The significance of oral ascorbic acid in patients with COVID-19
Retrospective 176 hospitalized patients, 96 treated with oral vitamin C (from 500mg to 1500mg daily), showing lower mortality with treatment.
Although the 29% lower mortality is not statistically significant, it is consistent with the significant 27% lower mortality [13‑38%]
from meta analysis of the 34 mortality results to date
risk of death, 29.5% lower, RR 0.71, p = 0.18, treatment 22 of 96 (22.9%), control 26 of 80 (32.5%), NNT 10.
risk of death, 15.6% lower, RR 0.84, p = 0.60, treatment 15 of 30 (50.0%), control 16 of 27 (59.3%), NNT 11, ICU patients.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Patel et al., 1 Oct 2020, retrospective, USA, peer-reviewed, 8 authors.
Abstract: Chest Infections
SESSION TITLE: Chest Infections Posters
SESSION TYPE: Original Investigation Posters
PRESENTED ON: October 18-21, 2020
THE SIGNIFICANCE OF ORAL ASCORBIC ACID IN PATIENTS WITH COVID-19
MANISHKUMAR PATEL GLORIA HONG BERNADETTE SCHMIDT LAITH AL-JANABI RADHA
KISHAN ADUSUMILLI JURGENA TUSHA PADMINI GIRI AND SARWAN KUMAR
PURPOSE: It is understood that COVID-19 creates a cytokine storm, which ultimately leads to patient demise. A key antioxidant,
Vitamin C (ascorbic acid), has been shown to decrease the production of cytokines leading to beneﬁts in sepsis secondary to both
viral and bacterial infections. By utilizing the known paradigm of suppressing the cytokine release, some recently emerging studies
have shown mortality beneﬁt with intravenous ascorbic acid when used in COVID-19 patients, however, there appears to be less
information regarding ascorbic acid beneﬁts when given via the oral route. Our study observed the mortality and extubation rate
in COVID-19 patients receiving oral ascorbic acid.
METHODS: A retrospective single-center cohort study was used to design the project. Patients who met the inclusion criteria
were those who were admitted to our hospital for COVID-19 related symptoms and also tested positive for COVID-19 by a
nasopharyngeal swab. The patients were divided into two groups of those who received a course of oral ascorbic acid and those
who did not receive ascorbic acid. Those in the ascorbic acid group received daily oral doses that ranged from 500 mg to 1500 mg.
Patients who received intravenous ascorbic acid were excluded. The primary outcome analyzed was the overall mortality rate,
while secondary outcomes analyzed were the extubation rate and mortality rate in ICU patients.
CONCLUSIONS: Our study found that COVID-19 patients receiving oral ascorbic acid had a statistically insigniﬁcant tendency
toward decreased overall mortality, increased extubation rate, and decreased ICU mortality compared to the control group. The
role of ascorbic acid in COVID-19 patients has not been clearly deﬁned by clinical trials. With the low side effect proﬁle, it has
been administered in higher doses in intravenous form frequently in many hospitals with anecdotal evidence showing beneﬁt. In
our study, it was observed that patients were given oral ascorbic acid at a lesser dose than would be given if in the intravenous
ascorbic acid form.
CLINICAL IMPLICATIONS: Our observational study showed even when ascorbic acid is administered in oral form as an
adjunct to COVID-19 therapy, it is associated with a mortality beneﬁt and improved extubation rate.
DISCLOSURES: No relevant relationships by Radha Kishan Adusumilli, source¼Web Response
No relevant relationships by Laith Al-janabi, source¼Web Response
No relevant relationships by Padmini Giri, source¼Web Response
No relevant relationships by Gloria Hong, source¼Web Response
No relevant relationships by Sarwan Kumar, source¼Web Response
No relevant relationships by Manishkumar Patel, source¼Web Response
No relevant relationships by Bernadette Schmidt, source¼Web Response
No relevant relationships by Jurgena Tusha, source¼Web Response
Copyright ª 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
RESULTS: Of the total of 210 patients, 176 patients met our inclusion criteria. Of these, 96 patients were in the ascorbic acid
is less effective
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