Considering the newest studies relating vitamin D status to CV-19 deaths, and considering the many recent studies regarding the benefits of IV vitamin C for preventing deaths caused by sepsis, I am really struggling to avoid negative vibes towards our governmental and medical authorities for refusing to inform the public of these scientific facts. While we will have to wait months for the studies on IV vitamin C vs CV-19, if they ever even actually do them other than in China and then if we can believe China, in the meantime we do have quite a few studies on IV vitamin C vs sepsis. In Wuhan China, 100% of those with CV who died had sepsis. Scroll down to table 2. 100% of non-survivors had sepsis, only 42% of survivors did. How many lives could have been saved with these alternative approaches as they await the prescript
ion, patented medication or vaccine that we hope will soon show up? Even if it does not live up to the promise of recent studies, if IV vitamin C reduced deaths by even 10% by reversing sepsis, how many thousands would that have saved? What about
combining with high(but safe) blood levels of vitamin D before you even need the IV vitamin C? Could we have also avoided the shut down of the economy and the bankruptcy of many people/companies if these therapies had been pushed, which work the same for plain old flu? It is shameful that information about
this simple, safe, cheap therapy has been withheld from the public. What could be the possible reason?
https://www.thelancet.com/journals/lancet/article/piis0140-6736(20)30566-3/fulltext ( study by Lancet of CV-19 and sepsis in Wuhan )
https://www.ncbi.nlm.nih.gov/pmc/articles/pmc3937164/"Ascorbic acid infusion rapidly and significantly increased plasma ascorbic acid levels.
No adverse safety events were observed in ascorbic acid-infused patients. Patients receiving ascorbic acid exhibited prompt reductions in SOFA scores while placebo patients exhibited no such reduction. Ascorbic acid significantly reduced the proinflammatory biomarkers C-reactive protein and procalcitonin. Unlike placebo patients, thrombomodulin in ascorbic acid infused patients exhibited no significant rise, suggesting attenuation of vascular endothelial injury.
Conclusions
Intravenous ascorbic acid infusion was safe and well tolerated in this study and may positively impact the extent of multiple organ failure and biomarkers of inflammation and endothelial injury...................
( BB adds: SOFA = sepsis )
SOFA scores at enrollment were: Placebo – 13.3 ± 2.9, Lo-AscA – 10.1 ± 2.0, and Hi-AscA 10.8 ± 4.4 and were not significantly different across groups. The components of the SOFA score are listed in Additional file 3: Table S2. Following normalization of the daily SOFA scores, patients treated with either dose of ascorbic acid exhibited descending SOFA scores over the 4-day study period (p < 0.05, slopes significantly non-zero). High dose ascorbic acid patients exhibited significantly faster declines in the regression slopes of delta daily total SOFA scores over time compared to placebo (-0.043 vs. 0.003, p < 0.01) (Figure 2). Placebo patients exhibited a gradual rise in SOFA scores. Though the cohort size is limited, these data suggest that ascorbic acid infusion significantly attenuates the systemic organ injury associated with sepsis.....................................
No patient in the low or high dose ascorbic acid treatment arms of this study suffered any identifiable adverse event....................................
SOFA scores are robust indicators of mortality during critical illness. SOFA score increases during the first 48 hours of ICU care predict a mortality rate of at least 50% [26]. In this study, the extent of organ failure accompanying patients with severe sepsis was high with an average SOFA score for all patients equal to 11.4 ± 3 confirming that multiple organ failure was present at enrollment. Given that the mean plasma ascorbic acid levels on admission were subnormal (17.9 ± 2.4 μM), a mean initial SOFA score of 11.4 ± 3 in patients with severe sepsis was not surprising. This study is in agreement with other studies which show that plasma ascorbic acid levels in severe sepsis correlate inversely with the incidence of multiple organ failure [13].
We showed that the addition of ascorbic acid to standard of care practice (i.e., fluid resuscitation, antibiotics, vasopressor medication) for patients with severe sepsis significantly reduced organ injury. Ascorbic acid treated patients exhibited prompt and sustained reductions in SOFA scores during the 4-day treatment regimen unlike placebo controls where SOFA scores slowly increased over time. SOFA score reduction was most remarkable in patients receiving the high dose ascorbic acid infusion (Figure 2)." https://www.ncbi.nlm.nih.gov/pmc/articles/pmc7070236/"The Emerging Role of Vitamin C as a Treatment for Sepsis
Markos G. Kashiouris,1,* Michael L’Heureux,1 Casey A. Cable,1 Bernard J. Fisher,1 Stefan W. Leichtle,2 and Alpha A. Fowler1
Author information Article notes Copyright and License information Disclaimer
1Department of Internal Medicine, Division of Pulmonary Disease and Critical Care Medicine, Virginia Commonwealth University School of Medicine, 1200 E Broad St., P.O. Box 980050, Richmond, VA 23298, USA; ..............................
Abstract
Sepsis, a life-threatening organ dysfunction due to a dysregulated host response to infection, is a leading cause of morbidity and mortality worldwide. Decades of research have failed to identify any specific therapeutic targets outside of antibiotics, infectious source elimination, and supportive care. More recently, vitamin C has emerged as a potential therapeutic agent to treat sepsis. Vitamin C has been shown to be deficient in septic patients and the administration of high dose intravenous as opposed to oral vitamin C leads to markedly improved and elevated serum levels. Its physiologic role in sepsis includes attenuating oxidative stress and inflammation, improving vasopressor synthesis, enhancing immune cell function, improving endovascular function, and epigenetic immunologic modifications. Multiple clinical trials have demonstrated the safety of vitamin C and two recent studies have shown promising data on mortality improvement. Currently, larger randomized controlled studies are underway to validate these findings.
