Vitamin C for COVID-19? US doctors and Chinese researchers trial intravenous doses

31 Mar 2020 --- Northwell Health, New York state’s largest healthcare provider, is administering large doses of vitamin C to some COVID-19 patients in its hospitals. A spokesperson for Northwell Health tells NutritionInsight that the provider is “exploring many therapies at this time, including utilizing vitamin C.” While the spokesperson declined to elaborate, the New York Post reports that intensive-care patients are immediately receiving 1,500 mg of intravenous vitamin C, which is then re-administered three or four times a day. The news comes as a clinical trial with vitamin C is underway in China, examining to what extent coronavirus symptoms can be treated.

“In terms of mechanisms, one likely beneficial action of intravenous vitamin C for COVID-19 symptoms is as an antioxidant. It may also protect from damage in the lung caused by inflammation that is part of the body’s response to the virus. However, there is no scientific evidence at present that vitamin C supplements will be effective in treatment of COVID-19,” Peter McCaffery, Professor at the University of Aberdeen and unaffiliated with Northwell Health, tells NutritionInsight. 

He continues that there is only mixed evidence for vitamin C supplements to treat the common cold, nothing that if there is an effect, it is minor. “Additionally, vitamin C supplements would be beneficial for someone who was actually vitamin C deficient, but in a normal diet, this is quite rare.” 

However, McCafferty further notes that there are few downsides to experimenting with intravenous vitamin C in relation to COVID-19 as it is relatively safe when applied under clinical supervision. “One reason for this is because vitamin C is easily excreted, unlike fat-soluble vitamins like vitamins A and D, which can be quite toxic at high doses.”

Addressing sepsis 
According to the New York Post, patients who received vitamin C did significantly better than those who did not get the vitamin, which is administered in addition to medication including anti-malaria drug hydroxychloroquine, the antibiotic azithromycin, various biologics and blood thinners.

Vitamin C levels in those with COVID-19 fall dramatically when people suffer from sepsis, which is an inflammatory response occurring when bodies overreact to the infection and can lead to multiple organ failure and death. The usage of vitamin C for sepsis is a controversial practice, with a recent paper published in the Journal of the American Medical Association refuting the idea that the combination of high-dose intravenous vitamin C, thiamine (vitamin B1) and hydrocortisone is beneficial in the treatment of sepsis.

The study examined 216 patients in septic shock between May 2018 and July 2019. There was no improvement in the duration of support with blood pressure drugs for the treatment of shock or survival of those receiving the mixture of vitamin C, thiamine and steroid therapy compared to steroid therapy alone.

Patients who received vitamin C did significantly better than those who did not get the vitamin.Ongoing clinical trials
Northwell Health’s use of vitamin C comes in the light of an ongoing clinical trial in China, which began in February and is set to be completed in September. The researchers hypothesize that vitamin C infusion can help improve the prognosis of patients with severe acute respiratory infection (SARI) related to COVID-19. They cite previous studies showing that vitamin C deficiency is related to the increased risk and severity of influenza infections, and affirm that the vitamin plays a role in reducing the inflammatory response and preventing the common cold. 

The study is set to include 140 individuals with COVID-19 and who are being treated in the Intensive Care Unit (ICU). The experimental group will be infused with 12 g vitamin C mixed with sterile water twice a day for seven days. An infusion pump with a speed of 12 ml/h will be used. Meanwhile, a placebo group will only receive 50 ml of sterile water twice a day for the seven days. 

The primary outcome measure is the number of ventilation-free days during the 28 days after the patient’s enrollment. Meanwhile, secondary measures include mortality within 28 days, length of stay in the ICU and demand for first aid measurements. 

With any clinical foray into nutritional pathways, great care must be taken not to spread misinformation to consumers. Vitamin C, along with oregano oil and bleach, has already been the topic of a great deal of false COVID-19-related “cures” disseminated via social media. The US Food and Drug Administration (FDA) and the Federal Trade Commission (FTC) recently warned seven companies for selling products claiming to prevent or treat COVID-19. 

Nonetheless, some members of the nutrition sector are looking inward to see if it can offer any potential insights, with research circulating surrounding fucoidan and coconut oil. Looking ahead, Cardax is seeking strategic collaborations to develop astaxanthin for the treatment of COVID-19. According to the US-based company, astaxanthin may hold promise for boosting the immune system and reducing the extreme inflammatory response that may lead to severe respiratory complications in subjects with COVID-19. 

Meanwhile, an immediate investigation into the safety and protective functions of breast milk as it relates to the coronavirus pandemic has been initiated by the University of California San Diego (UC San Diego) and the Family Larsson-Rosenquist Foundation (FLRF). The researchers hope to identify human milk bioactives that help protect the body from the virus. This knowledge may then potentially be leveraged to develop novel antiviral therapeutics.

In light of these rapid developments, NutritionInsight has launched a new daily news feed for the coronavirus-related information and insights you need to guide your business through this challenging period.

By Katherine Durrell

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