What do we know about Vitamin C and #COVID19 so far?

The role of #VitaminC goes beyond immunity-boosting & the micronutrient at high dose is crucial to prevent severity.

Making a case with 14 studies, postulating Vitamin C to be an integral part of COVID treatment.
Direct Association:

1. August 2020 case study in a 74 years old COVID 19 patient with acute respiratory distress syndrome treated with oral vitamin C 1 g twice a day along with antivirals was able to be taken off mechanical ventilation within 5 days.
2. A single-center observational study identified a total of 17 patients who received IV vitamin C for COVID-19 & noted a significant decrease in inflammatory markers, including ferritin and D-dimer, and a trend to decreasing FiO2 requirements.
3. In a research letter, Camon L et al illustrated that 17 patients (94.4%) of a cohort with ARDS had undetectable vitamin C levels and 1 patient had low levels (2.4 mg/L). The reference value is 5 mg/dl.
Aid in Recovery:

4. A meta-analysis of 29 controlled trials with 11,306 participants, showed that regular vitamin C intake of around 1 g/day shortened URTIs by 8% in adults and in children by 14%.
5. A meta-analysis of 12 trials with 1,766 patients in ICU found that vitamin C shortened ICU stay by 8%.
6. Another meta-analysis of 8 trials found that vitamin C shortened the duration of mechanical ventilation
in patients.
7. There is evidence that Vitamin C declines drastically in critically ill patients. In a study with 44 such patients, Carr A et al showed that nearly 40% of the septic shock patients were deficient in Vit-C, compared with 25% of the non-septic patients.
8. An RCT with 20 critically ill patients with multiple organ dysfunction demonstrated 2 g/d dose was associated with normal plasma concentrations, and the 10 g/d dose was associated with supranormal plasma concentrations.
9. Treatment with vitamin C decreases IL-6 and blocks in vivo the release of IL-6 in the endothelium induced by endothelin-1 (ET-1) in humans.
Prophylaxis & Prevention:

10. Feyaerts A et al proposed that Low dose (0.5–2 g/d) vitamin C may have benefits when used early in severe acute respiratory syndrome.
11. A total of 148 animal studies have indicated that a daily dose of a few grams of vitamin C may alleviate or prevent infections.
12. Vitamin C is known to support various cellular functions of both the innate and adaptive immune systems, including modifying susceptibility to various viral infections and by influencing inflammation.
portlandpress.com/biochemsoctran… A summary of the recently reported effects of ascorbate-depe
13. During the outbreak of SARS‐CoV‐1 in 2003, the use of vitamin C, an essential micronutrient for humans and free radical scavenger, was suggested as a nonspecific treatment for severe viral respiratory tract infections.
14. A Cochrane systematic review concludes that 1 to 2 g vitamin C per day is safe, inexpensive, and has a consistent effect on the duration and severity of the common cold.
All this evidence makes a very strong case on why a high dosage of Vitamin C needs to be a crucial part of COVID 19. More RCTs are recommended to establish this hypothesis.
@PeterVermont @drdavidsamadi @deboraha_rd @AndrewJacksonV3 @AAPSonline please take a look at this thread and opine.

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More from @DrSubhasree

20 Oct
Role of Zinc (Zn) during #COVID19: Probably The 2nd most important nutrient after #VitaminD. Zn is a must with antivirals in standard COVID care.

1. A study from Spain with 249 pts reported a zinc deficiency increased the risk of death by 2.3 times.
medicalxpress.com/news/2020-09-z… https://www.frontiersin.org...
2. A study from Japan reported Zn deficiency in 14% pts who remained mild to moderate & 84% among them later progressed into severe COVID 19.
3. A study from India with 47 COVID 19 pts & 45 healthy controls revealed that the COVID 19 pts had significantly lower Zn level & developed more complications (70.4% Vs. 30.0%, p=0.009). Zn def. pts also had a prolonged hospital stay. (7.9 d Vs 5.7 d).
Read 12 tweets
19 Oct
TRENDSETTER: In a scientific move, Vemulapalem Anganwadi, Gudur Mandal, #Nellore, Andhra Pradesh is providing 'Nandini Suraksha' milk & eggs to the kids. This milk is homogenized & fortified with Vitamin A & Vitamin D. Thanks @Bharat_J25 for sharing these. @ysjagan ImageImage
Kudos to the Anganwadi workers for understanding the importance of Vitamin A and D in a child's growth and development. Requesting relevant media houses to report this intelligent work. @xpressandhra @ThePrintIndia
Just came to know another Anganwadi in the Guntur district providing the same milk. @CollectorGuntr
Read 4 tweets
16 Oct
On #WorldFoodDay2020, #WestBengal's Three Distinct Schemes:

