scholarly journals Vitamin C—An Adjunctive Therapy for Respiratory Infection, Sepsis and COVID-19

Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3760 ◽  
Author(s):  
Patrick Holford ◽  
Anitra C. Carr ◽  
Thomas H. Jovic ◽  
Stephen R. Ali ◽  
Iain S. Whitaker ◽  
...  
Keyword(s):  
Vitamin C ◽  
Adjunctive Therapy ◽  
Respiratory Infections ◽  
Low Cost ◽  
Oral Vitamin ◽  
Vitamin C Deficiency ◽  
Favourable Safety ◽  
Favourable Safety Profile ◽  
Hospital Stays ◽  
Intravenous Vitamin

There are limited proven therapies for COVID-19. Vitamin C’s antioxidant, anti-inflammatory and immunomodulating effects make it a potential therapeutic candidate, both for the prevention and amelioration of COVID-19 infection, and as an adjunctive therapy in the critical care of COVID-19. This literature review focuses on vitamin C deficiency in respiratory infections, including COVID-19, and the mechanisms of action in infectious disease, including support of the stress response, its role in preventing and treating colds and pneumonia, and its role in treating sepsis and COVID-19. The evidence to date indicates that oral vitamin C (2–8 g/day) may reduce the incidence and duration of respiratory infections and intravenous vitamin C (6–24 g/day) has been shown to reduce mortality, intensive care unit (ICU) and hospital stays, and time on mechanical ventilation for severe respiratory infections. Further trials are urgently warranted. Given the favourable safety profile and low cost of vitamin C, and the frequency of vitamin C deficiency in respiratory infections, it may be worthwhile testing patients’ vitamin C status and treating them accordingly with intravenous administration within ICUs and oral administration in hospitalised persons with COVID-19.

scholarly journals Vitamin C—An Adjunctive Therapy for Respiratory Infection, Sepsis and COVID-19

2020 ◽  
Author(s):  
Patrick Holford ◽  
Anitra Carr ◽  
Thomas H. Jovic ◽  
Stephen R. Ali ◽  
Iain S. Whitaker ◽  
...  
Keyword(s):  
Vitamin C ◽  
Adjunctive Therapy ◽  
Respiratory Infections ◽  
Low Cost ◽  
Vitamin C Deficiency ◽  
Favourable Safety ◽  
Favourable Safety Profile ◽  
Hospital Stays ◽  
Anti Inflammatory ◽  
Intravenous Vitamin

There are limited proven therapies for the treatment of COVID-19. Vitamin C’s antioxidant, anti-inflammatory and immunomodulating effects, make it a potential therapeutic candidate, both for the prevention and amelioration of COVID-19 infection, and as an adjunctive therapy in the critical care of COVID-19, supporting anti-inflammatory treatment. This literature review focuses on vitamin C deficiency in respiratory infections including COVID-19; the mechanism of action in infectious disease and adrenal function supporting the anti-inflammatory actions of glucocorticosteroids: its role in preventing and treating colds and pneumonia and its role in treating sepsis and COVID-19. The evidence to date indicates that oral vitamin C (2-8g/d) may reduce incidence and duration of respiratory infections and intravenous vitamin C (2-24g/d) has been shown to reduce mortality, Intensive Care Unit and hospital stays, time on mechanical ventilation in severe respiratory infections. Further trials are urgently warranted. Given the favourable safety profile and low cost of vitamin C, and frequency of vitamin C deficiency in respiratory infections it may be worthwhile testing patients’ vitamin C status and treating accordingly with intravenous use within ICUs and orally with doses between 2 and 8g/day in hospitalised and infected persons.

scholarly journals Vitamin C—An Adjunctive Therapy for Respiratory Infection, Sepsis and COVID-19

