Overview of the possible role of vitamin C in management of COVID-19
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REVIEW
Overview of the possible role of vitamin C in management of COVID‑19 Anis Abobaker1 · Aboubaker Alzwi2 · Alsalheen Hamed A. Alraied3 Received: 22 September 2020 / Revised: 11 October 2020 / Accepted: 14 October 2020 © Maj Institute of Pharmacology Polish Academy of Sciences 2020
Abstract The mainstay of management of coronavirus disease 2019 (COVID-19) is mainly supportive as to date there is no effective antiviral treatment, apart from remdesivir which has been approved by Food and Drug administration (FDA) for treatment of COVID-19, or vaccine. Supplementation with micronutrients, such as vitamins and minerals, has gained an increasing interest as part of the supportive management of COVID-19. Vitamin C levels in serum and leukocytes are depleted during the acute stage of infection owing to increased metabolic demands. High-dose vitamin C supplement helps to normalise both serum and leukocytes vitamin C levels. Vitamin C has multiple pharmacological characteristics, antiviral, anti-oxidant, anti-inflammatory and immunomodulatory effects, which make it a potential therapeutic option in management of COVID19. The use of high dose of intravenous vitamin C for management of COVID-19 in China and the United Stated has shown promising results. There were no reported adverse reactions with the short-term use of high dose of vitamin C. Given the fact that vitamin C is cheap, available and safe drug with beneficial effects in management of viral infections and critically ill patients reported in previous clinical trials, it is sensible to add it to COVID-19 management protocol particularly if the current ongoing clinical trials testing the effect of vitamin C in management of COVID-19 show positive results. Keywords Vitamin C · COVID-19 · SARS-CoV-2 · Beneficial effects · Management Abbreviations COVID-19 Coronavirus disease 2019 FDA Food and Drug Administration ARDS Adult respiratory distress syndrome EBV Epstein–Barr virus CMV Cytomegalovirus HSV-1 Herpes simplex virus-1 HIV Human immunodeficiency virus RCT Randomised controlled trial IV Intravenous VZV Varicella zoster virus URTI Upper respiratory tract infection SOFA Sequential organ failure assessment ICU Intensive care unit AIDS Acquired Immune Deficiency Syndrome * Anis Abobaker [email protected] 1
Spire Fylde Coast Hospital, St Walburgas road, Blackpool FY3 8BP, UK
2
7th of October Hospital, Benghazi, Libya
3
Jomhorya Hospital, Benghazi, Libya
Introduction Since the start of coronavirus disease 2019 “COVID-19” pandemic, multiple treatment regimens have been tried under the compassionate use indications. So far, no specific antiviral drug has been proven to be effective, apart from remdesivir which showed promising results and has gained an emergency approval by Food and Drug Administration (FDA) to be used in the treatment of COVID-19 [1, 2]. That is why supportive treatment, including supplementation of micronutrients such as vitamin C, has become a crucial part in management of COVID-19. It is noticed that serum and
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