oxygen level, elevated respiratory and pulse rates. The only therapy associated with survival was non-invasive oxygen; invasive oxygen therapies and other specialized treatments were rarely received. Improving availability of oxygen monitoring and proven COVID-19 therapies in humanitarian and resource-poor settings is critical for health equity. Customizing training to reflect availability of specific medications, therapies and operational constraints is particularly important given the range of challenges faced by providers in these settings.
Supporting information S1
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Late treatment
is less effective
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