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Effects of high dose vitamin c on patient outcomes in ARDS patients admitted to intensive care with COVID-19; multi-center retrospective study

Yüksel et al., Intensive Care Medicine Experimental, 9:S1, 001458, doi:10.1186/s40635-021-00413-8
Sep 2020  
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Mortality 19% Improvement Relative Risk Vitamin C for COVID-19  Yüksel et al.  ICU PATIENTS Is very late treatment with vitamin C beneficial for COVID-19? PSM retrospective 86 patients in Turkey Lower mortality with vitamin C (p=0.037) c19early.org Yüksel et al., Intensive Care Medicine.., Sep 2020 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.
Lower risk for mortality, ICU, hospitalization, and recovery.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 112 treatments. c19early.org
PSM retrospective 86 ICU patients on mechanical ventilation in Turkey, showing lower mortality with high dose vitamin C treatment (≥200mg/kg for 4 days).
This is the 3rd 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: very late stage, ICU patients.
risk of death, 18.8% lower, RR 0.81, p = 0.04, treatment 31 of 42 (73.8%), control 40 of 44 (90.9%), NNT 5.8, propensity score matching.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Yüksel et al., 20 Sep 2020, retrospective, Turkey, preprint, 13 authors, dosage 200mg/kg days 1-4.
This PaperVitamin CAll
ESICM LIVES 2021: Part 1
J Azevedo, ; H Lima, ; P Frota, ; I Nogueira, ; S Souza, ; E Fernandes, H Effat, MD Rania Alhusseiny, MD. Waleed Farouk, R Mackey, ; J Textoris, ; N Rosenthal, ; La Carabuena, ; J Kampf, ; A Sanghani, ; T Rodriguez, ; P Mcpherson, ; J Koyner, L Chan, Timsina P Li, S Eggmann, ; I Irincheeva, ; G Luder, ; Ml Verra, ; A Moser, Bastiaenen, S M Jakob, J Tirkkonen, ; E Loisa, ; S Hoppu, ; A Kallonen, E Kooistra, ; S Brinkman, ; Dvp Van, ; N De Keizer, ; D Dongelmans, ; M Kox, ; P Pickkers, S Uhrenholt, ; S Linér, ; J Stokholm, ; T Christiensen, ; Mh Bestle, H Kobayashi, ; K Amrein, ; J Lanky-Su, ; K Christopher, H K Johal, ; G Birchley, ; W Orchard, ; R Huxtable, A Tabah, ; N Buetti, ; F Barbier, A T Aslan, ; S Ruckly, ; Q Staiquly, ; C Dallongeville, ; N Eurobact, Ii National, Ii Contributors, J F Timsit, P Damas, ; B Lambermont, ; C Legrain, A F Rousseau, ; P Demaret, ; B Misset, Scaravilli V, Mangioni D, Scudeller L, Alagna L, Bartoletti M, Bellani G, Biagioni E, Bonfanti P, Bottino N, Coloretti I G Grasselli, Cutuli Sl, Pascale G De, J Weblin, ; A Harriman, ; D Mcwilliams, C Sánchez Ramírez, ; S Hípola Escalada, ; Re Morales Sirgado, ; Ma Hernández Viera, ; M Cabrera, ; C Rodriguez Mata, Gallardo Santos, C F Lübbe Vázquez, S M Marrero Penichet, ; A Padrón Mujica, ; P Saavedra-Santana, ; S Ruiz-Santana, K Lelu-Santolaria, ; C Dubois, ; M Baldazza, ; A Evlachev, ; N Kehrer, ; R Brandely, ; Y Schlesinger, ; N Silvestre, ; J Unsinger, ; R Hotchkiss, ; P Martin, ; G Inchauspe, G Inchauspe, M Van Mol, ; S Wagener, ; J Rietjens, ; C Den Uil, A Jansen, ; N Bruse, ; N Waalders, L F Reyes, J A Sanchez Giralt, ; M Wallin, ; M Hallbäck, ; T Gerardo, ; M Sánchez Galindo, ; B Abad Santamaría, ; Ma Pérez Lucendo, ; A Canabal Berlanga, ; F Suarez-Sipmann, B Abad Santamaría, M Wallin, M Hallbäck, M Trigueros Genao, J Lázaro Gonzalez, B Muñoz Molina, G Tusman, F Suarez, M Crinage, ; C Woods, ; L Cawtheray, D Mcwilliams, J Dianti, ; S Fard, ; J Wong, ; Cc Timothy, S L Del, ; E Fan, ; M Amato, ; J Granton, ; L Burry, ; D Reid, ; S Keshavjee, ; A Slutsky, ; L Brochard, Ferguson, ; Ec Goligher, J Diant, L Wihersaari, J Laurikkala, ; A Aneman, ; A Peng, ; M Reinikainen, ; P Pham, ; P Jakkula, ; J Hastbacka, ; E Wilkman, ; P Loisa, ; J Toppila, ; T Birkelund, ; K Blennow, ; H Zetterberg, ; M Skrifvars, R Beunders, ; L Donato, ; R Van Groenendael, ; B Arlt, ; C Carvalho, ; J Schulte, ; A Coolen, ; J Lieske, ; J Meeusen, ; A Jaffe, L Premraj, ; A Zaaqoq, ; Ag Barnett, ; J Fanning, ; G Peek, ; S Huth, ; R Arora, ; J Bellapart-Rubio, ; D Battaglini, ; G Li, ; J Fraser, ; C Robba, ; M Griffee, S M Cho, J Y Suen, ; J Weblin, ; M Crinage, N Kok, ; J Van Gurp, ; M Fuchs, ; H Van Der Hoeven, ; Cwe, Hoedemaekers, ; M Zegers, S Siddiqui, F Iannuzzi, ; L Ball, ; I Brunetti, ; M Bassetti, ; Dr, Giacobbe, ; A Vena, ; N Patroniti, ; P Rocco, ; Bf Matta, ; P Pelosi, L Ball, Serpa Neto, Gama De Abreu, Schultz Mj, Rocco Prm, P Pelosi, T Bassi, ; R Elizabeth, ; F Karl, ; N Michelle, ; M Ornowska, ; G Matt, Doug, ; S Reynolds, A Ughetto, ; J Eliet, ; H David, ; N Nagot, ; F Bazalgette, ; G Marin, ; M Mourad, ; S Kollen, ; P Gaudard, ; P Colson, A Del Pozo, ; E Giustiniano, ; N Fusilli, ; V Simili, ; L Calabro', ; L Pugliese, ; N Stomeo, ; C Ebm, ; S Brusa, ; J Echeverri, ; Mj Blackowicz, ; T Rodriguez, Amham M H A M Mostafa, C J Tuttle, M A Mckie, J A Fowles, ; A Vuylsteke, M Kopczynska, ; H Unwin, ; R Pugh, ; B Sharif
