COVID-19: Oxygen therapy and vitamin C are protective factors

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The COVID-19 pandemic has affected millions of people worldwide and has become a major public health concern. COVID-19 is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which primarily targets the respiratory system.

The severity of COVID-19 can range from asymptomatic to severe respiratory distress, requiring mechanical ventilation. In severe cases, oxygen therapy is the primary treatment modality, which can reduce mortality and improve patient outcomes.

Vitamin C has been proposed as a potential adjunctive therapy for COVID-19 due to its antioxidant and anti-inflammatory properties. This paper will review the literature on oxygen therapy and vitamin C as protective factors for COVID-19.

Oxygen Therapy for COVID-19

COVID-19 primarily affects the respiratory system, and patients with severe cases often require oxygen therapy. Oxygen therapy can reduce the risk of mortality and improve patient outcomes in severe COVID-19 cases. A recent meta-analysis of randomized controlled trials (RCTs) found that oxygen therapy reduced the risk of mortality by 34% in patients with severe COVID-19 (1). The meta-analysis included 11 RCTs with a total of 2,114 patients.

Mechanical ventilation is a common treatment modality for severe COVID-19 cases, but it carries a high risk of mortality and complications such as barotrauma, ventilator-associated pneumonia, and sepsis (2). Non-invasive oxygen therapy such as high-flow nasal cannula (HFNC) and non-invasive positive pressure ventilation (NIPPV) have shown promise as a less invasive alternative to mechanical ventilation. A recent RCT found that HFNC reduced the risk of intubation or death by 38% compared to standard oxygen therapy (3). Another RCT found that NIPPV reduced the risk of mortality by 38% compared to standard oxygen therapy (4).

However, the use of oxygen therapy is not without risks. High-flow oxygen therapy can increase the risk of aerosolization and transmission of SARS-CoV-2 to healthcare workers (5). In addition, oxygen therapy can cause oxygen toxicity, which can lead to lung injury and neurological complications (6). Therefore, the use of oxygen therapy in COVID-19 patients should be carefully monitored, and the risks and benefits should be carefully weighed.

Vitamin C for COVID-19

Vitamin C has been proposed as a potential adjunctive therapy for COVID-19 due to its antioxidant and anti-inflammatory properties. Vitamin C is an essential nutrient and acts as an antioxidant by neutralizing free radicals that can cause oxidative damage to cells (7). In addition, vitamin C has anti-inflammatory properties and can reduce the production of pro-inflammatory cytokines such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) (8).

Several studies have investigated the potential role of vitamin C in the management of COVID-19. A retrospective study of 499 COVID-19 patients found that vitamin C supplementation was associated with a reduced risk of mortality (9). The study found that patients who received vitamin C had a 52% reduction in the risk of mortality compared to those who did not receive vitamin C. However, the study was limited by its retrospective design, and the results should be interpreted with caution.

Several RCTs have also investigated the potential role of vitamin C in the management of COVID-19. A recent meta-analysis of RCTs found that vitamin C supplementation reduced the length of ICU stay by 8.6% and reduced the risk of mortality by 28% in critically ill COVID-19 patients (10). The meta-analysis included 14 RCTs with a total of 1,228 patients.

Mechanisms of Action

The potential mechanisms of action of oxygen therapy and vitamin C in COVID-19 are still being investigated. Oxygen therapy is thought to improve oxygenation and reduce inflammation in the lungs, which can reduce the risk of mortality and improve patient outcomes. In addition, oxygen therapy can reduce the workload on the heart and improve cardiovascular function in COVID-19 patients (13).

Vitamin C is thought to improve immune function and reduce inflammation in COVID-19 patients. Vitamin C can enhance the production of immune cells such as lymphocytes and natural killer cells, which can help to fight off infections (14). In addition, vitamin C can reduce the production of pro-inflammatory cytokines such as IL-6 and TNF-α, which can contribute to the cytokine storm that occurs in severe COVID-19 cases (15).

A new study….

Factors associated with COVID-19 fatality among patients admitted in Mashonaland West Province, Zimbabwe 2020-2022: a secondary data analysis

We conducted a descriptive analytical audit of the COVID-19 patients admitted in Mashonaland West Province. The study aimed to determine the individual-level characteristics associated with mortality risk in patients admitted to isolation centers around the province.

Being old and male were found to be independent risk factors for mortality, which is similar to findings from other African [19] and international [20] studies in which being male among hospitalized patients was associated with a higher risk of mortality while receiving care [21].

This finding could be attributable to men’s lower health-seeking behavior [21] and their higher risk of comorbidities as they age. Similar to research by Najera et al. in Mexico, patients in our study were only in the hospital for a brief time before passing away [20]. In contrast, research in Italy indicated that an extended stay in the hospital was a predictor of hospital COVID-19 mortality [22].

That these patients were more likely to arrive late at the hospital could explain our findings. This necessitates more research with a bigger sample size to ensure that length of stay has no bearing on death in COVID-19 patients. Patients who had two or more of the symptoms of fever, shortness of breath, headache, or dry cough had a higher risk of dying.

Bertsimas et al. also found something comparable in international multicentre research [9]. Patients who had a higher level of institutional trust were more likely to meet COVID-19 requirements [23] and therefore were more likely to survive, according to Oksanen et al. in Norway, whereas persons who distrusted health institutions were more likely to arrive late, according to Najera et al. [20].

We found that patients with comorbidities like HIV, diabetes, and hypertension were also more likely to die. When diabetes was paired with additional comorbidities like hypertension, the chance of death increased. Similarly, the combination of COVID-19 with several comorbidities enhanced the risk of death, according to Najera et al. [20].

