Coronavirus: Researchers Now Exploring high-dose Vitamin C
I thought administering high-dose vitamin C, intravenously for acute respiratory infections was our little trade secret…
Word out of Wuhan is that doctors at the Zhongnan Hospital are now actively exploring the use of intravenous (IV) vitamin C for the treatment of coronavirus (2019-nCoV or COVID-19) infected pneumonia. (1)
While the World Health Organisation (WHO) has yet to declare the respiratory illness known COVID-19 a pandemic, it hasn’t stopped public health offices around the world from sounding their respective alarms. The general population (for the most part) is wondering what all the fuss is about? In most TV shows, really sick patients that go to hospitals are generally cured within the context of the 45-minute serial...fake news right?
Viral pneumonia, for those that aren’t aware doesn’t really have an effective treatment.
Let that sink in for a second.
So picture a hospital filled with quarantined patients suffering from a highly contagious viral pneumonia, and effectively...no treatment to offer them, beyond symptomatic supportive therapy i.e., oxygen therapy, IV fluids etc. (2) Imagine being a doctor or nurse fighting a potential global pandemic, with only a cheap mask, an oxygen tank and bag of saline. This is the basis for the terror that underlies this condition for most doctors.
Consequently, a small tsunami of potential therapies are being studied in hopes of finding an effective treatment, one of which is IV vitamin C therapy.
The researchers at Zhongnan Hospital at Wuhan University have proposed two arms to the study of patients suffering with severe acute respiratory illness (SARI) secondary to coronavirus infection. One group will receive 24 grams or 50 mL of vitamin C in sterile water, administered intravenously over a 7 hour period, while the second group will receive a placebo of a straight saline solution over the same 7 hour period. Patients will receive these IVs daily for 7 days.
The risk with severe, acute respiratory illness is the risk of sepsis, septic shock and death. When sepsis occurs, a group of cell-signalling immune proteins known as cytokines surge. This surge activates other immune cells which results in tissue and organ destruction. This process is also known as a “cytokine storm” and its effects can be lethal. (3)
Early studies have shown that vitamin C can effectively prevent this cytokine storm. Beyond this, it is further postulated by the researchers that vitamin C will help to reduce alveolar fluid and epithelial water channel damage and prevent vascular injury associated with neutrophil activation.
Some of my thoughts on this study.
I’m encouraged to see the use of IV-Vitamin C as a potential treatment. I think the dose of vitamin C they’ve chosen is also likely to be effective. I’m curious as to why they chose to administer the 25 grams over a 7-hour period? When we treat infections and respiratory illnesses, we will typically administer that same dose over a 2-3 hour period in the hopes of properly elevating serum levels of ascorbate. This dose-dependant elevation is part of the rationale behind using ascorbate as an adjunct in cancer treatment and why oral dosing doesn’t work.
I also wish that research design would embrace multiple modality interventions that more closely mimic clinical practice. For example, would intermittent fasting and or targeted diets improve the effects of IV therapies in this population? How about the use of botanical antivirals in addition to the IV vitamin C (similar to what we might see in naturopathic practice)?
For example, we know that in cancer patients, administering an antibiotic such as doxycycline will enhance “the kill” of IV vitamin C on cancer stem cells (4). Wouldn’t it make sense to consider adjunct botanical antivirals with an affinity for respiratory infections such as licorice root (Glycyrrhiza glabra) (5), or mullein (Verbascum thapsus) or even curcumin (Curcuma longa)? (6)
Would these or the use of other antivirals further improve outcomes? It's hard to know.
Nonetheless, I hope all the patients involved in this study in Zhongnan hospital recover, irrespective of which clinical arm they were assigned to.
Closer to home, I think it’s comforting knowing that many communities in Ontario are blessed to have naturopathic doctors providing this type of care to patients in need.