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All Studies   Meta Analysis   Recent:  
0 0.5 1 1.5 2+ Mortality 23% Improvement Relative Risk Ventilation 21% Vitamin C  Kumar et al.  ICU PATIENTS  DB RCT Is very late treatment with vitamin C beneficial for COVID-19? Double-blind RCT 60 patients in India Lower mortality with vitamin C (not stat. sig., p=0.6) Kumar et al., J. Family Medicine and P.., Aug 2022 Favors vitamin C Favors control

Efficacy of intravenous vitamin C in management of moderate and severe COVID-19: A double blind randomized placebo controlled trial

Kumar et al., Journal of Family Medicine and Primary Care, doi:10.4103/jfmpc.jfmpc_2437_21, CTRI/2020/11/029230
Aug 2022  
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RCT 60 ICU patients in India, showing no significant difference in outcomes with vitamin C. Mortality was lower in the vitamin C arm despite having more severe cases at baseline (87% vs. 67%). 1 gram intravenous vitamin C 8 hourly for four days.
Although the 23% lower mortality is not statistically significant, it is consistent with the significant 20% lower mortality [10‑29%] from meta analysis of the 38 mortality results to date.
This is the 14th of 17 COVID-19 RCTs for vitamin C, which collectively show efficacy with p=0.00000014.
This is the 52nd of 64 COVID-19 controlled studies for vitamin C, which collectively show efficacy with p=0.00000022. This study is excluded in the after exclusion results of meta analysis: very late stage, ICU patients.
risk of death, 23.1% lower, RR 0.77, p = 0.60, treatment 10 of 30 (33.3%), control 13 of 30 (43.3%), NNT 10.0.
risk of mechanical ventilation, 21.4% lower, RR 0.79, p = 0.60, treatment 11 of 30 (36.7%), control 14 of 30 (46.7%), NNT 10.0.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Kumar et al., 30 Aug 2022, Double Blind Randomized Controlled Trial, placebo-controlled, India, peer-reviewed, mean age 57.0, 11 authors, average treatment delay 7.5 days, trial CTRI/2020/11/029230.
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This PaperVitamin CAll
Efficacy of intravenous vitamin C in management of moderate and severe COVID-19: A double blind randomized placebo controlled trial
Dr Vijay Kumar, Divendu Bhushan, Sushmita Supriya, Avinasharavind Ganapule, Pallavi Lohani, Shyama, Sanjay Pandey, Pramodkumar Majhi, Utpal Anand, Ramesh Kumar, Umeshkumar Bhadani
Journal of Family Medicine and Primary Care, doi:10.4103/jfmpc.jfmpc_2437_21
Aim: To study the efficacy of intravenous vitamin C in management of moderate and severe COVID-19. Objective: To determine the efficacy of intravenous vitamin C in reducing in-hospital mortality in moderate and severe cases of COVID-19. Design: Parallel, double-blinded randomized controlled trial with placebo. Ethical clearance was obtained from the institutional ethics committee, AIIMS Patna. The trial was registered with the Clinical Trials Registry -India (registration number-CTRI/2020/11/029230.) Setting: A tertiary care centre in Bihar, India Participants: All patients above the age of 18 years both males and females, admitted in ICU with a diagnosis of moderate and severe COVID-19 (on the basis of a positive reverse transcriptase polymerase chain reaction (RT-PCR) report) at our facility during the study period (01/10/2020-31/12/2020) not having any of the exclusion criteria. Intervention: The patients in the intervention arm were given 1 gram (2 ampoules of 2 ml each containing 500 mg of vitamin C mixed in 100 ml normal saline) intravenous vitamin C 8 hourly for four days. The patients in the placebo arm received similar looking ampoules (2 ampoules of 2 ml sterile water for injection mixed in 100 ml normal saline) intravenously 8 hourly for four days. The rest of the treatment was given as per the standard operating procedure (SOP) of the institute with adjustments as per treating team's judgement. Outcome Measures: Primary outcome was reduction in in-hospital mortality. Secondary outcomes were improvement in qSOFA score, pO2/fiO2 ratio, fall in inflammatory markers, need for mechanical ventilation and vasopressors. Results: Regarding primary outcome, 10 (33.3%) patients died in intervention group compared to 13 (43.3%) in placebo. Worth noting from baseline characteristics is that 86.7% in intervention arm were of severe category compared to 66.7% severe category patients in placebo group. Though number of severe cases were more in intervention arm there has been comparatively less mortality in this group. Regarding secondary outcomes, amongst 30 patients in vitamin C group, 11 (36.7%) required invasive mechanical ventilation compared to 14 (46.7%) out of 30 in placebo group but the difference was not statistically significant. Although there were a greater number of moderate cases in placebo group, invasive ventilation requirement (and NIV requirement) was more in this group, thus it could be considered that vitamin C might have a role in reducing the severity of disease. The need for vasopressor therapy was higher in intervention arm 33.3% compared to 26.7% in placebo but not significant statistically. The secondary outcomes of the study such as improvement in organ failure score (qSOFA Score), fall in level of inflammatory markers, improvement in respiratory index (pO2/fiO2 ratio), need for mechanical ventilation and need for vasopressors also shown encouraging results but not up to the statistically significant level due to moderate..
Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
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Late treatment
is less effective
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