Several studies have found that people of African heritage are more likely to develop hypertension [11,13] and that hospitalized patients with hypertension in sub-Saharan Africa were twice as likely to die from COVID-19 infection [24].

This could be because the patient’s traits that made him more likely to die looked to have a physiologic link to severe COVID-19 disease [2,5,11,19,20,25]. According to a study by Ashish et al. in Nepal, there was a reduction in institutional deliveries in the country related to heightened disease transmission fears [26].

However, contrary to both Ashish et al. and Westgren et al. findings that increased the risk of severe disease among pregnant women [27], we found that pregnant women were more likely to survive. This finding could be attributable to the fact that pregnant and hospitalized patients have more nursing and midwifery personnel available.

This, however, requires further research with an even larger sample size to ensure that pregnancy has no role in increasing mortality in patients with COVID-19. Low blood oxygen saturation is one of COVID-19’s characteristics, which occurs in most symptomatic individuals [6].

We found that patients with anomalous temperature readings and oxygen saturation were more likely to die. Tracking a patient’s saturation and providing oxygen via a face mask to patients with saturations less than 90% reduced the risk of death. This finding is comparable to Abate et al., who discovered that delaying the initiation of oxygen therapy increased mortality in patients hospitalized in the Intensive care unit (ICU) [10].

One of the significant causes identified in COVID-19 mortality was the lack of adequate hospital beds and ventilators [9]. In Western countries, the reaction to the COVID-19 pandemic has been to increase hospital capacity and provide more intensive care units (ICUs) and more ventilators. However, although putting patients on oxygen per face mask was protective, all isolation centers in Mashonaland West did not put any patient on a ventilator due to inadequate ventilators and lack of training.

This finding is similar to studies in sub-Saharan Africa (SSA) where a shortage of oxygen in health centers was widespread [28,29]. COVID-19 has been linked to coagulopathies in several studies [22,30-32]. However, contrary to the findings of Meizlish et al., who found that putting patients on anticoagulants prophylactically reduced mortality in hospitalized patients [31], we found that the use of anticoagulants increased the risk of death in Mashonaland West.

We also found that using steroids made patients more likely to die in patients with heart problems, contrary to the findings of research by Rath et al. [30]. Our results could be explained by the fact that comorbidities and other risk factors often play a combined role in predicting a patient’s death [20,26,33]. However, more research with bigger sample size is needed to confirm that steroids and anticoagulation play a role in increasing mortality in COVID-19 patients.

Limitations: this research is not without flaws. We had no control over the sample or the data sources because the data was sourced from publicly available patient notes and audit forms. In addition, because our research was cross-sectional, we could not draw any conclusions about the temporal sequence of events. Despite these obstacles, we used solid statistical analytic approaches to reduce the risk of bias.

Conclusion Up Down

This study shows that COVID-19 mortality risk sharply increased in patients who were older, male and had comorbid diseases such as HIV, diabetes, hypertension, and CVDs in Mashonaland West. However, our study shows that death risk was less for pregnant patients and patients who were put on oxygen and vitamins C. The study of the source of these variations in risk across patients is central to understanding the impact of differences in individuals’ mortality.

referenc elink :https://www.panafrican-med-journal.com/content/article/44/142/full/#sec4


reference link :

Here are some resources related to COVID-19, oxygen therapy, and vitamin C:

  1. World Health Organization: Coronavirus disease (COVID-19) pandemic
    https://www.who.int/emergencies/disease/novel-coronavirus-2019
  2. Centers for Disease Control and Prevention: COVID-19 – https://www.cdc.gov/coronavirus/2019-ncov/index.html
  3. American Thoracic Society: COVID-19 Information for Health Professionals https://www.thoracic.org/professionals/clinical-resources/disease-related-resources/covid-19
  4. National Institutes of Health: COVID-19 Treatment Guidelines https://www.covid19treatmentguidelines.nih.gov/
  5. British Thoracic Society: COVID-19 Information for Health Professionals https://www.brit-thoracic.org.uk/covid-19/
  6. American Society for Parenteral and Enteral Nutrition: Vitamin C in COVID-19 https://www.nutritioncare.org/uploadedFiles/Documents/Clinical_Practice/COVID19/ASPEN_COVID-19_Vitamin_C_Supplementation.pdf
  7. National Center for Complementary and Integrative Health: Vitamin C and COVID-19: What We Know https://www.nccih.nih.gov/health/vitamin-c-and-covid-19-what-we-know
  8. ClinicalTrials.gov: Oxygen Therapy and COVID-19 https://clinicaltrials.gov/ct2/results?term=oxygen+therapy+AND+COVID-19
  9. ClinicalTrials.gov: Vitamin C and COVID-19 https://clinicaltrials.gov/ct2/results?term=vitamin+c+AND+COVID-19
  10. Journal of the American Medical Association: Effect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Care on Symptom Length and Reduction Among Ambulatory Patients With SARS-CoV-2 Infection: The COVID A to Z Randomized Clinical Trial https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2776563
  11. Journal of the American Medical Association: Effect of Vitamin C Infusion on Organ Failure and Biomarkers of Inflammation and Vascular Injury in Patients With Sepsis and Severe Acute Respiratory Failure: The CITRIS-ALI Randomized Clinical Trial https://jamanetwork.com/journals/jama/fullarticle/2669372
  12. The Lancet Respiratory Medicine: Efficacy and safety of high-dose vitamin C in patients with COVID-19: a randomized controlled trial https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30453-7/fulltext

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