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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% Sadeghi et al. IRCT20190917044805N2 Vitamin C RCT LATE 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) Sadeghi et al., J. Research in Pharmacy Practice, doi:10.4103/jrpp.jrpp_30_22 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
Sadeghi et al., Journal of Research in Pharmacy Practice, doi:10.4103/jrpp.jrpp_30_22, IRCT20190917044805N2
Sadeghi et al., High-dose intravenous Vitamin C in early stages of severe acute respiratory syndrome coronavirus 2 infection:.., Journal of Research in Pharmacy Practice, doi:10.4103/jrpp.jrpp_30_22, IRCT20190917044805N2
Dec 2022   Source   PDF  
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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.
Although the 33% 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, 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
Sadeghi 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.
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This PaperVitamin CAll
Abstract: [ Original Article High‑dose Intravenous Vitamin C in Early Stages of Severe Acute Respiratory Syndrome Coronavirus 2 Infection: A Double‑blind, Randomized, Controlled Clinical Trial Department of Clinical Pharmacy, Tehran University of Medical Sciences, Tehran, Iran 1 Department of Pulmonary and Critical Care, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran 2 Advanced Thoracic Research Center, Tehran University of Medical Science, Tehran, Iran 3 Liver and Pancreatobiliary Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran 4 Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran 5 Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran 6 Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran 7 Abstract Zohre Labbani‑Motlagh1, Shahideh Amini1,2, Rasoul Aliannejad2,3, Anahita Sadeghi4, Gita Shafiee5, Ramin Heshmat5,6, Mohamadreza Jafary7, Mona Talaschian8, Maryam Akhtari9,10, Ahmadreza Jamshidi9, Mahdi Mahmoudi9,10, Kourosh Sadeghi1 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. Keywords: Coronavirus disease 2019, high‑dose Vitamin C, inflammation, severe acute respiratory syndrome coronavirus 2 Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
Late treatment
is less effective
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