Vitamin C, also known as ascorbic acid, is an essential water-soluble nutrient. Humans and some other animals (such as primates, pigs) depend on the vitamin C in the nutritional supply of fruits and vegetables (red pepper, orange, strawberry, broccoli, mango, lemon). The potential role of vitamin C in preventing and improving infections has been recognized in the medical community.
Ascorbic acid is essential for the immune response. It has important anti-inflammatory, immunomodulatory, antioxidant, anti-thrombosis and anti-viral properties.
Vitamin C seems to be able to regulate the host's response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Coronavirus is the causative factor of the 2019 coronavirus disease (COVID-19) pandemic, especially It is in a critical period. In a recent comment published in Preprints*, Patrick Holford et al. Solved the role of vitamin C as an auxiliary treatment for respiratory infections, sepsis and COVID-19.
This article discusses the potential role of vitamin C in preventing the critical stage of COVID-19, acute respiratory infections and other inflammatory diseases. Vitamin C supplementation is expected to be a preventive or therapeutic agent for COVID-19-correcting deficiencies caused by the disease, reducing oxidative stress, enhancing interferon production and supporting the anti-inflammatory effects of glucocorticoids.
In order to maintain normal plasma levels in adults at 50 µmol/l, the vitamin C dosage for men is 90 mg/d and for women 80 mg/d. This is enough to prevent scurvy (a disease caused by a lack of vitamin C). However, this level is not sufficient to prevent viral exposure and physiological stress.
Therefore, the Swiss Nutrition Society recommends supplementing each person with 200 mg of vitamin C-to fill the nutritional gap of the general population, especially adults 65 years and older. This supplement is designed to strengthen the immune system. "
Under physiological stress conditions, human serum vitamin C levels drop rapidly. The serum vitamin C content of hospitalized patients is ≤11µmol/l, and most of them suffer from acute respiratory infection, sepsis or severe COVID-19.
Various case studies from around the world indicate that low vitamin C levels are common in severely ill hospitalized patients with respiratory infections, pneumonia, sepsis and COVID-19-the most likely explanation is increased metabolic consumption.
The meta-analysis highlighted the following observations: 1) Vitamin C supplementation can significantly reduce the risk of pneumonia, 2) Post-mortem investigations after death from COVID-19 showed secondary pneumonia, and 3) Vitamin C deficiency accounted for the total population with pneumonia 62%.
Vitamin C has an important homeostatic effect as an antioxidant. It is known to have direct virus killing activity and can increase the production of interferon. It has effector mechanisms in both innate and adaptive immune systems. Vitamin C reduces reactive oxygen species (ROS) and inflammation by reducing the activation of NF-κB.
SARS-CoV-2 down-regulates the expression of type 1 interferon (the host's main antiviral defense mechanism), while ascorbic acid up-regulates these key host defense proteins.
The critical phase of COVID-19 (usually the fatal phase) occurs during the overproduction of effective pro-inflammatory cytokines and chemokines. This led to the development of multiple organ failure. It is related to the migration and accumulation of neutrophils in the lung interstitium and bronchoalveolar cavity, the latter being a key determinant of ARDS (Acute Respiratory Distress Syndrome).
The concentration of ascorbic acid in the adrenal glands and pituitary gland is three to ten times higher than in any other organ. Under physiological stress (ACTH stimulation) conditions including viral exposure, vitamin C is released from the adrenal cortex, causing plasma levels to increase fivefold.
Vitamin C can enhance the production of cortisol, and enhance the anti-inflammatory and endothelial cell protective effects of glucocorticoids. Exogenous glucocorticoid steroids are the only drugs that have been proven to treat COVID-19. Vitamin C is a multi-effect stimulating hormone, which plays a vital role in mediating the adrenal cortex stress response (especially sepsis) and protecting the endothelium from oxidative damage.
Taking into account the effect of vitamin C on colds-reducing the duration, severity and frequency of colds-taking vitamin C can reduce the transition from mild infection to the critical period of COVID-19.
It has been observed that vitamin C supplementation can shorten the length of stay in the ICU, shorten the ventilation time of critically ill patients with COVID-19, and reduce the mortality rate of sepsis patients who require treatment with vasopressors.
Taking into account the various conditions of diarrhea, kidney stones and renal failure during high doses, the authors discussed the safety of oral and intravenous administration of vitamin C. A safe short-term high dose of 2-8 g/day can be recommended (carefully avoid high doses for people with a history of kidney stones or kidney disease). Because it is water-soluble, it can be excreted within a few hours, so dosage frequency is important to maintain adequate blood levels during active infection.
As we all know, vitamin C can prevent infection and improve immune response. Especially referring to the critical stage of COVID-19, vitamin C plays a key role. It down-regulates the cytokine storm, protects the endothelium from oxidative damage, plays an important role in tissue repair, and improves the immune response to infection.
The author recommends that vitamin C supplements should be added every day to encourage high-risk groups with high COVID-19 mortality and vitamin C deficiency. They should always ensure that vitamin C is adequate and increase the dose when the virus is infected, up to 6-8 g/day. A number of dose-dependent vitamin C cohort studies are ongoing worldwide to confirm its role in relieving COVID-19 and to better understand its role as a therapeutic potential.
Preprints will publish preliminary scientific reports that have not been peer-reviewed, and therefore should not be considered conclusive, guiding clinical practice/health-related behaviors or considered definitive information.
Tags: acute respiratory distress syndrome, anti-inflammatory, antioxidant, ascorbic acid, blood, broccoli, chemokine, coronavirus, coronavirus disease COVID-19, corticosteroid, cortisol, cytokine, cytokine, diarrhea, frequency, Glucocorticoids, hormones, immune response, immune system, inflammation, interstitial, kidney, kidney disease, kidney failure, mortality, nutrition, oxidative stress, pandemic, pneumonia, respiratory, SARS-CoV-2, scurvy , Sepsis, severe acute respiratory disease, severe acute respiratory syndrome, strawberry, stress, syndrome, vegetables, virus, vitamin C
Ramya has a PhD. Pune National Chemical Laboratory (CSIR-NCL) received a PhD in Biotechnology. Her work includes functionalizing nanoparticles with different molecules of biological interest, studying reaction systems and building useful applications.
Dwivedi, Ramya. (2020, October 23). Vitamin C and COVID-19: A review. News medical. Retrieved from https://www.news-medical.net/news/20201023/Vitamin-C-and-COVID-19-A-Review.aspx on November 12, 2020.
Dwivedi, Ramya. "Vitamin C and COVID-19: A Review." News medical. November 12, 2020. .
Dwivedi, Ramya. "Vitamin C and COVID-19: A Review." News medical. https://www.news-medical.net/news/20201023/Vitamin-C-and-COVID-19-A-Review.aspx. (Accessed on November 12, 2020).
Dwivedi, Ramya. 2020. "Vitamin C and COVID-19: A Review." News-Medical, browsed on November 12, 2020, https://www.news-medical.net/news/20201023/Vitamin-C-and-COVID-19-A-Review.aspx.
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