Treatment of COVID-19 with vitamin C
Critically ill COVID-19 patients develop an excessive inflammatory response, disseminated intravascular coagulation and multi-organ dysfunction. Immunosuppressive agents like tocilizumab (a humanized monoclonal antibody against the interleukin-6 receptor) (Salama et al., 2021) and dexamethasone (Group et al., 2021) have been shown to be beneficial treatments for such patients. The known actions of vitamin C indicate that it would also be a plausible adjunct treatment for COVID-19. The findings that plasma vitamin C levels are low in COVID-19 patients (Chiscano-Camon, Ruiz-Rodriguez, Ruiz-Sanmartin, Roca & Ferrer, 2020), and that vitamin C lowers expression of angiotensin converting enzyme 2, the entry point for SARS-CoV-2 into cells (Ivanov, Goc, Ivanova, Niedzwiecki & Rath, 2021), further indicate that it may have beneficial actions in COVID-19. Intravenous vitamin C (1.5-14.0 g) has been investigated in COVID-19 patients with mild beneficial effects, but the effects of mega-doses have not been studied.
Following our finding of potent beneficial effects of mega-dose vitamin C in ovine sepsis, a critically ill patient with COVID-19 induced acute respiratory distress syndrome, hypotension and AKI was treated with intravenous sodium ascorbate (60 g over 7 hours) (Lankadeva et al., 2021). As in septic sheep, sodium ascorbate restored arterial pressure in the face of withdrawal of noradrenaline, accompanied by reduced plasma creatinine, increased urine flow and reduced heart rate. Arterial blood oxygen levels improved while fractional inspired oxygen was reduced. The patient was subsequently extubated and discharged from hospital 22 days after mega-dose vitamin C treatment.