Most COVID-19 patients exhibit mild to moderate symptoms, while approximately 15% progress rapidly to severe pneumonia, and about 5% eventually develop acute respiratory distress syndrome (ARDS)…
[T]reatments aiming to improve mortality should focus on two aspects: first, prevention of the aggravation of the disease in mild and moderate COVID-19 patients; second, the rescue therapy for patients in serious conditions.
We have been applying high-dose intravenous vitamin C (HDIVC) in the treatment of critical illnesses for almost 10 years in our center.
Our studies showed the inflammatory response, immune and organ function improved after HDIVC application in a retrospective case series study, and the number of moderate COVID-19 patients transferring to severe type was reduced after HDIVC protocol application.
The rationale for HDIVC in the treatment of COVID-19 is based on the following aspects:
(1) Rapid scavenging of reactive oxygen species (ROS) and relieving ROS related inflammatory response, endothelial dysfunction, coagulopathy, ARDS, and MOF [multiple organ failure].
(2) Potential improving effect on lymphopenia. Lymphopenia was correlated with the development of
ARDS and disease severity.
Vitamin C is essential for the development, maturation, and proliferation of functional T-lymphocytes.
(3) Maintaining circulation function stability. Vitamin C is an important co-factor for the synthesis of the endogenous hormone, including catecholamine, corticosteroid, and vasopressin.
A previous clinical study showed less need for vasopressor and lower 28-day mortality in septic shock patients after HDIVC application. For COVID-19 patients with septic shock, HDIVC, especially a high bolus dose over a short time, might help the recovery of circulation failure.
(4) Attenuating the COVID-19 related scurvy rapidly. According to the latest report,[15] the level of vitamin C is almost undetectable in severe COVID-19 patients. The “scurvy” state is correlated with MOF in critically ill patients.
HDIVC is an efficient and safe treatment for patients with COVID-19. It might be applied in prevention of disease aggravation in moderate types, as well as rescue therapy for the severe and critical type.