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All Studies   Meta Analysis       

The Role of Vitamin C as Adjuvant Therapy in COVID-19

Kumari et al., Cureus, doi:10.7759/cureus.11779
Nov 2020  
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Mortality 36% Improvement Relative Risk Ventilation 20% Recovery time 26% Hospitalization time 24% Vitamin C  Kumari et al.  LATE TREATMENT  RCT Is late treatment with vitamin C beneficial for COVID-19? RCT 150 patients in Pakistan (March - July 2020) Faster recovery (p=0.0001) and shorter hospitalization (p=0.0001) c19early.org Kumari et al., Cureus, November 2020 Favorsvitamin C Favorscontrol 0 0.5 1 1.5 2+
Vitamin C for COVID-19
6th treatment shown to reduce risk in September 2020, now with p = 0.00000002 from 73 studies, recognized in 12 countries.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 109 treatments. c19early.org
RCT 150 hospitalized patients in Pakistan showing 26% faster recovery, p < 0.0001. 36% lower mortality, not statistically significant due to the small number of events. Dosage was 50 mg/kg/day of intravenous vitamin C.
This is the 2nd of 21 COVID-19 RCTs for vitamin C, which collectively show efficacy with p=0.0012.
This is the 7th of 73 COVID-19 controlled studies for vitamin C, which collectively show efficacy with p=0.00000002 (1 in 50 million).
risk of death, 36.4% lower, RR 0.64, p = 0.45, treatment 7 of 75 (9.3%), control 11 of 75 (14.7%), NNT 19.
risk of mechanical ventilation, 20.0% lower, RR 0.80, p = 0.67, treatment 12 of 75 (16.0%), control 15 of 75 (20.0%), NNT 25.
recovery time, 26.0% lower, relative time 0.74, p < 0.001, treatment 75, control 75, days to symptom-free.
hospitalization time, 24.3% lower, relative time 0.76, p < 0.001, treatment 75, control 75, days spent in hospital.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Kumari et al., 30 Nov 2020, Randomized Controlled Trial, Pakistan, peer-reviewed, 10 authors, study period March 2020 - July 2020, dosage 50mg/kg daily.
This PaperVitamin CAll
The Role of Vitamin C as Adjuvant Therapy in COVID-19
Poona Kumari, Suman Dembra, Pariya Dembra, Fnu Bhawna, Ambresha Gul, Basma Ali, Hamza Sohail, Besham Kumar, Muhammad Khizar Memon, Amber Rizwan
Cureus, doi:10.7759/cureus.11779
Background and objective The anti-inflammatory properties of vitamin C (VC) and the promising results it has shown in the treatment for common cold have prompted clinicians to use it as adjuvant therapy in the treatment of COVID-19. The purpose of this study was to find out the role of VC as adjunctive therapy in coronavirus disease 2019 . Methodology This study was conducted from March to July 2020 in the COVID-19 unit of a tertiary care hospital in Karachi. In this randomized controlled trial (RCT), one group received the intervention [50 mg/kg/day of intravenous (IV) VC] along with the standard therapy, and the other group received standard therapy only. Data such as age, gender, vitals, and biochemical values as well as outcomes including the number of days required for treatment, hospital stay, need for ventilation, and mortality were compared between the two groups and recorded using a self-structured questionnaire. Results COVID-19 patients who received IV VC became symptom-free earlier (7.1 ± 1.8 vs. 9.6 ± 2.1 days, p-value: <0.0001) and spent fewer days in the hospital (8.1 ± 1.8 vs. 10.7 ± 2.2 days, p-value: <0.0001) compared to those who received standard therapy only. However, there was no significant difference in the need for mechanical ventilation (p-value: 0.406) and mortality (p-value: 0.31) between the two groups. Conclusion VC can significantly improve clinical symptoms in patients affected with COVID-19; however, it had no impact on mortality and the need for mechanical ventilation. More large-scale studies are required to further assess the role of VC in the treatment of COVID-19.
Additional Information Disclosures Human subjects: Consent was obtained by all participants in this study. Ghulam Muhammad Mahar Medical College IRB issued approval GMMMC/20/03-4 (electronic). This study was approved by Ghulam Muhammad Mahar Medical College IRB. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.
References
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Fowler Aa 3rd, Truwit, Hite, Effect of vitamin C infusion on organ failure and biomarkers of inflammation and vascular injury in patients with sepsis and severe acute respiratory failure: the CITRIS-ALI randomized clinical trial, JAMA, doi:10.1001/jama.2019.11825
Hemilä, Chalker, Vitamin C may reduce the duration of mechanical ventilation in critically ill patients: a meta-regression analysis, J Intensive Care, doi:10.1186/s40560-020-0432-y
Hiedra, Lo, Elbashabsheh, The use of IV vitamin C for patients with COVID-19: a case series, Expert Rev Anti Infect Ther, doi:10.1080/14787210.2020.1794819
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Johnston, Barkyoumb, Schumacher, Vitamin C supplementation slightly improves physical activity levels and reduces cold incidence in men with marginal vitamin C status: a randomized controlled trial, Nutrients, doi:10.3390/nu6072572
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Marik, Khangoora, Rivera, Hooper, Catravas, Hydrocortisone, vitamin C, and thiamine for the treatment of severe sepsis and septic shock: a retrospective before-after study, Chest, doi:10.1016/j.chest.2016.11.036
Ran, Zhao, Wang, Wang, Zhao et al., Extra dose of vitamin C based on a daily supplementation shortens the common cold: a meta-analysis of 9 randomized controlled trials, Biomed Res Int, doi:10.1155/2018/1837634
Vorilhon, Arpajou, Roussel, Pereira, Cabaillot, Efficacy of vitamin C for the prevention and treatment of upper respiratory tract infection. A meta-analysis in children, Eur J Clin Pharmacol, doi:10.1007/s00228-018-2601-7
Zhang, Rao, Li, High-dose vitamin C infusion for the treatment of critically ill COVID-19, doi:10.21203/rs.3.rs-52778/v1
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Late treatment
is less effective
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