The Emerging Role of Vitamin C in the Prevention and Treatment of COVID-19
1
Nutrition in Medicine Research Group, Department of Pathology & Biomedical Science, University of Otago, Christchurch 8011, New Zealand
2
Intensive Care Department, Newham University Hospital, Barts NHS Trust, London E13 8SL, UK
3
Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(11), 3286; https://doi.org/10.3390/nu12113286
Received: 15 October 2020 / Accepted: 21 October 2020 / Published: 27 October 2020
(This article belongs to the Special Issue Vitamin C: From Bench to Bedside)
Investigation into the role of vitamin C in the prevention and treatment of pneumonia and sepsis has been underway for many decades. This research has laid a strong foundation for translation of these findings into patients with severe coronavirus disease (COVID-19). Research has indicated that patients with pneumonia and sepsis have low vitamin C status and elevated oxidative stress. Administration of vitamin C to patients with pneumonia can decrease the severity and duration of the disease. Critically ill patients with sepsis require intravenous administration of gram amounts of the vitamin to normalize plasma levels, an intervention that some studies suggest reduces mortality. The vitamin has pleiotropic physiological functions, many of which are relevant to COVID-19. These include its antioxidant, anti-inflammatory, antithrombotic and immuno-modulatory functions. Preliminary observational studies indicate low vitamin C status in critically ill patients with COVID-19. There are currently a number of randomized controlled trials (RCTs) registered globally that are assessing intravenous vitamin C monotherapy in patients with COVID-19. Since hypovitaminosis C and deficiency are common in low–middle-income settings, and many of the risk factors for vitamin C deficiency overlap with COVID-19 risk factors, it is possible that trials carried out in populations with chronic hypovitaminosis C may show greater efficacy. This is particularly relevant for the global research effort since COVID-19 is disproportionately affecting low–middle-income countries and low-income groups globally. One small trial from China has finished early and the findings are currently under peer review. There was significantly decreased mortality in the more severely ill patients who received vitamin C intervention. The upcoming findings from the larger RCTs currently underway will provide more definitive evidence. Optimization of the intervention protocols in future trials, e.g., earlier and sustained administration, is warranted to potentially improve its efficacy. Due to the excellent safety profile, low cost, and potential for rapid upscaling of production, administration of vitamin C to patients with hypovitaminosis C and severe respiratory infections, e.g., COVID-19, appears warranted.
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Keywords:
vitamin C; ascorbate; ascorbic acid; COVID-19; pneumonia; sepsis; acute respiratory distress syndrome; randomized controlled trials; low-middle-income
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MDPI and ACS Style
Carr, A.C.; Rowe, S. The Emerging Role of Vitamin C in the Prevention and Treatment of COVID-19. Nutrients 2020, 12, 3286. https://doi.org/10.3390/nu12113286
AMA Style
Carr AC, Rowe S. The Emerging Role of Vitamin C in the Prevention and Treatment of COVID-19. Nutrients. 2020; 12(11):3286. https://doi.org/10.3390/nu12113286
Chicago/Turabian StyleCarr, Anitra C.; Rowe, Sam. 2020. "The Emerging Role of Vitamin C in the Prevention and Treatment of COVID-19" Nutrients 12, no. 11: 3286. https://doi.org/10.3390/nu12113286
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