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Vitamin C as prophylaxis and adjunctive medical treatment for COVID-19?

ABSTRACT: Severe acute respiratory syndrome coronavirus 2 causes the potentially fatal coronavirus disease 2019 (COVID-19). Already during the outbreak of the severe acute respiratory syndrome coronavirus 1, the use of vitamin C was suggested. Many patients with severe COVID-19 have elevated levels of the mediators interleukin-6 and endothelin-1. These mediators may explain the age dependence of COVID-19 pneumonia, the preponderance of male and obese or hypertensive patients, as well as of persons of color and smokers. There is clear evidence that vitamin C in high doses can reduce these mediators. Vitamin C is cheap and safe. Hence, using a relatively low dose of vitamin C as prophylaxis, and in cases of severe COVID-19, an (intravenous) high-dose regimen may be beneficial. Ongoing clinical trials are expected to provide more definitive evidence.

SUBMITTER: Feyaerts AF

PROVIDER: S-EPMC7381407 | biostudies-literature | 2020 Nov - Dec

REPOSITORIES: biostudies-literature

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Vitamin C as prophylaxis and adjunctive medical treatment for COVID-19?

Feyaerts Adam F AF Luyten Walter W

Nutrition (Burbank, Los Angeles County, Calif.) 20200725

Severe acute respiratory syndrome coronavirus 2 causes the potentially fatal coronavirus disease 2019 (COVID-19). Already during the outbreak of the severe acute respiratory syndrome coronavirus 1, the use of vitamin C was suggested. Many patients with severe COVID-19 have elevated levels of the mediators interleukin-6 and endothelin-1. These mediators may explain the age dependence of COVID-19 pneumonia, the preponderance of male and obese or hypertensive patients, as well as of persons of colo ...[more]

PMID: 32911430

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Project description:BackgroundBromhexine hydrochloride has been suggested as a TMPRSS2 protease blocker that precludes the penetration of SARS-CoV-2 into cells. We aimed to assess the preventive potential of regular bromhexine hydrochloride intake for COVID-19 risk reduction in medical staff actively involved in the evaluation and treatment of patients with confirmed or suspected SARS-CoV-2 infection.MethodsIn a single-centre randomized open-label study, medical staff managing patients with suspected and confirmed COVID-19 were enrolled and followed up for 8 weeks. The study began at the initiation of COVID-19 management in the clinic. The study was prematurely terminated after the enrollment of 50 participants without a history of SARS-CoV-2 infection: 25 were assigned to bromhexine hydrochloride treatment (8 mg 3 times per day), and 25 were controls. The composite primary endpoint was a positive nasopharyngeal swab polymerase chain reaction (PCR) test for SARS-CoV-2 or signs of clinical infection within 28 days and at week 8. Secondary endpoints included time from the first contact with a person with COVID-19 to the appearance of respiratory infection symptoms; the number of days before a first positive SARS-CoV-2 test; the number of asymptomatic participants with a positive nasopharyngeal swab test; the number of symptomatic COVID-19 cases; and adverse events.ResultsThe rate of the combined primary endpoint did not differ significantly between the active treatment group (2/25 [8%]) and control group (7/25 [28%]); P=0.07. A fewer number of participants developed symptomatic COVID-19 in the treatment group compared to controls (0/25 vs. 5/25; P=0.02).ConclusionAlthough the study was underpowered, it showed that Bromhexine hydrochloride prophylaxis was associated with a reduced rate of symptomatic COVID-19. The prophylactic treatment was not associated with a lower combined primary endpoint rate, a positive swab PCR test, or COVID-19 (ClinicalTrials.gov number, NCT04405999).

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Vitamin C as prophylaxis and adjunctive medical treatment for COVID-19?

Publications

Vitamin C as prophylaxis and adjunctive medical treatment for COVID-19?

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