Effect of Vitamin C on Clinical Outcomes of Critically Ill Patients With COVID-19: An Observational Study and Subsequent Meta-Analysis

Frontiers in Medicine

article

Evdokia Gavrielatou¹  Eleni Xourgia¹  Nikoleta A. Xixi¹  Athina G. Mantelou¹  Eleni Ischaki¹  Aggeliki Kanavou¹  Dimitris Zervakis¹  Christina Routsi¹  Anastasia Kotanidou¹  Ilias I. Siempos¹ 

[1] First Department of Critical Care Medicine and Pulmonary Services, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens;Division of Pulmonary and Critical Care Medicine, Department of Medicine, New York-Presbyterian Hospital, Weill Cornell Medical Center, Weill Cornell Medicine

关键词: acute respiratory distress syndrome;    acute respiratory failure;    pneumonia;    mechanical ventilation;    intensive care unit;    coronavirus;   

DOI  :  10.3389/fmed.2022.814587

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background Whether vitamin C provides any benefit when administered in critically ill patients, including those with coronavirus disease (COVID-19), is controversial. We endeavored to estimate the effect of administration of vitamin C on clinical outcomes of critically ill patients with COVID-19 by performing an observational study and subsequent meta-analysis. Methods Firstly, we conducted an observational study of critically ill patients with laboratory-confirmed COVID-19 who consecutively underwent invasive mechanical ventilation in an academic intensive care unit (ICU) during the second pandemic wave. We compared all-cause mortality of patients receiving vitamin C (“vitamin C” group) or not (“control” group) on top of standard-of-care. Subsequently, we systematically searched PubMed and CENTRAL for relevant studies, which reported on all-cause mortality (primary outcome) and/or morbidity of critically ill patients with COVID-19 receiving vitamin C or not treatment. Pooled risk ratio (RR) and 95% confidence intervals (CI) were calculated using a random effects model. The meta-analysis was registered with PROSPERO. Results In the observational study, baseline characteristics were comparable between the two groups. Mortality was 20.0% (2/10) in the vitamin C group vs. 47.6% (49/103; p = 0.11) in the control group. Subsequently, the meta-analysis included 11 studies (6 observational; five randomized controlled trials) enrolling 1,807 critically ill patients with COVID-19. Mortality of patients receiving vitamin C on top of standard-of-care was not lower than patients receiving standard-of-care alone (25.8 vs. 34.7%; RR 0.85, 95% CI 0.57–1.26; p = 0.42). Conclusions After combining results of our observational cohort with those of relevant studies into a meta-analysis of data from 1,807 patients, we found that administration vitamin C as opposed to standard-of-care alone might not be associated with lower of mortality among critically ill patients with COVID-19. Additional evidence is anticipated from relevant large randomized controlled trials which are currently underway.

【 授权许可】

CC BY