The use of mono-intravenous (IV) vitamin C therapy in patients with sepsis may help to reduce short-term mortality rates and protect organ functions. This was among the results of a systematic review and meta-analysis based on randomized controlled trials (RCTs) recently published in the American Journal of Emergency Medicine.

The researchers conducted a systematic review of the efficacy of IV vitamin C supplementation for the treatment of sepsis, doing a comprehensive search of online databases for literature published between January 2000 and March 2021.

A total of 10 RCTs with 1400 patients were included in the final analysis. The primary outcomes of the selected studies were short-term (28- to 30-day) and long-term (90-day) mortality. Secondary outcomes included change in Sequential Organ Failure Assessment (SOFA) score within 72 hour after initial enrollment, ventilator-free days, and hospital and intensive care unit (ICU) length of stay (LOS).


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The overall meta-analysis showed that vitamin C supplementation did significantly improve SOFA scores in patients with sepsis within 72 hours (risk ratio [RR], 1.32; 95% CI, 0.80 to 1.85; P < .0001). The overall analysis also showed no significant differences in short-term mortality (RR, 0.83; 95% CI, 0.65 to 1.05; P =.11), long-term mortality (RR, 1.16; 95% CI, 0.82 to 1.66; P =.40), hospital LOS (RR, 0.15; 95% CI, –0.73 to 1.03; P =.55), ventilator-free days (RR, 0.09; 95% CI, –0.24 to 0.42; P =.60), and ICU LOS (RR, 0.22; 95% CI, –0.13 to 0.57; P =.22) between the vitamin C supplementation arm and the control arm.

However, subgroup results indicated that the use of IV vitamin C alone (ie, not combined with steroids or other antioxidant) did reduce the risk of short-term mortality among individuals with sepsis (RR, 0.61; 95% CI, 0.47 to 0.79; P =.0002).

The researchers concluded that mono-intravenous vitamin C therapy may reduce short term mortality of sepsis patients, as well as protect organ functions. However, investigators added, because of the limitation of the quantity and quality of the studies included in the current meta-analysis, the findings of this analysis warrant verification in additional large-scale, high-quality RCTs.

Disclosure: None of the study authors have declared affiliations with biotech, pharmaceutical, and/or device companies.

Reference

Li T, Zeng J, Li DH, et al.  Efficacy of intravenous vitamin C intervention for septic patients: a systematic review and meta-analysis based on randomized controlled trials. Am J Emerg Med. Published online August 12, 2021. doi: 10.1016/j.ajem.2021.08.012