Information provided by (Responsible Party):
ZhiYong Peng, Zhongnan Hospital
Brief Summary:
2019 new coronavirus (2019-nCoV) infected pneumonia, namely severe acute respiratory infection (SARI) has caused global concern and emergency. There is a lack of effective targeted antiviral drugs, and symptomatic supportive treatment is still the current main treatment for SARI.
Vitamin C is significant to human body and plays a role in reducing inflammatory response and preventing common cold. In addition, a few studies have shown that vitamin C deficiency is related to the increased risk and severity of influenza infections.
We hypothesize that Vitamin C infusion can help improve the prognosis of patients with SARI. Therefore, it is necessary to study the clinical efficacy and safety of vitamin C for the clinical management of SARI through randomized controlled trials during the current epidemic of SARI.
Vitamin C, also known as ascorbic acid, has antioxidant properties. When sepsis happens, the cytokine surge caused by sepsis is activated, and neutrophils in the lungs accumulate in the lungs, destroying alveolar capillaries. Early clinical studies have shown that vitamin C can effectively prevent this process. In addition, vitamin C can help to eliminate alveolar fluid by preventing the activation and accumulation of neutrophils, and reducing alveolar epithelial water channel damage.
At the same time, vitamin C can prevent the formation of neutrophil extracellular traps, which is a biological event of vascular injury caused by neutrophil activation. Vitamins can effectively shorten the duration of the common cold. In extreme conditions (athletes, skiers, art workers, military exercises), it can effectively prevent the common cold.
And whether vitamin C also has a certain protective effect on influenza patients, only few studies have shown that vitamin C deficiency is related to the increased risk and severity of influenza infections. In a controlled but non-randomized trial, 85% of the 252 students treated experienced a reduction in symptoms in the high-dose vitamin C group (1g / h at the beginning of symptoms for 6h, followed by 3 * 1g / day).
Management regimens helpful in severe COVID-19 pneumonia
Most of these patients with severe pneumonia will be having acute hypoxemic respiratory failure with or without other associated complications (as part of cytokine storm), and will need oxygen with or without ventilatory support.
These treatments have shown promise in such cases:
1. Dexamethasone: 6 mg iv or orally once daily for 10 days or until hospital discharge (1).
2. Remdesivir but more patients discontinued this treatment than placebo (2-3)
3. IL-6 Inhibitors e.g. Tocilizumab for cytokine release syndrome (4), increases fungal infections.
4. Convalescent plasma therapy or SARS-CoV-2 immunoglobulin therapy has variable success (5)
1.Article Dexamethasone in Hospitalized Patients with Covid-19 — Preli...
2. Article Remdesivir for the Treatment of Covid-19 — Preliminary Report
also see final report at NEJM website
3. Preprint Remdesivir in treatment of COVID-19: A systematic benefit-ri...
4. Article Can tocilizumab calm the cytokine storm of COVID-19?
5. Article Immunoglobulins or convalescent plasma to tackle COVID-19: b...
Please see the links below.
https://academic.oup.com/abt/article/3/2/115/5847675
https://www.pnas.org/content/117/17/9490
https://jamanetwork.com/journals/jama/fullarticle/2763983
Also go through the following RG links.
Article Pharmacological treatments of COVID-19
Article Ivermectin: potential candidate for the treatment of Covid 19
Article Tocilizumab for the Treatment of Severe COVID‐19
Article A Case of Successful Treatment of Severe COVID-19 Pneumonia ...
Article Favipiravir
Article Severe coronavirus disease 2019 (COVID‐19) pneumonia patient...
Article White paper on Ivermectin as a potential therapy for COVID-19
2019 new coronavirus (2019-nCoV) infected pneumonia, namely severe acute respiratory infection (SARI) has caused global concern and emergency. There is a lack of effective targeted antiviral drugs, and symptomatic supportive treatment is still the current main treatment for SARI.
Vitamin C is significant to human body and plays a role in reducing inflammatory response and preventing common cold. In addtion, a few studies have shown that vitamin C deficiency is related to the increased risk and severity of influenza infections.
We hypothize that Vitamin C infusion can help improve the prognosis of patients with SARI. Therefore, it is necessary to study the clinical efficacy and safety of vitamin C for the clinical management of SARI through randomized controlled trials during the current epidemic of SARI.
