Vitamin C cuts COVID deaths by two thirds

The world’s first randomised placebo controlled trial, using high dose intravenous vitamin C has reduced mortality in the most critically ill COVID-19 patients by two thirds. The study, currently going through peer-review, will shortly be published in the journal Pulmonology. Headed by Professor Zhiyong Peng at Wuhan’s Zhongnan University Hospital, the trial started in February and gave every other critically ill covid patient on ventilators either 12 grams of vitamin C twice daily, or sterile water in their drip. Neither the patient nor the doctors knew who was getting vitamin C or placebo so the trial was ‘double blind’. This is the gold standard of research design.

Overall, 5 out of 26 people (19%) died in the vitamin C group, while 10 out of 28 (36%) receiving the placebo died. That means that vitamin C almost halved deaths. Those on vitamin C were 60% more likely to survive. These results did not reach statistical significance due to the small numbers of people involved, however, the results were even striking, and statistically significant, in the most critically ill.

The key measure of the severity of symptoms is called the SOFA oxygenation index. Those with a SOFA score greater than 3 are the most critically ill at greatest risk of dying. Of those most critically ill 4 people (18%) in the vitamin C group died compared to 10 (50%) in the placebo group. That’s two thirds less deaths. Statistically this meant that those most critically ill who were given vitamin C were 68% less likely to die – in other words treating with vitamin C meant two thirds less deaths. This is shown below as the Hazard Ratio (HR) of 0.32, meaning that those taking vitamin C had reduced their risk of mortality to a third of those taking the placebo. This is a massive reduction, and a statistically significant effect. You can also see that, with each measure taken at 5 day intervals, those given vitamin C (HDIVC means High Dose Intravenous Vitamin C) had a fraction of the risk of dying versus the group given the placebo. The obvious trend towards improvement, albeit on the edge of statistical signifcance due to the small number, means a larger trial is clearly warranted. In the placebo group 50% died. compared to 18% in the vitamin C group.

Vit C graph

This result was backed up with a clear and substantial reduction in inflammation with IL-6, an inflammatory marker in the blood, being only 19pg/ml in the patients on vitamin C versus 158pg/ml in the placebo group, coupled with an improved oxygenation in the vitamin C group, thus objectively establishing the potent effect of the vitamin C treatment in dampening down the dangerous level of inflammation. IL-6 above 80 is associated with a high risk of respiratory failure, indicated by crashing oxygenation.  David Smith, Emeritus Professor of Pharmacology from the University of Oxford describes these results as ‘promising’ “It’s a small trial which shows improvements in oxygen status and a decrease in a key inflammatory marker (IL-6) in those treated with intravenous vitamin C, with a trend to a reduction in mortality that needs confirming in larger studies.” This level of benefit is much greater than the benefit seen in the randomised controlled trial on dexamethasone, the anti-inflammatory steroid drug that hit the headlines as the ‘only proven treatment’ for covid. Now there is another contender. In the steroid drug trial 23% of patients on the steroid drug died compared to 26% on placebo. However, there were over 6,000 people in the trial so the results were statistically significant.

The Wuhan trial needed 140 patients to be sufficiently ‘powered’ for the statistics but they ran out of covid cases during March, a month after 50 tons of vitamin C, which is 50 million one gram doses, was shipped into Wuhan and given to all hospitalised patients and also hospital workers. New admissions into Intensive Care Units plummeted. Professor Peng ran out of patients for his trial, ending up with a third as many as the trial was designed to include. So the overall result, showing almost half as many deaths, didn’t achieve statistical significance. (This is a bit like tossing a coin ten times and getting 3 heads and 7 tails, or a hundred times and getting 30 heads and 70 tails. Getting 3 heads versus 7 tails could be chance but when you get 30 versus 70 something significant is going on.) However, the fact that the sub-group of the most critically ill had such a big reduction in death meant that, even with these small numbers, the results were on the edge of significance, showing a clear trend to benefit..

we need more clinical trials on vitamin C for covid

If any drug had produced this kind of effect in a pilot trial it would be immediately rolled out into a large-scale, multi-centred trial, the cost of which would be in excess of $10 million. This is kind of happening. There is an international multi-centred trial planned namely the vitamin C ‘arm’ of the international REMAP-CAP study. Patients will be given 50mg of vitamin C per kg every six hours. So a 75kg man will receive 3,750mg. So that’s 15g a day – a bit less than the Wuhan trial, giving 24g but still substantial. The Royal Surrey ICU in Guildford is signed up to this. But I have two concerns. Firstly, according to the design vitamin C is to be given for 16 doses only, in other words 4 days, then stopped. This is, potentially, extremely dangerous as a patient who is in the throws of a cytokine storm must be kept on vitamin C, and other life-saving medication, until they are out of the woods. One can even get a ‘rebound’ effect if vitamin C is suddenly stopped, yet the body’s demands are still high which has happened in sepsis trials when vitamin C is given for only up to 4 days. This is either an innocent fault in the design or the trial is designed to fail. The main measure is mortality after 28 days. The Wuhan trial gave vitamin C for 7 days – almost twice as long.