1. 'Didir Rannaghar (Mamata's Kitchen):

a. In a kind gesture, WB CM @MamataOfficial is offering meals at just Rs. 5 to all migrant workers from 11 am to 3 pm with a new menu every day. (1/4)
b. What else is included in 'Didir Rannaghar'?

- New clothes are also donated to the poor keeping the auspicious occasion of Durga Puja in mind.

- As per the guideline, hygiene and Social distancing are maintained with special attention. (2/4)
2. Khadya Sathi scheme:

Incepted on January 27, 2016, this scheme aimed to provide 90% of the state population with rice & wheat at Rs. 2/kg. According to the latest report, the state has ensured food security of 90% of people across the state. (3/4)
Read 4 tweets
13 Oct
Vitamin K & #COVID19:

Thrombosis is a major manifestation of COVID-19 that contributes to poor outcomes. Vitamin K plays a crucial role in the activation of both pro & anti-clotting factors in the liver, prevent elastic fiber degradation, possibly prevent comorbidities. THREAD Article source: https://www.cambridge.org/core/services/aop-
1. Matrix Gla protein (MGP) is a vitamin K-dependent inhibitor of soft tissue calcification & elastic fiber degradation. Severe extrahepatic vitamin K insufficiency is recently demonstrated in COVID-19 pts, w/high inactive MGP levels correlating w/elastic fiber degradation rates.
MGP Protects against elastic fiber degradation that provides deformability to the lungs & arteries, which facilitates respiration & circulation. The balance between elastic fiber degradation & repair is of vital importance in cardiac & pulmonary health.
Read 13 tweets
11 Oct
Unique Initiative: As #COVID19 spreads to rural pockets of Delhi, Govt. to create task force called 'Nigrani Samiti' for effective containment of the virus and enforce COVID appropriate behaviour among the residents. (1/4) @ArvindKejriwal
google.com/amp/s/indianex… Image
Delhi Disaster Management Authority stated every task force will be made up of a patwari, a local civil defence warden and two members of the village committee to assess the ground situation and submit its report regularly to the SDM/tehsildar concerned. (2/4)
The teams will create awareness through posters, wall paintings and distribution of pamphlets. They will have to ensure regular spraying of disinfectants like sodium hypochlorite solution in public places like chaupals and akhadas. (3/4)
Read 4 tweets
8 Oct
Thread: Antioxidant & Anti-inflammatory phytonutrients could target the pathogenesis of #COVID19.

Do phytonutrients have the capacity to enhance immunity? Existing literature and evidence to support the hypotheses for 4 phytonutrients & 2 micronutrients.
1. Curcumin:

a. Inhibits the production of pro-inflammatory cytokines (IL-6 and TNF- α) in lipopolysaccharide (LPS)-stimulated BV2 microglial cells and IL- 1β and IL-6 in TNF-α treated HaCaT cells via inhibiting the NF-κB and MAPK signaling pathways.
pubmed.ncbi.nlm.nih.gov/17883952/ https://www.spandidos-publications.com/ijmm/19/3/469
b. Curcumin exerts an antiviral effect on a broad range of viruses including influenza virus, adenovirus, hepatitis, human papillomavirus (HPV), human immunodeficiency virus (HIV), herpes simplex virus−2 (HSV-2), and Zika viruses.
ncbi.nlm.nih.gov/pmc/articles/P… (A) 4 HA units of Newcastle disease viruses (NDV) were incub
Read 17 tweets

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