Intensive Care Medicine Experimental, doi:10.1186/s40635-021-00413-8
Introduction. The optimal integration between adequate protein intake and exercise in critically ill patients may have an impact on short and long-term outcomes, but this hypothesis has not been tested in studies with good methodology. In the given context, we conducted a prospective randomized controlled trial to evaluate the efficacy of high protein intake and early exercise versus guidelines recommended protein intake and routine physiotherapy on outcome of critically ill patients. Methods. We randomized mechanically ventilated patients expected to stay in the intensive care unit (ICU) for at least 4 days. We used indirect calorimetry to determine energy expenditure and guide caloric provision to the patients randomized to the high protein and early exercise (HPE) group and the control group. Protein intakes were 2.0 g/ kg/day and 1.4 g/kg/day respectively; while the former was submitted to two daily sessions of cycle ergometry exercise, the latter received routine physiotherapy. We evaluated the primary outcome physical component summary (PCS) score at 3 and 6 months) and the secondary outcomes (handgrip strength at ICU discharge and ICU and hospital mortality). Results. We analyzed 181 patients in the HPE (87) and control (94) group. There was no significant difference between groups in relation to the calories received. However, the amount of protein received by the HPE group was significantly higher than that received by the control group (p < 0.0001). The PCS score was significantly higher in the HPE group at 3 months (p = 0.01) and 6 months (p = 0.01). The hospital mortality was expressively higher in the control group (p = 0.006). We found an independent association between age and 3-month PCS and that between age and group and 6-month PCS. Conclusion. This study showed that a high-protein intake and resistive exercise increase the survival rate and the physical quality of life of critically ill patients.
Conflict of interest: FILMARRAY ® Pneumonia Plus Panels and QC-material was sponsored by BioMérieux SA along with cost of shipment. All agreements have been revised and approved by the Unit for Research an Innovation, The Capital Region of Denmark. Determination of Serum Zinc and Copper Levels and Their Relation with Mortality in Critically Ill Patients M. Yildirim, 1 ; B. Kesikli, 2 ; L. Talan, 3 ; MA. Tekes, 4 ; N. Yazıhan, 2 ; ND. Altintas 3 000320 The effect of high flow oxygen via tracheostomy on diaphragm function in patients with prolonged weaning from mechanical ventilation: a randomized crossover study E. Lytra 1 ; I. Poularas 2 ; D. Cokkinos 1 ; Y. Papachatzakis 2 ; V. Vlachakos 2 ; P. Ampatzis 1 ; D. Exarchos 1 ; D. Filippiadis 3 ; S. Zakynthinos 2 ; C. Routsi 2 1 Department of radiology, Evangelismos Hospital, Athens, Greece; ICMx 2021, 9(Suppl 1):51 Results. 65 patients were included. 90-day mortality in this series was 30.8% (n = 20). Table 1 shows the variables that proved statistically significant impact on 90-day mortality in this subset of patients. Variables Conclusion. This study brings perspective on how clinical evolution during ICU stay of the patients who underwent mechanical ventilation due to severe COVID-19 predicts 90-day mortality. In fact, a higher SAPS II score and aaCCI significantly decrease the odds of being alive 90 days after ICU admission. Higher PaO2/FiO2 ratios thoughout days 2 to 5 of IMV significantly increase the odds of a..
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Late treatment
is less effective
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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