Vitamin C alone does not improve treatment outcomes in mechanically ventilated patients with severe sepsis or septic shock: a retrospective cohort study

Abstract

Background: Vitamin C has shown several beneficial effects on sepsis in preclinical studies. However, clinical data supporting these reports are scarce. This study aimed to evaluate whether adjunctive intravenous vitamin C therapy could reduce hospital mortality in patients with severe sepsis or septic shock requiring mechanical ventilation. Methods: For this retrospective cohort study, consecutive medical ICU patients with severe sepsis or septic shock requiring mechanical ventilation were included. The study patients were classified into the vitamin C or control groups depending on the administration of intravenous vitamin C (2 g every 8 hours). The primary outcome was hospital mortality. Results: Thirty-five patients in the vitamin C group and 40 patients in the control group were included. The two groups were comparable in regards to the baseline characteristics at ICU admission. The hospital mortality was 46% (16 of 35 patients) in the vitamin C group and 40% (16 of 40 patients) in the control group, showing a statistically nonsignificant difference (P=0.62). The mortality at 90 days after ICU admission (60% vs. 48%) did not significantly differ between groups. The median time to shock reversal was 3 days [interquartile range (IQR), 2 to 5 days] in both groups. The changes in the Sepsis-related Organ Failure Assessment (SOFA) scores during the first 4 ICU days were −1.4±3.3 and −1.4±3.0 in the vitamin C and control groups, respectively. Conclusions: Adjunctive intravenous vitamin C therapy alone did not reduce hospital mortality in mechanically ventilated patients with severe sepsis or septic shock.

The efficiency and safety of high-dose vitamin C in patients with COVID-19: a retrospective cohort study

“…While many previous studies [ 11 , 44 , 45 ] have confirmed that the body weight was not associated with the prognosis of patients with COVID-19. In addition, the effect of high-dose vitamin C on anti-oxidation and reducing inflammatory reaction did not show significant correlation with body weight based on recent studies [ 30 , 46 ]. Although we did not record the body weight of patients in baseline, the body weight might not affect the results of our study.…”

Mortality in septic patients treated with vitamin C: a systematic meta-analysis

“…Interestingly, six studies reported no adverse events related to the intervention [ 9 – 11 , 19 , 20 , 24 ], while three studies documented more frequent adverse events in patients treated with intravenous vitamin C (hypernatremia n = 24, hospital-acquired infections n = 14, hyperglycemia n = 13, gastrointestinal bleeding n = 3, and fluid overload n = 1) [ 14 , 21 , 25 ]. The remaining eight studies did not specifically address this issue [ 12 , 13 , 15 – 18 , 22 , 23 ]. With regard to the large population included in this analysis, only little adverse events were reported when considering the extremely high doses of intravenous vitamin C that were used across the studies.…”

Overview of the possible role of vitamin C in management of COVID-19

“…Meta-analysis showed that vitamin C as an adjuvant treatment shortened the duration of mechanical ventilation and ICU stay in non-surgical critically ill patients [ 83 , 84 ]. Although an individual study showed that treatment of septic patients requiring mechanical ventilation with IV vitamin C (6 g/day) did not improve mortality rate [ 85 ], a meta-analysis which enrolled 1210 patients from different clinical trials showed that treatment of critically ill patients with a dose ranging between 3 and 10 g/day of IV vitamin C decreased mortality rate [ 86 ]. In conclusion, all the above observations support the idea of using high dose of IV vitamin C as a part of the supportive management of severe COVID-19.…”