COVID-19 Evidence Alerts
from McMaster PLUSTM

Current best evidence for clinical care (more info)

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Treatment JamaliMoghadamSiahkali S, Zarezade B, Koolaji S, et al. Safety and effectiveness of high-dose vitamin C in patients with COVID-19: a randomized open-label clinical trial. Eur J Med Res. 2021 Feb 11;26(1):20. doi: 10.1186/s40001-021-00490-1.

BACKGROUND: Vitamin C is an essential water-soluble nutrient that functions as a key antioxidant and has been proven to be effective for boosting immunity. In this study, we aimed to assess the efficacy of adding high-dose intravenous vitamin C (HDIVC) to the regimens for patients with severe COVID-19 disease.

METHODS: An open-label, randomized, and controlled trial was conducted on patients with severe COVID-19 infection. The case and control treatment groups each consisted of 30 patients. The control group received lopinavir/ritonavir and hydroxychloroquine and the case group received HDIVC (6 g daily) added to the same regimen.

RESULTS: There were no statistically significant differences between two groups with respect to age and gender, laboratory results, and underlying diseases. The mean body temperature was significantly lower in the case group on the 3rd day of hospitalization (p = 0.001). Peripheral capillary oxygen saturations (SpO2) measured at the 3rd day of hospitalization was also higher in the case group receiving HDIVC (p = 0.014). The median length of hospitalization in the case group was significantly longer than the control group (8.5 days vs. 6.5 days) (p = 0.028). There was no significant difference in SpO2 levels at discharge time, the length of intensive care unit (ICU) stay, and mortality between the two groups.

CONCLUSIONS: We did not find significantly better outcomes in the group who were treated with HDIVC in addition to the main treatment regimen at discharge. Trial registration (IRCT20200411047025N1), April 14, 2020.

Discipline / Specialty Area Score
Hospital Doctor/Hospitalists
Internal Medicine
Intensivist/Critical Care
Family Medicine (FM)/General Practice (GP)
General Internal Medicine-Primary Care(US)
Infectious Disease
Comments from MORE raters

General Internal Medicine-Primary Care(US) rater

The world continues to search for novel ways to treat complications of coronavirus infections. High dose vitamin C use is one of those possibilities. In this study, it is interesting to note comparison of treatment with high dose vitamin C and use of antivirals plus hydroxychloroquine. The results showed no clinical or statistically significant differences. The unusual choice of a control group receiving specific medications is a little troublesome. We remain with limited, effectual treatment options for coronavirus infection at this time.

Infectious Disease rater

This is a small, open label study of high dose vitamin C in patients with covid-19. There were 30 patients in each group - placebo and vitamin C. There was no difference in outcomes including length of hospital stay and mortality. Even if there was a difference, the small sample size makes the study underpowered.

Intensivist/Critical Care rater

This well conducted clinical study provides knowledge about the role of vitamin C in severe Covid-19. As many intensivists suspect, most vitamins do not play an important role by themselves.

Respirology/Pulmonology rater

In this small open label study of high dose IV vitamin C, there was no major impact on the course of Covid-19 when compared to lopinavir/ritonavir plus hydroxychloroquine. In other words, similar to placebo, the meds used in the control group have been found to be ineffective.