THE SCIENCE

Review: Vitamin C – an Adjunctive Therapy for

Respiratory Infection, Sepsis and COVID-19


Patrick Holford 1,* Anitra C. Carr 2, Thomas H Jovic 3 4, Stephen R Ali 3 4, Iain S Whitaker 3 4, Paul E Marik 5, A. David Smith 6

1 Founder of the Institute for Optimum Nutrition, Ambassador House, Paradise Road, TW9 1SQ Richmond, UK; pat@patrickholford.com
2 Nutrition in Medicine Research Group, Department of Pathology & Biomedical Science, University of Otago, Christchurch, P.O. Box 4345, Christchurch 8140, New Zealand. anitra.carr@otago.ac.nz
3 Reconstructive Surgery & Regenerative Medicine Research Group, Institute of Life Sciences, Swansea University Medical School, Swansea University, SA28PY Swansea, UK; Thomas.Jovic@wales.nhs.uk
(T.H.J.); Stephen.Ali@wales.nhs.uk (S.R.A.); Iain.Whitaker@wales.nhs.uk (I.S.W.)
4 Welsh Centre for Burns & Plastic Surgery, Morriston Hospital, SA66NL Swansea, UK
5 Division of Pulmonary and Critical Care Medicine, Eastern Virginia Medical School, Norfolk, VA 23507, USA. marikpe@evms.edu
6 Department of Pharmacology, University of Oxford, Oxford OX1 3QT, UK. david.smith@pharm.ox.ac.uk.

Abstract: There are limited proven therapies for the treatment of COVID-19. Vitamin C’s antioxidant, anti-inflammatory and immunomodulating effects, make it a potential therapeutic candidate, both for the prevention and amelioration of COVID-19 infection, and as an adjunctive therapy in the critical care of COVID-19, supporting anti-inflammatory treatment.

This literature review focuses on vitamin C deficiency in respiratory infections including COVID-19; the mechanism of action in infectious disease and adrenal function supporting the anti-inflammatory actions of glucocorticosteroids: its role in preventing and treating colds and pneumonia and its role in treating sepsis and COVID-19.

The evidence to date indicates that oral vitamin C (2-8g/d) may reduce incidence and duration of respiratory infections and intravenous vitamin C (2-24g/d) has been shown to reduce mortality, Intensive Care Unit and hospital stays, time on mechanical ventilation in severe respiratory infections. Further trials are urgently warranted.

Given the favourable safety profile and low cost of vitamin C, and frequency of vitamin C deficiency in respiratory infections it may be worthwhile testing patients’ vitamin C status and treating accordingly with intravenous use within ICUs and orally with doses between 2 and 8g/day in hospitalised and infected persons.

Correspondence: pat@patrickholford.com | Posted: 20 October 2020 doi:10.20944/preprints202010.0407.v1

Keywords: COVID-19; SARS-CoV-2; coronavirus; vitamin C; ascorbate; colds; pneumonia; sepsis; immunonutrition; supplementation

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  • "Non survivors had much lower Vitamin C levels than survivors"
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  • "Vitamin C levels drop precipitously in infection"
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  • "Vitamin C reduces both duration and severity of colds"
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  • "68% less mortality in vitamin C group of covid critically ill"
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  • "17 out of 18 covid ICU patients had undetetactable vitamin C levels"
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  • "Vitamin C reduces stays in ICU, hospital and ventilators"
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