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Therapeutic effects of high-dose vitamin C supplementation in patients with COVID-19: a meta-analysis
Lei Sun1, Jia-Hao Zhao1, Wen-Yi Fan1
1Department of Environmental Health, School of Public Health, Zhengzhou University, Environment and Health Innovation Team, Zhengzhou, Henan, China.
Insights
High-dose vitamin C supplementation shows promise in managing COVID-19 by reducing inflammation and disease severity. This meta-analysis indicates vitamin C can improve key health markers and shorten intensive care unit stays for patients.
Area of Science:
- Immunology
- Nutritional Science
- Infectious Diseases
Background:
- Coronavirus disease 2019 (COVID-19) can trigger a cytokine storm, leading to severe complications like acute respiratory distress syndrome.
- Vitamin C has demonstrated efficacy in mitigating inflammation and improving lung function in patients.
Purpose of the Study:
- To evaluate the therapeutic benefits of high-dose vitamin C supplementation in patients diagnosed with COVID-19 through a comprehensive meta-analysis.
Main Methods:
- A systematic literature search was conducted across major databases (PubMed, Cochrane Library, Web of Science, EMBASE, CNKI) up to August 2022.
- Data from 14 studies (7 RCTs, 7 retrospective) involving 751 COVID-19 patients were analyzed using PRISMA guidelines and Stata 14.0 software.
- Random-effects or fixed-effects models were applied based on heterogeneity assessment (I2 statistics).
Main Results:
- Vitamin C supplementation significantly increased ferritin and lymphocyte counts in COVID-19 patients.
- A notable reduction in the length of intensive care unit stays was observed in patients receiving vitamin C.
- Vitamin C intake was associated with a significant alleviation of disease aggravation.
Conclusions:
- High-dose vitamin C supplementation effectively alleviates inflammatory responses associated with COVID-19.
- Vitamin C can play a role in hindering the progression and severity of COVID-19.
Context:
Coronavirus disease 2019 (COVID-19) could induce the "cytokine storm" due to overactivation of immune system and accompanied by acute respiratory distress syndrome as a serious complication. Vitamin C has been effective in improving lung function of patients by reducing inflammation.
Objective:
The aim was to explore the therapeutic effects of high-dose vitamin C supplementation for patients with COVID-19 using meta-analysis.
Data Sources:
Published studies were searched from PubMed, Cochrane Library, Web of Science, EMBASE, and China National Knowledge Infrastructure databases up to August 2022 using the terms "vitamin C" and "COVID-19". Data analyses were performed independently by 2 researchers using the PRISMA guidelines.
Data Extraction:
Heterogeneity between the included studies was assessed using I2 statistics. When I2 ≥50%, the random-effects model was used; otherwise, a fixed-effects model was applied. Stata 14.0 software was used to pool data by standardized mean differences (SMDs) with 95% CIs or odds ratios (ORs) with 95% CIs.
Data Analysis:
The 14 studies had a total of 751 patients and 1583 control participants in 7 randomized controlled trials and 7 retrospective studies. The vitamin C supplement significantly increased ferritin (SMD = 0.272; 95% CI: 0.059 to 0.485; P = 0.012) and lymphocyte count levels (SMD = 0.376; 95% CI: 0.153 to 0.599; P = 0.001) in patients with COVID-19. Patients administered vitamin C in the length of intensive care unit staying (SMD = 0.226; 95% CI: 0.073 to 0.379; P = 0.004). Intake of vitamin C prominently alleviate disease aggravation (OR = 0.344, 95%CI: 0.135 to 0.873, P = 0.025).
Conclusions:
High-dose vitamin C supplementation can alleviate inflammatory response and hinder the aggravation of COVID-19.
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