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0 0.5 1 1.5 2+ Mortality 33% Improvement Relative Risk Hospitalization time -13% Progression, SOFA 16% Progression, NEWS -9% Progression, WHO -6% Progression, AKI 60% Vitamin C  Labbani-Motlagh et al.  LATE TREATMENT  DB RCT Is late treatment with vitamin C beneficial for COVID-19? Double-blind RCT 74 patients in Iran (April - November 2020) Lower progression with vitamin C (not stat. sig., p=0.12) Labbani-Motlagh et al., J. Research in.., Dec 2022 Favors vitamin C Favors control

High-dose intravenous Vitamin C in early stages of severe acute respiratory syndrome coronavirus 2 infection: A double-blind, randomized, controlled clinical trial

Labbani-Motlagh et al., Journal of Research in Pharmacy Practice, doi:10.4103/jrpp.jrpp_30_22, IRCT20190917044805N2
Dec 2022  
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Vitamin C for COVID-19
6th treatment shown to reduce risk in September 2020
*, now known with p = 0.000000087 from 70 studies, recognized in 11 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,100+ studies for 60+ treatments.
RCT 74 patients in Iran, showing no significant differences in outcomes with high dose vitamin C treatment. Tables 1b and 2a show conflicting baseline SOFA scores. The percentages of patients receiving antiviral treatments and corticosteroids are switched between the text and Table 1b. Authors indicate ICU admission was an outcome, but the result is not provided. AKI was lower with treatment, though not reaching statistical significance.
This is the 15th of 21 COVID-19 RCTs for vitamin C, which collectively show efficacy with p=0.0012.
This is the 57th of 70 COVID-19 controlled studies for vitamin C, which collectively show efficacy with p=0.000000087 (1 in 11 million).
risk of death, 33.3% lower, RR 0.67, p = 0.74, treatment 4 of 37 (10.8%), control 6 of 37 (16.2%), NNT 18, day 28.
hospitalization time, 12.8% higher, relative time 1.13, p = 0.49, treatment mean 9.24 (±7.5) n=37, control mean 8.19 (±5.34) n=37.
risk of progression, 15.9% lower, RR 0.84, p = 0.12, treatment 37, control 37, SOFA, day 5.
risk of progression, 9.3% higher, RR 1.09, p = 0.47, treatment 37, control 37, NEWS, day 5.
risk of progression, 5.8% higher, RR 1.06, p = 0.38, treatment 37, control 37, WHO, day 5.
risk of progression, 60.0% lower, RR 0.40, p = 0.14, treatment 4 of 37 (10.8%), control 10 of 37 (27.0%), NNT 6.2, AKI.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Labbani-Motlagh et al., 14 Dec 2022, Double Blind Randomized Controlled Trial, placebo-controlled, Iran, peer-reviewed, 12 authors, study period 5 April, 2020 - 19 November, 2020, trial IRCT20190917044805N2. Contact:
This PaperVitamin CAll
High-dose intravenous Vitamin C in early stages of severe acute respiratory syndrome coronavirus 2 infection: A double-blind, randomized, controlled clinical trial
Dr Kourosh Sadeghi, Zohre Labbani-Motlagh, Shahideh Amini, Rasoul Aliannejad, Anahita Sadeghi, Gita Shafiee, Ramin Heshmat, Mohamadreza Jafary, Mona Talaschian, Maryam Akhtari, Ahmadreza Jamshidi, Mahdi Mahmoudi
Journal of Research in Pharmacy Practice, doi:10.4103/jrpp.jrpp_30_22
Objective: Based on previous studies in the sepsis population, Vitamin C could prevent injuries when administered in high doses and before the damage is established. This study aimed to evaluate the protective potentials of high-dose Vitamin C in the progression of coronavirus disease 2019 (COVID-19). Methods: A double-blind, placebo-controlled clinical trial was conducted. Patients with moderate-to-severe disease severity based on the World Health Organization definition were enrolled and received 12 g/d Vitamin C (high-dose intravenous Vitamin C [HDIVC]) or placebo for 4 days. Sequential Organ Failure Assessment (SOFA) score as a primary outcome, National Early Warning Score, Ordinal Scale of Clinical Improvement, and cytokine storm biomarkers were recorded on days 0, 3, and 5. Survival was also assessed on day 28 after enrollment. Findings: Seventy-four patients (37 patients in each group) were enrolled from April 5, 2020, to November 19, 2020, and all patients completed follow-up. A lower increase in SOFA score during the first 3 days of treatment (+0.026 vs. +0.204) and a higher decrease in this parameter in the last 2 days (−0.462 vs. −0.036) were observed in the treatment group. However, these differences did not reach a significance level (P = 0.57 and 0.12, respectively). Other indices of clinical and biological improvement, length of hospitalization, and intensive care unit admission days were the same between the two groups. Treatment did not affect the 28-day mortality. Conclusion: Among patients with moderate-to-severe disease of COVID-19, the use of HDIVC plus standard care resulted in no significant difference in SOFA score or 28-day mortality compared to the standard care alone.
Authors' Contribution Z. Labbani-Motlagh, R. Aliannejad, A. Sadeghi, M. Jafary, and M. Talaschian: Acquisition of clinical data and patient's diagnosis and treatment, interpretation of data, drafting the article, and final approval of the article. G. Shafiee and R. Heshmat: Acquisition of data, the conception and design of the study, analysis and interpretation of data, drafting the article, and final approval of the article. S. Amini, M. Akhtari, A. Jamshidi, M. Mahmoudi, and K. Sadeghi: The conception and design of the study, interpretation of data, revising the article critically for important intellectual content, and final approval of the article. Financial support and sponsorship This study was supported by a grant from the Deputy of Research, Tehran University of Medical Sciences (Grant No. 99-1-96-47169). Conflicts of interest There are no conflicts of interest.
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Late treatment
is less effective
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