High-dose intravenous vitamin C attenuates hyperinflammation in severe coronavirus disease 2019

Xia, Guozhi; Fan, Di; He, Yanru; Zhu, Yaohu; Zheng, Qiangsun

BACKGROUND: High-dose intravenous vitamin C (HIVC) is a major concern on treating coronavirus disease 2019 (COVID-19). OBJECTIVE: To assess the clinical efficacy of HIVC on hyperinflammation among patients with severe COVID-19. METHODS: The retrospective cohort study included inpatients with severe COVID-19, a subset of whom was treated with HIVC. The medical records were screened for demographic data, laboratory findings, medications, as well as initial and repeated values of multiple inflammatory markers for analysis. RESULTS: The percentages of patients presented hyperinflammation based on inflammatory markers levels above upper limit of normal (hs-CRP, 80.1%; IL-6, 91.5%; TNF-a, 67.4%). A total of 85 (36.0%) patients received HIVC therapy. After treatment with HIVC, the levels of inflammatory markers displayed significant decrease related to those among patients without HIVC. Furthermore, the percentages of reduction in inflammatory markers levels were higher in patients receiving HIVC compared with those in patients treated without HIVC. Stepwise multiple linear regression analysis revealed that HIVC was independently associated with percentages of reduction in inflammatory markers levels. CONCLUSIONS: HIVC has potential benefit in attenuating hyperinflammation through reducing inflammatory markers levels in patients with severe COVID-19.