Intravenous Vitamin C Linked to Early Recovery in Critically Ill COVID-19 Patient

A recently published report describes the case of a critically ill patient with coronavirus disease 2019 (COVID-19) who rapidly recovered after receiving treatment with high dose intravenous vitamin C.

The patient, a 74-year-old female, presented to the emergency department after experiencing a low grade fever, cough, and shortness of breath (SOB) for 2 days. She reported that she underwent an elective right total knee replacement 1 week prior to her presentation but was otherwise healthy at the time. She denied having any sick contacts or recent travel. The patient’s past medical history was significant for essential hypertension, obesity, myasthenia gravis (MG) in remission, and osteoarthritis.

Assessment of the patient revealed an oxygen saturation level of 87% and bilateral rhonchi on lung auscultation, but her vital signs were otherwise normal. Chest radiography was performed and showed “air space opacity in the right upper lobe, suspicious for pneumonia.”

The patient was initiated on broad spectrum antibiotics and supplemental oxygen for suspected pneumonia as well as intravenous immunoglobulin for mild MG exacerbation. She experienced worsening of SOB over the next 4 days of her hospital stay.

On day 4 of hospitalization, while in the airborne-isolation unit, the patient’s nasopharyngeal swab for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) came back positive. Laboratory findings also revealed that the patient had lymphopenia as well as elevated levels of lactate dehydrogenase, ferritin, and interleukin-6.

She was initiated on oral hydroxychloroquine, intravenous azithromycin, zinc sulfate, and oral vitamin C. After developing acute respiratory distress syndrome and septic shock on day 6 of her stay, she was mechanically ventilated and pressor support and high dose intravenous vitamin C were initiated. The patient clinically improved and, within 5 days, was taken off mechanical ventilation.

Numerous studies have previously assessed the role of vitamin C in severe sepsis and intensive care unit (ICU) care due to its antioxidant and anti-inflammatory properties. “High dose intravenous vitamin C treat­ment in our case was associated with fewer days on mechani­cal ventilation, shorter ICU stay, and earlier recovery compared to the average length of mechanical ventilation, disease du­ration, and ICU stay in critical COVID-19 patients at our insti­tute,” the authors concluded. They added that the results of this case suggest further investigation into the use of intravenous vitamin C in critically ill COVID-19 patients.

Reference:

1. Khan HMW, Parikh N, Megala SM, Predeteanu GS. Unusual early recovery of a critical COVID-19 patient after administration of intravenous vitamin C [published online July 14, 2020]. Am J Case Rep. 2020. doi: 10.12659/AJCR.925521.