With further study, vitamin C may become standard of care for the treatment of sepsis, but given its safety profile, current treatment can be justified with compassionate use.......... .......................................................................................................................................................................
2.3. Vitamin C’s Mechanism of Action in Sepsis and ARDS
Subnormal plasma vitamin C concentrations are common in critically ill patients and, in particular, patients with sepsis [26,27,32,113]. Furthermore, lower vitamin C levels correlate with higher incidence of organ failure and worse outcomes in septic patients [93]. In fact, very low plasma vitamin C levels, averaging around 18 uM, are a predictable feature in severely septic patients [114]. This is caused by the explosive cytokine release present in sepsis, which interferes with the cellular regulation of vitamin C absorption. ..........................................
3. Clinical Trials
The initial data on the clinical use of vitamin C was obtained in animal models. Subsequently, several completed clinical trials contributed evidence for the therapeutic effects of HDIVC in human sepsis. The first study, published in 1986, treated 16 ARDS patients with intravenous vitamin C (1000 mg IV every 6 h) plus antioxidants (N-acetylcysteine, selenium, and vitamin E) versus 16 ARDS patients who received the standard care at that time (i.e., control group) [130].
There was a dramatic reduction in mortality in the vitamin C group —37% versus 71% in the standard care group (p < 0.01) [130]. A phase I trial in 2014 [114] proved that plasma vitamin C levels in patients with severe sepsis were low, almost at scorbutic levels, and that HDIVC administration had a dose-dependent effect in the prevention of multi-organ failure, as measured by the Sequential Organ Failure Assessment (SOFA) scores [131].
Patients who received a total of 200 mg/kg/day of HDIVC for 4 days (administered in 50 mg/kg/dose, every 6 h), had significantly lower SOFA scores than placebo, and even lower scores than the patients who received lower-doses of IV vitamin C (50 mg/kg/day administered at 12.5 mg/kg/dose, every 6 h for 4 days). In this trial, the patients in the HDIVC group (200 mg/kg/day) achieved plasma levels of up to 3000 uM at day 4. The patients receiving HDIVC also demonstrated statistically lower inflammatory biomarker levels (C-Reactive protein and procalcitonin) and lower thrombomodulin levels, which is a marker of endothelial injury [114].
In 2016, a retrospective before–after study of 94 patients with severe sepsis and septic shock [132] compared patients who received hydrocortisone (50 mg IV every 6 h for 7 days or until ICU discharge), thiamine (200 mg IV every 12 h for 4 days or until ICU discharge) and HDIVC (6000 mg/day, in 4 divided doses for 4 days or until ICU discharge) to control. This study showed a 31.9% decrease in absolute hospital mortality between cases who received the triple-therapy and controls (8.5% vs. 40.4% respectively). A small randomized controlled trial, performed around the same time, of 28 patients with septic shock who received moderate doses of IV vitamin C (25 mg/kg every 6 h for 3 days) showed
significantly lower mortality in patients who received IV vitamin C—14.3% vs. 64.3% [117]. The same trial found a significant reduction in average norepinephrine doses, total norepinephrine doses and total duration of norepinephrine infusion [117].
A subsequent meta-analysis of the three above studies found a significant benefit of intravenous vitamin C, with “marked reduction” in mortality and duration of vasopressor administration [133]. The largest trial completed on vitamin C to date, the CITRIS-ALI trial, was published in 2019 [134]. This multicenter, randomized, double-blinded trial included 167 patients with sepsis and ARDS who were randomized
to receive 50 mg/kg every 6 h of HDIVC for 4 days versus placebo and showed statistically significant difference in 28-day all-cause mortality. The 28-day mortality was 29.8% in the vitamin C group versus 46.3% in the placebo group , although this was a secondary outcome. The statistical effect on mortality remained for up to 60 days following trial completion.
The most dramatic reduction in mortality was noted during the period of HDIVC infusion (Figure 5). Furthermore, the HDIVC group had a strong trend towards more ventilator-free days (13.1 in the HDIVC group vs 10.6 in the placebo group mean difference, 2.47, 95% CI −0.90–5.85, p = 0.15), ICU-free days to day 28 (10.7 in HDIVC group vs. 7.7, in the placebo group, p = 0.03), and more hospital-free days (22.6 in HDIVC group vs. 15.5, respectively, p = 0.04). This trial did not find significant reductions in the SOFA scores, C-reactive protein, thrombomodulin or procalcitonin. Those biomarkers and scores, however, were not measured among the patients who “graduated” early from the ICU (a group that was heavily shifted towards the HDIVC group) or in those patients who died (heavily shifted towards the placebo group), indicating a strong selection bias, which makes these results difficult to interpret...................."
Since it is safe and cheap, what the heck are they waiting for? Just give it! Maybe it will help, but if not, no huge loss. If future studies are the least bit like the previous ones, the failure of medicine and government to publicize this ( and other supplements like D and zinc) has already resulted in thousands of deaths. Not to forget the financial wrecking of many families. Disgusting.
Post Edited (BillyBob@388) : 5/9/2020 9:41:22 AM (GMT-6)