2020 ◽  
Author(s):  
Patrick Holford ◽  
Anitra Carr ◽  
Thomas H. Jovic ◽  
Stephen R. Ali ◽  
Iain S. Whitaker ◽  
...  
Keyword(s):  
Vitamin C ◽  
Adjunctive Therapy ◽  
Respiratory Infections ◽  
Low Cost ◽  
Vitamin C Deficiency ◽  
Favourable Safety ◽  
Favourable Safety Profile ◽  
Hospital Stays ◽  
Anti Inflammatory ◽  
Intravenous Vitamin

There are limited proven therapies for the treatment of COVID-19. Vitamin C’s antioxidant, anti-inflammatory and immunomodulating effects, make it a potential therapeutic candidate, both for the prevention and amelioration of COVID-19 infection, and as an adjunctive therapy in the critical care of COVID-19, supporting anti-inflammatory treatment. This literature review focuses on vitamin C deficiency in respiratory infections including COVID-19; the mechanism of action in infectious disease and adrenal function supporting the anti-inflammatory actions of glucocorticosteroids: its role in preventing and treating colds and pneumonia and its role in treating sepsis and COVID-19. The evidence to date indicates that oral vitamin C (2-8g/d) may reduce incidence and duration of respiratory infections and intravenous vitamin C (2-24g/d) has been shown to reduce mortality, Intensive Care Unit and hospital stays, time on mechanical ventilation in severe respiratory infections. Further trials are urgently warranted. Given the favourable safety profile and low cost of vitamin C, and frequency of vitamin C deficiency in respiratory infections it may be worthwhile testing patients’ vitamin C status and treating accordingly with intravenous use within ICUs and orally with doses between 2 and 8g/day in hospitalised and infected persons.

scholarly journals Oral vitamin C supplementation to patients with myeloid cancer on azacitidine treatment: Normalization of plasma vitamin C induces epigenetic changes

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Linn Gillberg ◽  
Andreas D. Ørskov ◽  
Ammar Nasif ◽  
Hitoshi Ohtani ◽  
Zachary Madaj ◽  
...  
Keyword(s):  
Vitamin C ◽  
Biological Effects ◽  
Pilot Trial ◽  
Dna Demethylation ◽  
Controlled Clinical Trial ◽  
Plasma Vitamin ◽  
Oral Vitamin ◽  
Oral Supplementation ◽  
Vitamin C Deficiency ◽  
Vitamin C Supplementation

Abstract Background Patients with haematological malignancies are often vitamin C deficient, and vitamin C is essential for the TET-induced conversion of 5-methylcytosine (5mC) to 5-hydroxymethylcytosine (5hmC), the first step in active DNA demethylation. Here, we investigate whether oral vitamin C supplementation can correct vitamin C deficiency and affect the 5hmC/5mC ratio in patients with myeloid cancers treated with DNA methyltransferase inhibitors (DNMTis). Results We conducted a randomized, double-blinded, placebo-controlled pilot trial (NCT02877277) in Danish patients with myeloid cancers performed during 3 cycles of DNMTi-treatment (5-azacytidine, 100 mg/m2/d for 5 days in 28-day cycles) supplemented by oral dose of 500 mg vitamin C (n = 10) or placebo (n = 10) daily during the last 2 cycles. Fourteen patients (70%) were deficient in plasma vitamin C (< 23 μM) and four of the remaining six patients were taking vitamin supplements at inclusion. Global DNA methylation was significantly higher in patients with severe vitamin C deficiency (< 11.4 μM; 4.997 vs 4.656% 5mC relative to deoxyguanosine, 95% CI [0.126, 0.556], P = 0.004). Oral supplementation restored plasma vitamin C levels to the normal range in all patients in the vitamin C arm (mean increase 34.85 ± 7.94 μM, P = 0.0004). We show for the first time that global 5hmC/5mC levels were significantly increased in mononuclear myeloid cells from patients receiving oral vitamin C compared to placebo (0.037% vs − 0.029%, 95% CI [− 0.129, − 0.003], P = 0.041). Conclusions Normalization of plasma vitamin C by oral supplementation leads to an increase in the 5hmC/5mC ratio compared to placebo-treated patients and may enhance the biological effects of DNMTis. The clinical efficacy of oral vitamin C supplementation to DNMTis should be investigated in a large randomized, placebo-controlled clinical trial. Trial registration ClinicalTrials.gov, NCT02877277. Registered on 9 August 2016, retrospectively registered.

