Citations

Background: Vitamin C is a vital nutrient that functions as an antioxidant and is important as a co-factor and regulator of several immune system pathways. The role of vitamin C in the treatment of COVID-19 is largely debatable. We conducted this meta-analysis to evaluate the efficacy and safety of vitamin C in the treatment of COVID-19. Methods: We searched several electronic databases from inception to March 2023 to retrieve randomized controlled trials on the use of vitamin C for COVID-19. RevMan 5.4 was used to calculate risk ratios (RRs) and mean differences (MDs) along with confidence intervals (95% CI) using a random-effects model. Results: We included nine randomized controlled trials in our meta-analysis. Vitamin C did not reduce the all-cause mortality in patients with COVID-19 compared to the standard treatment (RR 0.92, 95% CI: 0.83–1.02; I 2 = 1%). Vitamin C was found to be associated with a similar incidence of ventilation in COVID-19 patients when compared to standard treatment (RR 0.98, 95% CI: 0.87–1.11, I 2 = 0%). There were no significant differences between both groups regarding the incidence of hospitalization (RR 1.00, 95% CI: 0.98–1.02; I 2 = 0%), incidence of recovery (RR 1.57, 95% CI: 0.45–5.50; I 2 = 52%), hospital mortality (RR 0.68, 95% CI: 0.44–1.06; I 2 = 0%) and length of hospital stay (MD −0.63, 95% CI: −3.04 to 1.78; I 2 = 81%). Conclusion: Vitamin C administration did not reduce all-cause mortality in COVID-19 patients. Additional studies are required to evaluate the role of vitamin C in the prevention and treatment of COVID-19 especially in ICU patients.

Vitamin C is a vital nutrient that functions as an antioxidant and is important as a co-factor and regulator of several immune system pathways. The role of vitamin C in the treatment of COVID-19 is largely debatable. We conducted this meta-analysis to evaluate the efficacy and safety of vitamin C in the treatment of COVID-19. We searched several electronic databases from inception to March 2023 to retrieve randomized controlled trials on the use of Vitamin C for COVID-19. RevMan 5.4 was used to calculate risk ratios (RRs) and Mean Differences (MDs) along with confidence intervals (95% CI) using a random-effects model. We included 9 randomized controlled trials in our meta-analysis. Vitamin C did not reduce the all-cause mortality in patients with COVID-19 compared to the standard treatment [RR 0.86, 95% CI: 0.65-1.14; I 2 =66%]. Vitamin C was found to be associated with an increased incidence of ventilation in COVID-19 patients when compared to standard treatment [RR 1.37, 95% CI: 1.18-1.59; I 2 =58%]. There were no significant differences between both groups regarding the incidence of hospitalization [RR 1.00, 95% CI: 0.98-1.02; I 2 =0%], incidence of recovery [RR 1.57, 95% CI: 0.45-5.50; I 2 =52%], hospital mortality [RR 0.68, 95% CI: 0.44-1.06; I 2 =0%] and length of hospital stay [MD -0.63, 95% CI: -3.04 to 1.78; I 2 =81%]. Vitamin C administration did not reduce all-cause mortality in COVID-19 patients. Additional studies are required to evaluate the role of Vitamin C in the prevention and treatment of COVID-19 especially in ICU patients.

Introduction D-dimer levels, which originate from the lysis of cross-linked fibrin, are serially measured during coronavirus disease 2019 illness to rule out hypercoagulability as well as a septic marker. Methods This multicenter retrospective study was carried out in two tertiary care hospitals in Karachi, Pakistan. The study included adult patients admitted with a laboratory-confirmed coronavirus disease 2019 infection, with at least one measured d-dimer within 24 h following admission. Discharged patients were compared with the mortality group for survival analysis. Results The study population of 813 patients had 68.5% males, with a median age of 57.0 years and 14.0 days of illness. The largest d-dimer elevation was between 0.51–2.00 mcg/ml (tertile 2) observed in 332 patients (40.8%), followed by 236 patients (29.2%) having values greater than 5.00 mcg/ml (tertile 4). Within 45 days of hospital stay, 230 patients (28.3%) died, with the majority in the ICU (53.9%). On multivariable logistic regression between d-dimer and mortality, the unadjusted (Model 1) had a higher d-dimer category (tertile 3 and tertile 4) associated with a higher risk of death (OR: 2.15; 95% CI: 1.02–4.54, P=0.044) and (OR: 4.74; 95% CI: 2.38–9.46, P<0.001). Adjustment for age, sex, and BMI (Model 2) yields only tertile 4 being significant (OR: 4.27; 95% CI: 2.06–8.86, P<0.001). Conclusion: Higher d-dimer levels were independently associated with a high risk of mortality. The added value of d-dimer in risk stratifying patients for mortality was not affected by invasive ventilation, ICU stays, length of hospital stays, or comorbidities.