Background and importance Proinflammatory cytokines seem to have an influence on the course and severity of a COVID-19 infection. The use of high-dose vitamin C (HDVC) represents a possible adjunctive therapy approach for the treatment of critically ill COVID-19 patients owing to its immune-modulating, anti-inflammatory and antioxidant properties.
Aim and objectives To determine the impact of adjunctive HDVC therapy on inflammatory markers such as interleukin-6 (IL-6).
Material and methods Setting: A descriptive, retrospective analysis with critically ill COVID-19 patients admitted to the intermediate care unit (IMCU) and intensive care unit (ICU) in a public hospital.
Adult ICU-hospitalised patients with COVID-19 were included with those who were to receive, besides the standard of care, either:
HDVC (treatment group with 7.5 g/day VC up to 10 days)
Low-dose VC (LDVC with 1g/day VC up to 10 days)
No additional VC (control group).
All data were obtained from the patients’ medical records from November to December 2020 and from March to May 2021.
Results Data were collected from 83 critically ill patients with confirmed COVID-19 infection. 40 patients were administered HDVC, 24 patients received LDVC and 19 patients did not receive any VC.
The mean age of the patients in the treatment group was 57.3 years, in the LDVC group 62.1 years and in the control group 55.8 years. The average IMCU and ICU length of stay was 17.4 days for patients in the HDVC-group, 21.4 days in the LDVC-group and 21.5 days in the control group. 68% from the HDVC group survived and were discharged from hospital. In the LDVC group 58% survived and in the control group 42%. Lower levels of IL-6 in the HDVC-group as compared with the LDVC-group and control group were detected.
Conclusion and relevance Our findings have demonstrated that the use of HDVC can lead to a clinical benefit due to decreased levels of IL-6. Additional investigations should be encouraged in order to further characterise adjunctive HDVC treatment in COVID-19 infection. Unlike some previous studies, our results have shown no detrimental effects of HDVC on glomerular filtration rate and serum creatinine levels.
Conflict of interest No conflict of interest