scholarly journals Vitamin C Intervention for Critical COVID-19: A Pragmatic Review of the Current Level of Evidence

Life ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 1166
Author(s):  
Patrick Holford ◽  
Anitra C. Carr ◽  
Masuma Zawari ◽  
Marcela P. Vizcaychipi
Keyword(s):  
Vitamin C ◽  
Respiratory Infections ◽  
Current Level ◽  
Vitamin Supplementation ◽  
Level Of Evidence ◽  
Vitamin C Supplementation ◽  
Retrospective Cohort Studies ◽  
High Doses ◽  
Intravenous Vitamin ◽  
Randomised Controlled

Severe respiratory infections are characterized by elevated inflammation and generation of reactive oxygen species (ROS) which may lead to a decrease in antioxidants such as vitamin C and a higher requirement for the vitamin. Administration of intravenous vitamin C to patients with pneumonia and sepsis appears to decrease the severity of the disease and potentially improve survival rate. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes pneumonia, sepsis and acute respiratory distress syndrome (ARDS) in severe cases, and is referred to as coronavirus disease 2019 (COVID-19). Patients with COVID-19 infection also appear to have depleted vitamin C status and require additional supplementation of vitamin C during the acute phase of the disease. To date there have been 12 vitamin C and COVID-19 trials published, including five randomised controlled trials (RCTs) and seven retrospective cohort studies. The current level of evidence from the RCTs suggests that intravenous vitamin C intervention may improve oxygenation parameters, reduce inflammatory markers, decrease days in hospital and reduce mortality, particularly in the more severely ill patients. High doses of oral vitamin C supplementation may also improve the rate of recovery in less severe cases. No adverse events have been reported in published vitamin C clinical trials in COVID-19 patients. Upcoming findings from larger RCTs will provide additional evidence on vitamin supplementation in COVID-19 patients.

scholarly journals Intravenous vitamin C in the supportive care of cancer patients: a review and rational approach

2018 ◽  
Vol 25 (2) ◽  
pp. 139 ◽  
Author(s):  
E. Klimant ◽  
H. Wright ◽  
D. Rubin ◽  
D. Seely ◽  
M. Markman
Keyword(s):  
Vitamin C ◽  
Supportive Care ◽  
Rational Approach ◽  
Oral Vitamin ◽  
Cancer Treatments ◽  
Clinical Safety ◽  
Medical Oncologists ◽  
Intravenous Vitamin ◽  
Safety Considerations ◽  
Supportive Intervention

This article reviews intravenous vitamin C (IV C) in cancer care and offers a rational approach to enable medical oncologists and integrative practitioners to safely provide IV C combined with oral vitamin C to patients. The use of IV C is a safe supportive intervention to decrease inflammation in the patient and to improve symptoms related to antioxidant deficiency, disease processes, and side effects of standard cancer treatments. A proposed rationale, together with relevant clinical safety considerations for the application of IV C in oncologic supportive care, is provided.

Role of nitric oxide and oxidative stress in baroreceptor dysfunction in patients with chronic heart failure

2003 ◽  
Vol 104 (5) ◽  
pp. 529-535 ◽  
Author(s):  
Angus K. NIGHTINGALE ◽  
Daniel J. BLACKMAN ◽  
Rachel FIELD ◽  
Natalie J. GLOVER ◽  
Nicholas PEGGE ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Vitamin C ◽  
Radical Scavenging ◽  
Oral Vitamin ◽  
Baroreflex Control ◽  
Age Related ◽  
Intravenous Vitamin ◽  
To Receive

