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Accès ouvert déclaré 2023 article

Intravenous Vitamin C for Patients Hospitalized With COVID-19

51Citations signalées — pas une note de qualité
73Institutions déclarées
20Pays d’affiliation déclarés

Résumé fourni par la source

Importance: The efficacy of vitamin C for hospitalized patients with COVID-19 is uncertain. Objective: To determine whether vitamin C improves outcomes for patients with COVID-19. Design, Setting, and Participants: Two prospectively harmonized randomized clinical trials enrolled critically ill patients receiving organ support in intensive care units (90 sites) and patients who were not critically ill (40 sites) between July 23, 2020, and July 15, 2022, on 4 continents. Interventions: Patients were randomized to receive vitamin C administered intravenously or control (placebo or no vitamin C) every 6 hours for 96 hours (maximum of 16 doses). Main Outcomes and Measures: The primary outcome was a composite of organ support-free days defined as days alive and free of respiratory and cardiovascular organ support in the intensive care unit up to day 21 and survival to hospital discharge. Values ranged from -1 organ support-free days for patients experiencing in-hospital death to 22 organ support-free days for those who survived without needing organ support. The primary analysis used a bayesian cumulative logistic model. An odds ratio (OR) greater than 1 represented efficacy (improved survival, more organ support-free days, or both), an OR less than 1 represented harm, and an OR less than 1.2 represented futility. Results: Enrollment was terminated after statistical triggers for harm and futility were met. The trials had primary outcome data for 1568 critically ill patients (1037 in the vitamin C group and 531 in the control group; median age, 60 years [IQR, 50-70 years]; 35.9% were female) and 1022 patients who were not critically ill (456 in the vitamin C group and 566 in the control group; median age, 62 years [IQR, 51-72 years]; 39.6% were female). Among critically ill patients, the median number of organ support-free days was 7 (IQR, -1 to 17 days) for the vitamin C group vs 10 (IQR, -1 to 17 days) for the control group (adjusted proportional OR, 0.88 [95% credible interval {CrI}, 0.73 to 1.06]) and the posterior probabilities were 8.6% (efficacy), 91.4% (harm), and 99.9% (futility). Among patients who were not critically ill, the median number of organ support-free days was 22 (IQR, 18 to 22 days) for the vitamin C group vs 22 (IQR, 21 to 22 days) for the control group (adjusted proportional OR, 0.80 [95% CrI, 0.60 to 1.01]) and the posterior probabilities were 2.9% (efficacy), 97.1% (harm), and greater than 99.9% (futility). Among critically ill patients, survival to hospital discharge was 61.9% (642/1037) for the vitamin C group vs 64.6% (343/531) for the control group (adjusted OR, 0.92 [95% CrI, 0.73 to 1.17]) and the posterior probability was 24.0% for efficacy. Among patients who were not critically ill, survival to hospital discharge was 85.1% (388/456) for the vitamin C group vs 86.6% (490/566) for the control group (adjusted OR, 0.86 [95% CrI, 0.61 to 1.17]) and the posterior probability was 17.8% for efficacy. Conclusions and Relevance: In hospitalized patients with COVID-19, vitamin C had low probability of improving the primary composite outcome of organ support-free days and hospital survival. Trial Registration: ClinicalTrials.gov Identifiers: NCT04401150 (LOVIT-COVID) and NCT02735707 (REMAP-CAP).

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Contrôle bibliographique ouvert

DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.

Titre Crossref
Intravenous Vitamin C for Patients Hospitalized With COVID-19
Date Crossref
14/11/2023
Éditeur
American Medical Association (AMA)
Type
journal-article

Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude et ne compte pas comme une seconde source scientifique indépendante.

Institutions déclarées

University of PittsburghNational Institute of Cardiovascular DiseasesRadboud University NijmegenRadboud University Medical CenterZiauddin UniversitySunnybrook Health Science CentreUniversity of TorontoHealth Sciences CentreUniversité de Versailles Saint-Quentin-en-YvelinesHôpital Raymond-PoincaréCentre Hospitalier Universitaire de SherbrookeBishop's UniversityImpactSt. Joseph’s Healthcare HamiltonMcMaster UniversityQueen's UniversityKingston Health Sciences CentreOttawa HospitalOttawa Hospital Research InstituteApollo HospitalsGeorge Institute for Global HealthUniversité de SherbrookeAuckland City HospitalAustralian and New Zealand Intensive Care SocietyMedical Research Institute of New ZealandMonash UniversityUniversity of AucklandImperial College LondonUniversity of Pittsburgh Medical CenterKing Saud bin Abdulaziz University for Health SciencesKing Abdullah International Medical Research CenterMahidol Oxford Tropical Medicine Research UnitCentre for Inflammation ResearchUniversity of EdinburghBerry & Associates (United States)St. Michael's HospitalUnity Health TorontoUniversity Medical Center UtrechtUniversity of BristolJena University HospitalAlfred HealthHumanitas UniversityIRCCS Humanitas Research HospitalMonash HealthNational University of SingaporeUniversity of AntwerpImperial College Healthcare NHS TrustSt. Mary’s HospitalJikei University School of MedicineUniversity Health NetworkMcGill University Health CentreQueen's University BelfastRoyal Victoria Eye and Ear HospitalIntensive Care National Audit & Research CentreUniversity of British ColumbiaUniversity College DublinUniversidad de La SabanaYokohama City Seibu HospitalNHS LothianEdinburgh Royal InfirmaryMRC Centre for Regenerative MedicineUniversité LavalSt John of God HospitalUniversity of ManitobaNational Hospital of Sri LankaDr. Kamakshi Memorial HospitalThe University of Western AustraliaFiona Stanley HospitalSir Charles Gairdner HospitalAmsterdam University Medical CentersThe Alfred HospitalNHS Blood and TransplantUniversity of Oxford

Une affiliation ne permet pas de déduire la nationalité d’un auteur.

Sujets associés

Vitamin C and Antioxidants ResearchAntioxidant Activity and Oxidative StressCOVID-19 Clinical Research Studies

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