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The Effect of a Low Dose of Vitamin C in Patients With COVID-19: A Double-Blind Randomized Controlled Trial

Mousaviasl et al., Disease and Diagnosis, doi:10.34172/ddj.500
Jul 2023  
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Mortality 20% Improvement Relative Risk Mortality, ICU -99% Ventilation -200% ICU admission -33% Vitamin C  Mousaviasl et al.  LATE TREATMENT  DB RCT Is late treatment with vitamin C beneficial for COVID-19? Double-blind RCT 401 patients in Iran (November 2020 - May 2021) Trial underpowered to detect differences c19early.org Mousaviasl et al., Disease and Diagnosis, Jul 2023 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 401 hospitalized COVID-19 patients showing no significant differences with low-dose oral vitamin C (1000mg daily for 5 days).
Although the 20% lower mortality is not statistically significant, it is consistent with the significant 20% lower mortality [10‑28%] from meta analysis of the 44 mortality results to date.
This is the 17th of 21 COVID-19 RCTs for vitamin C, which collectively show efficacy with p=0.0012.
This is the 64th of 73 COVID-19 controlled studies for vitamin C, which collectively show efficacy with p=0.00000002 (1 in 50 million).
risk of death, 20.4% lower, RR 0.80, p = 0.64, treatment 8 of 201 (4.0%), control 10 of 200 (5.0%), NNT 98, day 28.
risk of death, 99.0% higher, RR 1.99, p = 1.00, treatment 2 of 201 (1.0%), control 1 of 200 (0.5%), ICU mortality.
risk of mechanical ventilation, 199.5% higher, RR 3.00, p = 1.00, treatment 1 of 201 (0.5%), control 0 of 200 (0.0%), continuity correction due to zero event (with reciprocal of the contrasting arm).
risk of ICU admission, 32.7% higher, RR 1.33, p = 0.79, treatment 8 of 201 (4.0%), control 6 of 200 (3.0%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Mousaviasl et al., 22 Jul 2023, Double Blind Randomized Controlled Trial, placebo-controlled, Iran, peer-reviewed, 13 authors, study period November 2020 - May 2021, dosage 500mg bid days 1-5.
This PaperVitamin CAll
The Effect of a Low Dose of Vitamin C in Patients With COVID-19: A Double-Blind Randomized Controlled Trial
Sajedeh Mousaviasl, Sara Sayar, Esmat Radmanesh, Bagher Pahlavanzade, Hani Esmaeilian, Mona Ebrahimzadeh, Raha Tabahfar, Maryam Khalili, Tara Borzoo, Saeed Jelvay, Saeid Bitaraf, Mahshid Naghashpour, Sara Mobarak
Disease and Diagnosis, doi:10.34172/ddj.500
Background: Vitamin C is a micronutrient with anti-inflammatory and free radical scavenging properties that can strengthen the body's immune system. In this study, it was attempted to assess the clinical efficiency of oral vitamin C in treating COVID-19. Materials and Methods: This double-blind randomized clinical trial was conducted on 401 patients hospitalized in Taleghani hospital, Abadan, over 18 years of age and with confirmed COVID-19 infection, from November 2020 to May 2021. The patients were randomly assigned to intervention groups (201 people, two tablets per day, each containing 500 mg of vitamin C) and the control group (200 people, placebo, containing starch received for five days). Improvements in clinical symptoms, death from baseline to the 28-day follow-up after the intervention, hospital length of stay, and laboratory values of C-reactive protein (CRP) were some of the considered outcome variables. Results: No significant difference was observed between the two groups in terms of the daily improvement of clinical symptoms and the odds of healing from each symptom increased by about 48-50%. The difference in the length of hospital stay between the two groups was close to significant (P = 0.051). There was no significant difference in mortality between the two groups (P = 0.8). There was no difference between the two groups in the laboratory parameters, except for alkaline phosphatase (P = 0.03). Conclusion: Vitamin C had no significant effect on improving patients' clinical symptoms such as fatigue, fever, cough, and shortness of breath.
Authors' Contribution Competing Interests The authors declare that they have no conflict of interests regarding the publication of this study. Disclaimer This article doesn't have prior publication or presentation in a conference/seminar. Ethical Approval The protocol of this study was approved by Abadan Medical Sciences Ethics Committee with the ethics code IR.ABADANUMS. REC.1398.119. The trial was conducted in accordance with the principles of the Declaration of Helsinki and registered in the Iranian Registry of Clinical Trials (www.irct.ir) on April 4, 2020 (identifier: IRCT20200324046850N5; https://www.irct.ir/). Informed Consent All participants gave their written informed consent after receiving explanations regarding the study objective and methodology.
References
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Moghadam Siahkali, Zarezade, Koolaji, Alinaghi, Zendehdel et al., Safety and effectiveness of high-dose vitamin C in patients with COVID-19: a randomized open-label clinical trial, Eur J Med Res, doi:10.1186/s40001-021-00490-1
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Ried, Binjemain, Sali, Therapies to prevent progression of COVID-19, including hydroxychloroquine, azithromycin, zinc, and vitamin D3 with or without intravenous vitamin C: an international, multicenter, randomized trial, Cureus, doi:10.7759/cureus.19902
Schloss, Lauche, Harnett, Hannan, Brown et al., Efficacy and safety of vitamin C in the management of acute respiratory infection and disease: a rapid review, Adv Integr Med, doi:10.1016/j.aimed.2020.07.008
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Vitamin, Fact Sheet for Health Professionals
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Late treatment
is less effective
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