Abnormalities of autonomic control of the cardiovascular system are seen in chronic heart failure (CHF) and confer a poor prognosis. Nitric oxide appears to be important in the regulation of baroreflex control in health and in disease states. The antioxidant vitamin C increases nitric oxide bioavailability in CHF. We evaluated the effects of vitamin C on baroreceptor sensitivity (BRS) by sequence analysis in 100 CHF patients and 44 control subjects. Groups of 55 CHF patients and 22 controls were randomly allocated to receive a single intravenous injection of vitamin C (2 g) or placebo. In addition, 45 CHF patients were randomly allocated to receive a 4-week course of oral vitamin C (4 g/day) or placebo. An age-related reference range for BRS was developed in 22 healthy controls matched for age and gender to the CHF group. BRS was significantly impaired in the CHF group compared with age-matched older controls and young controls (6.9 ± 3.1, 12.5 ± 4.9 and 21.7 ± 9.1 mmHg/ms respectively; P < 0.001 between groups). Intravenous vitamin C acutely improved BRS in CHF patients by 24% (by 1.8 ± 4.1 mmHg/ms; P < 0.05), but not in controls. There was no improvement in BRS in CHF patients given chronic oral vitamin C. Thus acute intravenous, but not chronic oral, vitamin C improved BRS in CHF patients. There was no effect of intravenous vitamin C in healthy subjects, suggesting that the mechanism was either by free radical scavenging or due to central effects.

scholarly journals Potential Role of Vitamins and Zinc on Acute Respiratory Infections Including Covid-19

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110217
Author(s):  
Indah K. Murni ◽  
Endy P. Prawirohartono ◽  
Rina Triasih
Keyword(s):  
Vitamin A ◽  
Vitamin C ◽  
Large Dose ◽  
Common Cold ◽  
Potential Role ◽  
Respiratory Infections ◽  
Acute Respiratory Infections ◽  
Under Five ◽  
Short Period

Background. Vitamin C, E, D, A, zinc are considered to be essential in preventing and treating of acute respiratory infections (ARI) including COVID-19. Methods. We reviewed published studies evaluating the potential roles of these vitamin and zinc for ARIs and COVID-19 using Medline database, medRxiv, and bibliographic references. Results. Vitamins C, D, and E did not reduce incidence of common cold in general, but vitamin C reduced by half in population with physical and environment stresses. Vitamins C and E shortened duration and reduced severity of common cold. A large-dose vitamin A had no effect on recovery from pneumonia. Zinc improved clinical deterioration and pneumonia duration in under five. The effect on preventing COVID-19 morbidity and related-death was lacking. Conclusions. Although the effects of vitamins and zinc on ARIs including COVID-19 were inconclusive, taking these for a short period during pandemic may be beneficial when there is risks of deficiency.

scholarly journals Vitamin C in the Treatment of COVID-19

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1172
Author(s):  
Gregorio Paolo Milani ◽  
Marina Macchi ◽  
Anat Guz-Mark
Keyword(s):  
Clinical Trials ◽  
Vitamin C ◽  
Respiratory Infections ◽  
Medical Condition ◽  
Case Reports ◽  
Case Series ◽  
Theoretical Background ◽  
Current Evidence ◽  
Vitamin C Supplementation ◽  
Essential Nutrient

Vitamin C is an essential nutrient that serves as antioxidant and plays a major role as co-factor and modulator of various pathways of the immune system. Its therapeutic effect during infections has been a matter of debate, with conflicting results in studies of respiratory infections and in critically ill patients. This comprehensive review aimed to summarize the current evidence regarding the use of vitamin C in the prevention or treatment of patients with SARS-CoV2 infection, based on available publications between January 2020 and February 2021. Overall, 21 publications were included in this review, consisting of case-reports and case-series, observational studies, and some clinical trials. In many of the publications, data were incomplete, and in most clinical trials the results are still pending. No studies regarding prevention of COVID-19 with vitamin C supplementation were found. Although some clinical observations reported improved medical condition of patients with COVID-19 treated with vitamin C, available data from controlled studies are scarce and inconclusive. Based on the theoretical background presented in this article, and some preliminary encouraging studies, the role of vitamin C in the treatment of patients with SARS-CoV-2 infection should be further investigated.

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