Europe PMC

This website requires cookies, and the limited processing of your personal data in order to function. By using the site you are agreeing to this as outlined in our privacy notice and cookie policy.

Abstract 


No abstract provided.

Free full text 


Logo of ccforumLink to Publisher's site
Crit Care. 2020; 24: 133.
Published online 2020 Apr 7. https://doi.org/10.1186/s13054-020-02851-4
PMCID: PMC7137406
PMID: 32264963

A new clinical trial to test high-dose vitamin C in patients with COVID-19

With the 2019 novel coronavirus (2019-nCoV) outbreak now spreading across the world, people are seeking ways in which to potentially protect themselves from the virus or to alleviate its effects once caught. One such means that is being touted online and in the media is vitamin C.

Vitamin C is best known for its antioxidant properties, being able to scavenge damaging reactive oxygen species, thus protecting the body’s cells and tissues from oxidative damage and dysfunction. However, the vitamin also has numerous other important functions within the body, many of which are known to support healthy immune function. During infection, vitamin C levels can become depleted and a person’s requirement for vitamin C increases with the severity of the infection [1]. In severe cases, this may require intravenous administration of gram doses in order to achieve high enough levels in the body to compensate for the enhanced turnover of the vitamin.

As of February 2020, the clinical characteristics of patients hospitalized with COVID-19-related pneumonia indicated that 26% were transferred to the ICU because of complications such as ARDS and shock [2]. A recently published RCT carried out in the USA in 167 patients with sepsis-related ARDS indicated that administration of ~ 15 g/day of IV vitamin C for 4 days may decrease mortality in these patients [3]. An earlier IV vitamin C trial of patients admitted to the ICU with pneumonia included hydrocortisone administration [4], however, systemic corticosteroid treatment has not been shown to have significant benefits in patients with COVID-19 [5].

Just recently registered on clincialtrials.gov (Identifier: NCT04264533), a new clinical trial to investigate vitamin C infusion for the treatment of severe 2019-nCoV infected pneumonia has begun in Wuhan, China. This is one of the first RCTs to test the effects of IV vitamin C in patients infected with this virus. In this trial, the investigators will treat 140 patients with a placebo control or intravenous vitamin C at a dose of 24 g/day for 7 days. They will assess requirements for mechanical ventilation and vasopressor drugs, organ failure scores, ICU length of stay and 28-day mortality.

The investigators of the new study hope to complete the trial by the end of September. Although the findings of this trial will be too late for the many thousands of people currently infected with the virus, the study will nevertheless provide valuable information as to the potential mitigation of symptoms by vitamin C during future viral outbreaks.

Acknowledgements

ACC is the recipient of a Health Research Council of New Zealand Sir Charles Hercus Health Research Fellowship.

Author’s contributions

ACC wrote the letter. The author read and approved the final manuscript.

Funding

None

Availability of data and materials

N/A

Ethics approval and consent to participate

N/A

Consent for publication

N/A

Competing interests

None

Footnotes

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

1. Carr AC, Rosengrave PC, Bayer S, Chambers S, Mehrtens J, Shaw GM. Hypovitaminosis C and vitamin C deficiency in critically ill patients despite recommended enteral and parenteral intakes. Crit Care. 2017;21:300. 10.1186/s13054-017-1891-y. [Europe PMC free article] [Abstract] [CrossRef] [Google Scholar]
2. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y, Li Y, Wang X, Peng Z. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9. [Europe PMC free article] [Abstract]
3. Fowler AA, 3rd, Truwit JD, Hite RD, Morris PE, DeWilde C, Priday A, Fisher B, Thacker LR, 2nd, Natarajan R, Brophy DF, Sculthorpe R, Nanchal R, Syed A, Sturgill J, Martin GS, Sevransky J, Kashiouris M, Hamman S, Egan KF, Hastings A, Spencer W, Tench S, Mehkri O, Bindas J, Duggal A, Graf J, Zellner S, Yanny L, McPolin C, Hollrith T, Kramer D, Ojielo C, Damm T, Cassity E, Wieliczko A, Halquist M. 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. 2019;322(13):1261–1270. 10.1001/jama.2019.11825. [Europe PMC free article] [Abstract] [CrossRef] [Google Scholar]
4. Kim WY, Jo EJ, Eom JS, Mok J, Kim MH, Kim KU, Park HK, Lee MK, Lee K. Combined vitamin C, hydrocortisone, and thiamine therapy for patients with severe pneumonia who were admitted to the intensive care unit: propensity score-based analysis of a before-after cohort study. J Crit Care. 2018;47:211–218. 10.1016/j.jcrc.2018.07.004. [Abstract] [CrossRef] [Google Scholar]
5. Liu K, Fang YY, Deng Y, Liu W, Wang MF, Ma JP, Xiao W, Wang YN, Zhong MH, Li CH, Li GC, Liu HG. Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province. Chin Med J. 2020. 10.1097/CM9.0000000000000744. [Europe PMC free article] [Abstract]

Articles from Critical Care are provided here courtesy of BMC

Citations & impact 


Impact metrics

Jump to Citations

Citations of article over time

Alternative metrics

Altmetric item for https://www.altmetric.com/details/79461916
Altmetric
Discover the attention surrounding your research
https://www.altmetric.com/details/79461916

Article citations


Go to all (105) article citations

Data 


Data behind the article

This data has been text mined from the article, or deposited into data resources.

Similar Articles 


To arrive at the top five similar articles we use a word-weighted algorithm to compare words from the Title and Abstract of each citation.