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The use of vitamin C in the intensive care unit during the COVID-19 pandemic

Özgünay et al., The European Research Journal, doi:10.18621/eurj.938778
Jul 2021  
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Mortality 9% Improvement Relative Risk Ventilation -1% Vitamin C for COVID-19  Özgünay et al.  ICU PATIENTS Is very late treatment with vitamin C beneficial for COVID-19? Retrospective 160 patients in Turkey No significant difference in outcomes seen c19early.org Özgünay et al., The European Research J., Jul 2021 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
Retrospective 160 ICU patients, 32 with raised neutrophil/lymphocyte ratio treated with vitamin C, showing no significant differences.
This is the 30th of 73 COVID-19 controlled studies for vitamin C, which collectively show efficacy with p=0.00000002 (1 in 50 million).
21 studies are RCTs, which show efficacy with p=0.0012.
This study is excluded in the after exclusion results of meta analysis: substantial unadjusted confounding by indication likely; very late stage, ICU patients.
risk of death, 9.3% lower, RR 0.91, p = 0.69, treatment 17 of 32 (53.1%), control 75 of 128 (58.6%), NNT 18.
risk of mechanical ventilation, 1.1% higher, RR 1.01, p = 1.00, treatment 23 of 32 (71.9%), control 91 of 128 (71.1%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Özgünay et al., 4 Jul 2021, retrospective, Turkey, peer-reviewed, 7 authors, dosage 2000mg tid days 1-10.
This PaperVitamin CAll
The use of vitamin C in the intensive care unit during the COVID-19 pandemic
Seyda Efsun Ozgunay, İlkay Ceylan, Korgün Ökmen, Halil Erkan Sayan, Şermin Eminoglu, Derya Karasu, Senol Yavuz
The European Research Journal, doi:10.18621/eurj.938778
Objectives: An exaggerated inflammatory immune response is observed in cases of COVİD 19. This study aims to evaluate the effects of vitamin C, as a significant modulator of inflammation, on the inflammatory parameters and mortality in patients followed up in the intensive care unit (ICU) during the pandemic. Methods: This single-center retrospective study included 160 adult patients with confirmed positive nasopharyngeal swab COVID-19 PCR test results, who were followed up in the ICU between 01 March and 01 August 2020. Hospital files were scanned and patients given and not given vitamin C were assigned, to Group 1 and Group 2, respectively. The Acute Physiology and Chronic Health Evaluation (APACHE II) scores, the data entries on demographics, ventilation, laboratory tests, duration of ICU stay, discharge, and mortality were compared. Interventions with antiviral and antibacterial agents. steroids, cytokine apheresis, and renal replacement therapy were evaluated. Results: Vitamin C treatment was started in patients with raised neutrophil/lymphocyte ratio (NLR) at admission to ICU, who made up 20% of the total 160 ICU patients. Mortality incidence was higher among patients with raised NLR. Vitamin C at the doses used did not affect the inflammatory parameters, length of stay or mortality, and 37.5% of the patients recovered and were discharged from the ICU. Conclusions: We think that vitamin C treatment will have positive effects on the initiation of COVID-19 and that the time of intiation of the therapy and the optimal doses used should be determined with prospective studies.
Authors' Contribution Conflict of interest The authors disclosed no conflict of interest during the preparation or publication of this manuscript. Financing The authors disclosed that they did not receive any grant during conduction or writing of this study.
References
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Hospital files were scanned and patients given and not ' 'given vitamin C were assigned, to Group 1 and Group 2, respectively. The Acute Physiology and ' 'Chronic Health Evaluation (APACHE II) scores, the data entries on demographics, ventilation, ' 'laboratory tests, duration of ICU stay, discharge, and mortality were compared. Interventions ' 'with antiviral and antibacterial agents. steroids, cytokine apheresis, and renal replacement ' 'therapy were evaluated. \n' 'Results: Vitamin C treatment was started in patients with raised neutrophil/lymphocyte ratio ' '(NLR) at admission to ICU, who made up 20% of the total 160 ICU patients. Mortality incidence ' 'was higher among patients with raised NLR. Vitamin C at the doses used did not affect the ' 'inflammatory parameters, length of stay or mortality, and 37.5% of the patients recovered and ' 'were discharged from the ICU. \n' 'Conclusions: We think that vitamin C treatment will have positive effects on the initiation ' 'of COVID-19 and that the time of intiation of the therapy and the optimal doses used should ' 'be determined with prospective studies.</jats:p>', 'DOI': '10.18621/eurj.938778', 'type': 'journal-article', 'created': {'date-parts': [[2021, 7, 2]], 'date-time': '2021-07-02T11:32:22Z', 'timestamp': 1625225542000}, 'page': '425-431', 'source': 'Crossref', 'is-referenced-by-count': 1, 'title': 'The use of vitamin C in the intensive care unit during the COVID-19 pandemic', 'prefix': '10.18621', 'volume': '7', 'author': [ { 'ORCID': 'http://orcid.org/0000-0003-1501-9292', 'authenticated-orcid': True, 'given': 'Seyda Efsun', 'family': 'OZGUNAY', 'sequence': 'first', 'affiliation': [ { 'name': 'Department of Anesthesiology and Reanimation, University of ' 'Health Sciences, Bursa Yüksek İhtisas Training and Research ' 'Hospital, Bursa, Turkey'}]}, { 'ORCID': 'http://orcid.org/0000-0003-3306-3107', 'authenticated-orcid': True, 'given': 'İlkay', 'family': 'CEYLAN', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Anesthesiology and Reanimation, University of ' 'Health Sciences, Bursa Yüksek İhtisas Training and Research ' 'Hospital, Bursa, Turkey'}]}, { 'ORCID': 'http://orcid.org/0000-0001-8546-4661', 'authenticated-orcid': True, 'given': 'Korgün', 'family': 'ÖKMEN', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Anesthesiology and Reanimation, University of ' 'Health Sciences, Bursa Yüksek İhtisas Training and Research ' 'Hospital, Bursa, Turkey'}]}, { 'ORCID': 'http://orcid.org/0000-0003-3943-5549', 'authenticated-orcid': True, 'given': 'Halil Erkan', 'family': 'SAYAN', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Anesthesiology and Reanimation, University of ' 'Health Sciences, Bursa Yüksek İhtisas Training and Research ' 'Hospital, Bursa, Turkey'}]}, { 'ORCID': 'http://orcid.org/0000-0001-5741-2960', 'authenticated-orcid': True, 'given': 'Şermin', 'family': 'EMİNOGLU', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Anesthesiology and Reanimation, University of ' 'Health Sciences, Bursa Yüksek İhtisas Training and Research ' 'Hospital, Bursa, Turkey'}]}, { 'ORCID': 'http://orcid.org/0000-0003-1867-9018', 'authenticated-orcid': True, 'given': 'Derya', 'family': 'KARASU', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Anesthesiology and Reanimation, University of ' 'Health Sciences, Bursa Yüksek İhtisas Training and Research ' 'Hospital, Bursa, Turkey'}]}, { 'ORCID': 'http://orcid.org/0000-0001-5246-0808', 'authenticated-orcid': True, 'given': 'Senol', 'family': 'YAVUZ', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Cardiovascular Surgery, University of Health ' 'Sciences, Bursa Yüksek İhtisas Training and Research Hospital, ' 'Bursa, Turkey'}]}], 'member': '7865', 'published-online': {'date-parts': [[2021, 7, 4]]}, 'reference': [ { 'key': 'ref1', 'doi-asserted-by': 'crossref', 'unstructured': '1. 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Late treatment
is less effective
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