Is Vitamin C the Unsung COVID-19 Hero?

vitamin C

So we know that it’s not OK to talk about dietary supplements, like vitamin C, as a part of a treatment plan for anything, much less COVID-19. We can already see it, can you? The FDA red flags are popping up. We promise not to make any sensational claims, but in times of crisis, it’s just amazing what people will try. We’ve found two recent studies by the same authors, in two separate journals about vitamin C being used to shorten the length of ICU stays and the duration of mechanical ventilation.

And, even mainstream media is reporting that Long Island, New York hospitals are using vitamin C for COVID-19 patients as part of an integrative treatment. Physicians there made the decision based on experimental treatments in Wuhan, China.

“The patients who received vitamin C did significantly better than those who did not get vitamin C,” said Dr. Andrew G. Weber, a pulmonologist and critical-care specialist affiliated with two Northwell Health facilities on Long Island. “It helps a tremendous amount, but it is not highlighted because it’s not a sexy drug,” he told the New York Post.

So for strictly educational purposes, we bring you two vitamin C studies authored by Harri Hemila and Elizabeth Chalker, published in Journal of Intensive Care and and the journal Nutrients respectively with links to the full text.

Vitamin C may reduce the duration of mechanical ventilation in critically ill patients: a meta-regression analysis

Abstract/ Our recent meta-analysis indicated that vitamin C may shorten the length of ICU stay and the duration of mechanical ventilation. Here we analyze modification of the vitamin C effect on ventilation time, by the control group ventilation time (which we used as a proxy for severity of disease in the patients of each trial).

Methods/ The researchers searched MEDLINE, Scopus, and the Cochrane Central Register of Controlled Trials and reference lists of relevant publications. The study included controlled trials in which the administration of vitamin C was the only difference between the study groups. The research did not limit the search to randomized trials and did not require placebo control. All doses and all durations of vitamin C administration were included. One author extracted study characteristics and outcomes from the trial reports and entered the data in a spreadsheet. Both authors checked the data entered against the original reports. They used meta-regression to examine whether the vitamin C effect on ventilation time depends on the duration of ventilation in the control group.

Results/ The researchers identified nine potentially eligible trials, eight of which were included in the meta-analysis.

  • The pooled the results of the eight trials, included 685 patients in total, and found that vitamin C shortened the length of mechanical ventilation on average by 14% (P = 0.00001).
  • However, there was significant heterogeneity in the effect of vitamin C between the trials.
  • Heterogeneity was fully explained by the ventilation time in the untreated control group.
  • Vitamin C was most beneficial for patients with the longest ventilation, corresponding to the most severely ill patients.
  • In five trials including 471 patients requiring ventilation for over 10 h, a dosage of 1–6 g/day of vitamin C shortened ventilation time on average by 25% (P < 0.0001).

Conclusion/ Researchers found strong evidence that vitamin C shortens the duration of mechanical ventilation, but the magnitude of the effect seems to depend on the duration of ventilation in the untreated control group. The level of baseline illness severity should be considered in further research. Different doses should be compared directly in future trials.

Vitamin C Can Shorten the Length of Stay in the ICU: A Meta-Analysis

Abstract/ A number of controlled trials have previously found that in some contexts, vitamin C can have beneficial effects on blood pressure, infections, bronchoconstriction, atrial fibrillation, and acute kidney injury. However, the practical significance of these effects is not clear. The purpose of this meta-analysis was to evaluate whether vitamin C has an effect on the practical outcomes: length of stay in the intensive care unit (ICU) and duration of mechanical ventilation.

Results/ Researchers identified 18 relevant controlled trials with a total of 2004 patients, 13 of which investigated patients undergoing elective cardiac surgery. Researchers carried out the meta-analysis using the inverse variance, fixed effect options, using the ratio of means scale.

  • In 12 trials with 1766 patients, vitamin C reduced the length of ICU stay on average by 7.8% (95% CI: 4.2% to 11.2%; p = 0.00003).
  • In six trials, orally administered vitamin C in doses of 1–3 g/day (weighted mean 2.0 g/day) reduced the length of ICU stay by 8.6% (p = 0.003).
  • In three trials in which patients needed mechanical ventilation for over 24 hours, vitamin C shortened the duration of mechanical ventilation by 18.2% (95% CI 7.7% to 27%; p = 0.001).
  • Given the insignificant cost of vitamin C, even an 8% reduction in ICU stay is worth exploring. The effects of vitamin C on ICU patients should be investigated in more detail.

Click Here for Full Text J of Intensive Care Study

Click Here for Full Text J Nutrients

Sources: Hemilä, H., Chalker, E. Vitamin C may reduce the duration of mechanical ventilation in critically ill patients: a meta-regression analysis. J Intensive Care. 2020;8, 15. doi.org/10.1186/s40560-020-0432-y
Hemilä H, Chalker E. Vitamin C Can Shorten the Length of Stay in the ICU: A Meta-Analysis. Nutrients. 2019; 11(4):708. doi.org/10.3390/nu11040708