Condition or disease Intervention/treatment Phase Vitamin CPneumonia, ViralPneumonia, Ventilator-AssociatedDrug: VCDrug: Sterile Water for InjectionPhase 2 Detailed Description:
At the end of 2019, patients with unexplained pneumonia appeared in Wuhan, China. At 21:00 on January 7, 2020, a new coronavirus was detected in the laboratory, and the detection of pathogenic nucleic acids was completed at 20:00 on January 10. Subsequently, the World Health Organization officially named the new coronavirus that caused the pneumonia epidemic in Wuhan as 2019 new coronavirus (2019-nCoV), and the pneumonia was named severe acute respiratory infection (SARI). Up to February 4, 2020, over 20000 cases have been diagnosed in China, 406 of which have died, and 154 cases have been discovered in other countries around the world. Most of the deaths were elderly patients or patients with severe underlying diseases. SARI has caused global concern and emergency.
Statistics of the 41 patients with SARI published in JAMA initially showed that 13 patients were transferred into the ICU, of which 11 (85%) had ARDS and 3 (23%) had shock. Of these, 10 (77%) required mechanical ventilation support, and 2 (15%) required ECMO support. Of the above 13 patients, 5 (38%) eventually died and 7 (38%) were transferred out of the ICU. Viral pneumonia is a dangerous condition with a poor clinical prognosis. For most viral infections, there is a lack of effective targeted antiviral drugs, and symptomatic supportive treatment is still the current main treatment.
Vitamin C, also known as ascorbic acid, has antioxidant properties. When sepsis happens, the cytokine surge caused by sepsis is activated, and neutrophils in the lungs accumulate in the lungs, destroying alveolar capillaries. Early clinical studies have shown that vitamin C can effectively prevent this process. In addition, vitamin C can help to eliminate alveolar fluid by preventing the activation and accumulation of neutrophils, and reducing alveolar epithelial water channel damage. At the same time, vitamin C can prevent the formation of neutrophil extracellular traps, which is a biological event of vascular injury caused by neutrophil activation. Vitamins can effectively shorten the duration of the common cold. In extreme conditions (athletes, skiers, art workers, military exercises), it can effectively prevent the common cold. And whether vitamin C also has a certain protective effect on influenza patients, only few studies have shown that vitamin C deficiency is related to the increased risk and severity of influenza infections. In a controlled but non-randomized trial, 85% of the 252 students treated experienced a reduction in symptoms in the high-dose vitamin C group (1g / h at the beginning of symptoms for 6h, followed by 3 * 1g / day). Among patients with sepsis and ARDS, patients in the high-dose vitamin group did not show a better prognosis and other clinical outcomes. There are still some confounding factors in the existing research, and the conclusions are different.
Therefore, during the current epidemic of SARI, it is necessary to study the clinical efficacy and safety of vitamin C for viral pneumonia through randomized controlled trials.
Please also take a look at the following RG links.
Article Molnupiravir—A novel oral anti-SARS-CoV-2 agent
Preprint Molnupiravir, an Oral Antiviral Treatment for COVID-19
Also visit the following useful links.
https://www.bmj.com/content/375/bmj.n2713
https://www.nytimes.com/2021/11/16/business/pfizer-covid-pill-paxlovid-unvaccinated.html
Dear Dr Dennis Evans . For most viral infections, there is a lack of effective targeted antiviral drugs, and symptomatic supportive treatment is still the current main treatment. Vitamin C Infusion for the Treatment of Severe 2019-nCoV Infected Pneumonia. See the link: https://clinicaltrials.gov/ct2/show/NCT04264533
See the following RG link: Article Successful recovery from COVID-19 pneumonia after receiving ...
See the following link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7137406/
See also the following link: https://www.webmd.com/lung/covid-and-pneumonia
Also the following RG link: Article Therapeutic strategy for severe COVID-19 pneumonia from clin...
Kindly see also the following link: https://nimr.gov.ng/nimr/wp-content/uploads/2020/02/Novel-Coronavirus-Pneumonia-diagnosis-and-treatment-protocol@.pdf
Scholarly articles for treatment of severe 2019 n cov infected pneumonia
… therapy for severe 2019-nCoV pneumonia - Zhou - Cited by 233
… the use of corticosteroids for 2019-nCoV pneumonia - Shang - Cited by 582
… novel coronavirus (2019-nCoV) infected pneumonia ( … - Jin - Cited by 2033,kindly check this link.
Scholarly articles for treatment of severe 2019 n cov infected pneumonia
… therapy for severe 2019-nCoV pneumonia - Zhou - Cited by 233
… the use of corticosteroids for 2019-nCoV pneumonia - Shang - Cited by 582
… novel coronavirus (2019-nCoV) infected pneumonia ( … - Jin - Cited by 2033,kindly check this link for the most effective treatment for pneumonia
https://clinicaltrials.gov/ct2/show/NCT04264533,also this link may be useful for the treatment of pneumonia.