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.