Retrospective 323 hospitalized patients, 153 treated with vitamin C, showing no significant differences. Patients in each group were in different time periods, with the vitamin C group first. Time based confounding is possible due to improvements in SOC.
Although the 21% lower mortality is not statistically significant, it is consistent with the significant 20% lower mortality [10‑29%]
from meta analysis of the 38 mortality results to date
This is the 25th of 63 COVID-19 controlled studies
for vitamin C, which collectively show efficacy with p=0.00000026
. 16 studies are RCTs
, which show efficacy with p=0.00000018
This study is excluded in the after exclusion results of meta
substantial confounding by time
likely due to declining usage over the early stages of the pandemic when overall treatment protocols improved dramatically.
risk of death, 21.3% lower, RR 0.79, p = 0.52, treatment 17 of 153 (11.1%), control 24 of 170 (14.1%), NNT 33.
risk of ICU admission, 1.9% higher, RR 1.02, p = 1.00, treatment 11 of 153 (7.2%), control 12 of 170 (7.1%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Suna et al., 11 May 2021, retrospective, Turkey, peer-reviewed, 5 authors.
Effect of high-dose intravenous vitamin C on prognosis in patients with SARS-CoV-2 pneumonia
Medicina Clínica, doi:10.1016/j.medcli.2021.04.010
Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre -including this research content -immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
Conflict of interest The authors declare that they have no conflict of interest.
Alhazzani, Møller, Arabi, Loeb, Gong, Surviving sepsis campaign: guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19), Intensive Care Med, doi:10.1007/s00134-020-06022-5
Cheng, Can early and high intravenous dose of vitamin C prevent and treat coronavirus disease 2019 (COVID-19)?, Med Drug Discov, doi:10.1016/j.medidd.2020.100028
Fowler, Truwit, Hite, Morris, Dewilde, Effect of vitamin C infusion on organ failure and biomarkers of inflammation and vascular injury in patients with sepsis and severe acute respiratory failure: the CITRIS-ALI randomized clinical trial, JAMA, doi:10.1016/j.chest.2016.11.036
Fujii, Luethi, Young, Frei, Eastwood et al., Effect of vitamin C, hydrocortisone, and thiamine vs hydrocortisone alone on time alive and free of vasopressor support among patients with septic shock: the vitamins randomized clinical trial, JAMA, doi:10.1093/jn/137.7.1757
Hiedra, Lo, Elbashabsheh, Gul, Wright et al., The use of IV vitamin C for patients with COVID-19: a case series, Expert Rev Anti Infect Ther, doi:10.21037/apm-20-1387
Hiedra, Lo, Elbashabsheh, Gul, Wright et al., The use of IV vitamin C for patients with COVID-19: a case series, Expert Rev Anti Infect Ther, doi:10.1001/jama.2019.22176
Jayawardena, Sooriyaarachchi, Chourdakis, Jeewandara, Ranasinghe, Enhancing immunity in viral infections, with special emphasis on COVID-19: a review, Diabetes Metab Syndr, doi:10.1007/s00134-020-06022-5
Johnston, Beezhold, Mostow, Swan, Plasma vitamin C is inversely related to body mass index and waist circumference but not to plasma adiponectin in nonsmoking adults, J Nutr, doi:10.1016/j.medidd.2020.100028
Johnston, Corte, Swan, Marginal vitamin C status is associated with reduced fat oxidation during submaximal exercise in young adults, Nutr Metab, doi:10.1186/s13054-018-2191-x
Marik, Khangoora, Rivera, Hooper, Catravas, Hydrocortisone, vitamin C, and thiamine for the treatment of severe sepsis and septic shock: a retrospective before-after study, Chest, doi:10.7326/0003-4819-140-7-200404060-00010
Padayatty, Sun, Wang, Riordan, Hewitt et al., Vitamin C pharmacokinetics: implications for oral and intravenous use, Ann Intern Med, doi:10.1080/14787210.2020.1794819
Suna, Melahat, Murat, None, Medicina Clínica xxx
Wang, Hu, Hu, Zhu, Liu et al., Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus infected pneumonia in Wuhan, China, JAMA, doi:10.1002/jmv.25948
Zhao, Ling, Li, Peng, Huang et al., Beneficial aspects of high dose intravenous vitamin C on patients with COVID-19 pneumonia in severe condition: a retrospective case series study, Ann Palliat Med, doi:10.1001/jama.2020.1585