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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Mortality -204% Improvement Relative Risk Hospitalization 31% Recovery time 18% primary Vitamin C  COVIDAtoZ  EARLY TREATMENT  RCT Is early treatment with vitamin C beneficial for COVID-19? RCT 98 patients in the USA (April 2020 - February 2021) Faster recovery with vitamin C (not stat. sig., p=0.15) c19early.org Thomas et al., JAMA Network Open, February 2021 Favors vitamin C Favors control

Effect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Care on Symptom Length and Reduction Among Ambulatory Patients With SARS-CoV-2 Infection: The COVID A to Z Randomized Clinical Trial

Thomas et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2021.0369, COVIDAtoZ, NCT04342728
Feb 2021  
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Vitamin C for COVID-19
7th treatment shown to reduce risk in September 2020
 
*, now known with p = 0.000000098 from 67 studies, recognized in 10 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,800+ studies for 60+ treatments. c19early.org
Small 214 low-risk outpatient RCT showing non-statistically significant faster recovery with zinc and with vitamin C. A secondary analysis concludes that vitamin C increases recovery rate by 71% (p = 0.036) pubpeer.com. See also patrickholford.com.
This is the 5th of 18 COVID-19 RCTs for vitamin C, which collectively show efficacy with p=0.00088.
This is the 12th of 67 COVID-19 controlled studies for vitamin C, which collectively show efficacy with p=0.000000098 (1 in 10 million).
Study covers vitamin C and zinc.
risk of death, 204.2% higher, RR 3.04, p = 0.49, treatment 1 of 48 (2.1%), control 0 of 50 (0.0%), continuity correction due to zero event (with reciprocal of the contrasting arm).
risk of hospitalization, 30.6% lower, RR 0.69, p = 1.00, treatment 2 of 48 (4.2%), control 3 of 50 (6.0%), NNT 55.
recovery time, 17.9% lower, relative time 0.82, p = 0.15, treatment mean 5.5 (±3.7) n=48, control mean 6.7 (±4.4) n=50, mean time to a 50% reduction in symptoms, primary outcome.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Thomas et al., 12 Feb 2021, Randomized Controlled Trial, USA, peer-reviewed, 11 authors, study period 8 April, 2020 - 11 February, 2021, trial NCT04342728 (history) (COVIDAtoZ).
This PaperVitamin CAll
Effect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Care on Symptom Length and Reduction Among Ambulatory Patients With SARS-CoV-2 Infection
MD, MBA Suma Thomas, MD, MS Divyang Patel, BSN, RN Barbara Bittel, MPH Kathy Wolski, MS Qiuqing Wang, MD, MS Anirudh Kumar, Zachary J Il’giovine, MD, MS Reena Mehra, MD Carla Mcwilliams, MD Steve E Nissen, MD, MBA Milind Y Desai
JAMA Network Open, doi:10.1001/jamanetworkopen.2021.0369
IMPORTANCE There is limited evidence regarding early treatment of novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to mitigate symptom progression. OBJECTIVE To examine whether high-dose zinc and/or high-dose ascorbic acid reduce the severity or duration of symptoms compared with usual care among ambulatory patients with SARS-CoV-2 infection. DESIGN, SETTING, AND PARTICIPANTS This multicenter, single health system randomized clinical factorial open-label trial enrolled 214 adult patients with a diagnosis of SARS-CoV-2 infection confirmed with a polymerase chain reaction assay who received outpatient care in sites in Ohio and
ARTICLE INFORMATION Additional Contributions: Serpil Erzurum, MD, James Young, MD, Daniel Culver, MD, Joan Booth, RN, Nancy Obuchowski, MPH, and John Petrich, RPh (Cleveland Clinic), were members of the operational and safety monitoring board. They were not compensated for their time. We would like to thank Samantha Xu, BS (Cleveland Clinic), for help with logistics of study set-up and coordination. She was compensated for her time.
References
Carr, Vitamin C administration in the critically ill: a summary of recent meta-analyses, Crit Care, doi:10.1186/s13054-019-2538-y
Eby, Davis, Halcomb, Reduction in duration of common colds by zinc gluconate lozenges in a double-blind study, Antimicrob Agents Chemother, doi:10.1128/AAC.25.1.20
Gammoh, Rink, Zinc in infection and inflammation, Nutrients, doi:10.3390/nu9060624
Hemilä, Chalker, Vitamin C for preventing and treating the common cold, Cochrane Database Syst Rev, doi:10.1002/14651858.CD000980.pub4
Hemilä, Vitamin C and infections, Nutrients, doi:10.3390/nu9040339
Hemilä, Vitamin C, respiratory infections and the immune system, Trends Immunol, doi:10.1016/j.it.2003.09.004
Hemilä, Zinc lozenges and the common cold: a meta-analysis comparing zinc acetate and zinc gluconate, and the role of zinc dosage, JRSM Open, doi:10.1177/2054270417694291
Huang, Wang, Li, Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Lancet, doi:10.1016/S0140-6736(20)30183-5
Krenn, Gaudernak, Holzer, Lanke, Van Kuppeveld et al., Antiviral activity of the zinc ionophores pyrithione and hinokitiol against picornavirus infections, J Virol, doi:10.1128/JVI.01543-08
Li, Moore, Vasilieva, Angiotensin-converting enzyme 2 is a functional receptor for the SARS coronavirus, Nature, doi:10.1038/nature02145
Singh, Das, Zinc for the common cold, Cochrane Database Syst Rev, doi:10.1002/14651858.CD001364.pub3
Velthuis, Van Den Worm, Sims, Baric, Snijder et al., Zn(2+) inhibits coronavirus and arterivirus RNA polymerase activity in vitro and zinc ionophores block the replication of these viruses in cell culture, PLoS Pathog, doi:10.1371/journal.ppat.1001176
Wang, Il'giovine, Mehra, Nissen, Desai, None
Wu, Mcgoogan, Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention, JAMA, doi:https://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2020.2648&utm_campaign=articlePDF%26utm_medium=articlePDFlink%26utm_source=articlePDF%26utm_content=jamanetworkopen.2021.0369
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