These results are especially important when case reports in American ICUs using 12 grams of vitamin C show almost no deaths in anyone without a pre-existing end stage disease already and also over 85, and a UK ICU using a 2 grams of vitamin C have reported 25% less mortality than the average for ICUs in the UK.

The best results are being reported in ICUs using vitamin C, steroids and anti-coagulant drugs combined, which has been standard treatment protocol in China since April. China’s mortality rate from covid is 3 per million compared to the UK’s 624 per million, according to Worldometer data. This is a massive difference which UK authorities need to take heed of.

ICUs are reporting scurvy levels of vitamin C in their non-survivors

On top of this reports are coming in from ICUs who are testing vitamin C levels in the blood of their patients. The majority of their critically ill patients are vitamin C deficient, many with undetectable levels of vitamin C that would diagnose scurvy. One ICU in Barcelona found 17 out of 18 patients had ‘undetectable’ vitamin C levels, akin to  those found in scurvy.

Another ICU in the US, found almost all their patients were vitamin C deficient but those who didn’t survive had much lower levels than those who did. Half had deficient levels below 11nmol/l – as seen in scurvy. We can say that this is a disease-induced scurvy.

Scurvy killed two million sailors around the world between 1500 and 1800. In 1747 James Lind worked out the cure – vitamin C in limes, but it took fifty years before the Navy took it seriously. So dramatic was the life-saving effect that sailors became known as ‘limeys’.

Will the same thing happen with Covid-19? With over a million deaths worldwide and the potential of vitamin C to more than halve the death toll, every day our governments, digital ringmasters and doctors fail to take vitamin C seriously is another day of unnecessary deaths due to ignoring the evidence. This is not fake news.

 It’s not the coronavirus that kills people with covid

It’s not the coronavirus that kills people with covid – it’s the immune system over-reacting against dead virus particles usually, once the viral infection is over, triggering a ‘cytokine storm’ which is like an inflammatory fire out of control. That’s when very high doses of both steroids and vitamin C are needed. Normally, the adrenal glands, which have a hundred times more vitamin C in them than any other organ, release both the body’s most powerful steroid hormone, cortisol, as well as vitamin C, when in a state of emergency. The steroid helps the vitamin C get inside cells and calm down the fire – vitamin C is both anti-inflammatory and antioxidant, mopping up the ‘oxidant’ fumes of the cytokine storm. Without vitamin C the steroid hormone cortisol can’t work so well. That’s why you need both extra vitamin C and steroids to get a patient out of the danger zone.

Our government should tell us to supplement

But even better is to prevent a person ever getting into this critical phase of covid-19. That’s why early intervention, taking 1 gram of vitamin C an hour upon first signs of infection, is likely to save even more lives. This reduces duration and severity of symptoms with most people becoming symptom-free within 24 hours. It takes, on average, two weeks of being sick with covid-19 to trigger the ‘cytokine storm’ phase. If you can beat the infection within 48 hours you’ll be out of the woods. Prevention is better than cure.

Those most at risk start with very low levels of vitamin C and D. The Swiss Nutrition Society, which advises the Government ,recognise this and are recommending all citizens supplement vitamin C and D to ‘strengthen the immune system’. They recommend all take supplements of 200mg of vitamin C and 2,000iu of vitamin D ‘because this dose has demonstrated to reduce risk of respiratory tract infections.’ The vitamin C dose is too low but it does guarantee no-one will succumb to infection in a state of vitamin C deficiency. which can only make outcomes worse This expert report, produced for the Swiss government by the Swiss Society of Nutrition, came out earlier this week.

Pauling put the C in Colds – who will put the C in Covid?

Much like Lind’s limes twice NobelPrize winner Dr Linus Pauling, Patron of the Institute for Optimum Nutrition which I founded in 1984, largely inspired by his research into nutrition as medicine, proved the power of high dose vitamin C in the 1970’s. It is thanks to him we know about the benefits of high dose vitamin C. The cover of his landmark book ‘Vitamin C and the Common Cold’ has a statement that reads, in relation to a predicted swine flu epidemic at that time “it is especially important that everyone know that he can protect himself to a considerable extent against the disease, and its consequences, with this important nutrient, vitamin C.” It’s been 50 years since Pauling proved the anti-viral power of vitamin C. Isn’t it time we took this seriously?

Patrick Holford, a student of Linus Pauling, is author of Flu Fighters – see www. for more details.