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0 0.5 1 1.5 2+ Mortality 20% Improvement Relative Risk Ventilation 40% Ventilation (b) 50% ICU admission 27% ICU admission (b) 30% Vitamin C for COVID-19  Hess et al.  LATE TREATMENT Is late treatment with vitamin C beneficial for COVID-19? Retrospective 100 patients in the USA (March - July 2020) Lower mortality (p=0.54) and ICU admission (p=0.11), not sig. Hess et al., Internal and Emergency Me.., Mar 2022 Favors vitamin C Favors control

High-dose intravenous vitamin C decreases rates of mechanical ventilation and cardiac arrest in severe COVID-19

Hess et al., Internal and Emergency Medicine, doi:10.1007/s11739-022-02954-6
Mar 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.
Retrospective 100 severe condition hospitalized patients in the USA, 25 treated with high dose IV vitamin C, showing lower mechanical ventilation and cardiac arrest, and increased length of survival with treatment. 3g IV vitamin C every 6h for 7 days.
This is the 46th 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.
risk of death, 20.0% lower, HR 0.80, p = 0.54, treatment 10 of 25 (40.0%), control 37 of 75 (49.3%), NNT 11, time to event analysis, propensity score weighting.
risk of mechanical ventilation, 39.5% lower, RR 0.60, p = 0.05, treatment 18 of 25 (72.0%), control 54 of 75 (72.0%), odds ratio converted to relative risk, propensity score weighting.
risk of mechanical ventilation, 50.0% lower, HR 0.50, p = 0.03, treatment 18 of 25 (72.0%), control 54 of 75 (72.0%), time to event analysis, propensity score weighting.
risk of ICU admission, 27.2% lower, RR 0.73, p = 0.10, treatment 22 of 25 (88.0%), control 63 of 75 (84.0%), odds ratio converted to relative risk, propensity score weighting.
risk of ICU admission, 30.0% lower, HR 0.70, p = 0.19, treatment 22 of 25 (88.0%), control 63 of 75 (84.0%), time to event analysis, propensity score weighting.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Hess et al., 29 Mar 2022, retrospective, USA, peer-reviewed, 9 authors, study period March 2020 - July 2020.
This PaperVitamin CAll
High-dose intravenous vitamin C decreases rates of mechanical ventilation and cardiac arrest in severe COVID-19
Andrea L Hess, Alexandra Halalau, Jonathan J Dokter, Tania S Paydawy, Patrick Karabon, Aveh Bastani, Rebecca E Baker, Abdalla Kara Balla, Stephen A Galens
Internal and Emergency Medicine, doi:10.1007/s11739-022-02954-6
Intravenous vitamin C (IV-VitC) has been suggested as a treatment for severe sepsis and acute respiratory distress syndrome; however, there are limited studies evaluating its use in severe COVID-19. Efficacy and safety of high-dose IV-VitC (HDIVC) in patients with severe COVID-19 were evaluated. This observational cohort was conducted at a single-center, 530 bed, community teaching hospital and took place from March 2020 through July 2020. Inverse probability treatment weighting (IPTW) was utilized to compare outcomes in patients with severe COVID-19 treated with and without HDIVC. Patients were enrolled if they were older than 18 years of age and were hospitalized secondary to severe COVID-19 infection, indicated by an oxygenation index < 300. Primary study outcomes included mortality, mechanical ventilation, intensive care unit (ICU) admission, and cardiac arrest. From a total of 100 patients enrolled, 25 patients were in the HDIVC group and 75 patients in the control group. The average time to death was significantly longer for HDIVC patients (P = 0.0139), with an average of 22.9 days versus 13.7 days for control patients. Patients who received HDIVC also had significantly lower rates of mechanical ventilation (52.93% vs. 73.14%; OR IPTW = 0.27; P = 0.0499) and cardiac arrest (2.46% vs. 9.06%; OR IPTW = 0.23; P = 0.0439). HDIVC may be an effective treatment in decreasing the rates of mechanical ventilation and cardiac arrest in hospitalized patients with severe COVID-19. A longer hospital stay and prolonged time to death may suggest that HDIVC may protect against clinical deterioration in severe COVID-19.
Author contributions ALH and AH were responsible for drafting and coordinating the manuscript writing process, multiple critical revisions, and final approval of the manuscript. AH was responsible for the institutional review board approval and has overseen the entire study. JD was responsible for drafting part of the manuscript and critical revision of the manuscript. AK was responsible for the manuscript introduction and critical revision of the manuscript. ALH, JD, TP and RB are responsible for the data integrity. PK was responsible for the statistical analysis and for critical revision of the manuscript. PK drafted the results and tables. AB and SG provided critical revision of the manuscript. All authors read and approved the final manuscript. Conflict of interest The authors have no competing interests to declare. Human and animal rights statement This study as approved by the Institutional Review Board, Beaumont Health. Informed consent Informed consent was waived as the curent study was had a retrospective design. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Late treatment
is less effective
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