Therapeutic potential of megadose vitamin C to reverse organ dysfunction in sepsis and COVID-19

Abstract

Sepsis induced by bacteria or viruses can result in multiorgan dysfunction, which is a major cause of death in intensive care units. Current treatments are only supportive, and there are no treatments that reverse the pathophysiological effects of sepsis. Vitamin C has antioxidant, anti-inflammatory, anticoagulant and immune modulatory actions, so it is a rational treatment for sepsis. Here, we summarise data that support the use of megadose vitamin C as a treatment for sepsis and COVID-19. Megadose intravenous sodium ascorbate (150 g per 40 kg over 7 h) dramatically improved the clinical state and cardiovascular, pulmonary, hepatic and renal function and decreased body temperature, in a clinically relevant ovine model of Gram-negative bacteria-induced sepsis. In a critically ill COVID-19 patient, intravenous sodium ascorbate (60 g) restored arterial pressure, improved renal function and increased arterial blood oxygen levels. These findings suggest that megadose vitamin C should be trialled as a treatment for sepsis and COVID-19.

Keywords: COVID-19; acute kidney injury; hypotension; hypoxia; inflammation; oxidative stress; sepsis; sodium ascorbate; vitamin C.

FIGURE 1

Overview of the systemic and organ specific effects of ovine sepsis, the effects of treatment we have observed with intravenous megadose vitamin C and the possible mechanisms of action that require investigation