High-dose intravenous vitamin C decreases rates of mechanical ventilation and cardiac arrest in severe COVID-19
Hess et al.
, High-dose intravenous vitamin C decreases rates of mechanical ventilation and cardiac arrest in severe..
, Internal and Emergency Medicine, doi:10.1007/s11739-022-02954-6
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.
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 = 0.0499, 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.
Abstract: Internal and Emergency Medicine
EM - ORIGINAL
High‑dose intravenous vitamin C decreases rates of mechanical
ventilation and cardiac arrest in severe COVID‑19
Andrea L. Hess1 · Alexandra Halalau1,2 · Jonathan J. Dokter1 · Tania S. Paydawy3 · Patrick Karabon4 ·
Aveh Bastani1,5 · Rebecca E. Baker3 · Abdalla Kara Balla2 · Stephen A. Galens1,6
Received: 30 March 2021 / Accepted: 22 February 2022
© The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI) 2022
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%; ORIPTW = 0.27; P = 0.0499) and cardiac arrest (2.46% vs. 9.06%; ORIPTW = 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.
Keywords Ascorbic acid · Vitamin C · Treatment · Intensive care · SARS-CoV-2
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