AUTHOR=Zhao Bing , Liu Min , Liu Ping , Peng Yibing , Huang Jun , Li Mengjiao , Wang Yihui , Xu LiLi , Sun Silei , Qi Xing , Ling Yun , Li Jian , Zhang Wenhong , Mao Enqiang , Qu Jieming 

TITLE=High Dose Intravenous Vitamin C for Preventing The Disease Aggravation of Moderate COVID-19 Pneumonia. A Retrospective Propensity Matched Before-After Study

JOURNAL=Frontiers in Pharmacology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2021.638556

DOI=10.3389/fphar.2021.638556

ISSN=1663-9812

ABSTRACT=<p><bold>Background:</bold> Coronavirus disease 2019 (COVID-19) pandemic is continuing to impact multiple countries worldwide and effective treatment options are still being developed. In this study, we investigate the potential of high-dose intravenous vitamin C (HDIVC) in the prevention of moderate COVID-19 disease aggravation.</p><p><bold>Methods:</bold> In this retrospective before-after case-matched clinical study, we compare the outcome and clinical courses of patients with moderate COVID-19 patients who were treated with an HDIVC protocol (intravenous injection of vitamin C, 100 mg/kg/day, 1 g/h, for 7 days from admission) during a one-month period (between March 18 and april 18, 2020, HDIVC group) with a control group treated without the HDIVC protocol during the preceding two months (January 18 to March 18, 2020). Patients in the two groups were matched in a 1:1 ratio according to age and gender.</p><p><bold>Results:</bold> The HDIVC and control groups each comprised 55 patients. For the primary outcomes, there was a significant difference in the number of patients that evolved from moderate to severe type between the two groups (HDIVC: 4/55 vs. control: 12/55, relative risk [RR] = 0.28 [0.08, 0.93], <italic>P</italic> = 0.03). Compared to the control group, there was a shorter duration of systemic inflammatory response syndrome (SIRS) (<italic>P</italic> = 0.0004) during the first week and lower SIRS occurrence (2/21 vs 10/22, <italic>P</italic> = 0.0086) on Day 7 (6–7 days after admission). In addition, HDIVC group had lower C-reactive protein levels (<italic>P</italic> = 0.005) and higher number of CD4<sup>+</sup> T cells from Day 0 (on admission) to Day 7 (<italic>P</italic> = 0.04).” The levels of coagulation indicators, including activated partial thromboplastin time and D-dimer were also improved in the HDIVC compared to the control group on Day 7.</p><p><bold>Conclusion:</bold> HDIVC may be beneficial in limiting disease aggravation in the early stage of COVID-19 pneumonia, which may be related to its improvements on the inflammatory response, immune function and coagulation function. Further randomized controlled trials are required to augment these findings.</p>