Oops! Vitamin C beats hydroxychloroquin for preventing SARS-CoV-2!
09, 12 20, 18:30 Filed in: Medical
In a paper released yesterday in the Annals of Internal Medicine, “Hydroxychloroquine as Postexposure Prophylaxis to Prevent Severe Acute Respiratory Syndrome Coronavirus 2 Infection”, vitamin C performed better then hydroxychloroquine in preventing exposed people from developing SARS-CoV-2, with about 20% fewer people progressing to COVID-19 disease in the vitamin C group.
The authors intended the vitamin C as a placebo to compare against the medicine, but they did use a dose that was a good start (500mg for 3 days and then 250mg daily) since the body will burn through vitamin C when fighting infections. Their references for the claim that vitamin C is a placebo and ineffective dose for this were based on 2 articles that do not support their contention: one article on using a multivitamin with only 60mg of C to prevent respiratory infections that didn’t show any benefit, and a second article that gave 1.5g of C IV 4x/day to patients who were already in the ICU with sceptic shock. Clearly the first article used a dose that 1/4 to 1/8 of the “placebo” dose so we could expect a larger effect (which did, after all, show a non-significant 5% reduction in infections, so maybe we could expect a 4x greater benefit from 4x the dose, like the 20% we saw if we assume the medicine had no effect). On the other hand, the second trial had patients that were infinitely sicker (the current trial subjects weren’t sick) with a greater vitamin C requirement and already on death’s doorstep (15% of the patients died in the first week), and also is in contrast to other trials that showed benefit from similar doses.
In any event, the contention that this study shows that hydroxychloroquine doesn’t work but actually causes harm may actually just be showing that vitamin C even at modest doses is more beneficial than the medicine. Since they haven’t actually done a trial with a real inactive placebo, the outcome is still not clear, but at a minimum vitamin C isn’t going to hurt and might help. There have been other case reports showing benefit to large doses of vitamin C in people with active COVID-19 disease, but the response from the medical establishment has largely been silence.
The authors intended the vitamin C as a placebo to compare against the medicine, but they did use a dose that was a good start (500mg for 3 days and then 250mg daily) since the body will burn through vitamin C when fighting infections. Their references for the claim that vitamin C is a placebo and ineffective dose for this were based on 2 articles that do not support their contention: one article on using a multivitamin with only 60mg of C to prevent respiratory infections that didn’t show any benefit, and a second article that gave 1.5g of C IV 4x/day to patients who were already in the ICU with sceptic shock. Clearly the first article used a dose that 1/4 to 1/8 of the “placebo” dose so we could expect a larger effect (which did, after all, show a non-significant 5% reduction in infections, so maybe we could expect a 4x greater benefit from 4x the dose, like the 20% we saw if we assume the medicine had no effect). On the other hand, the second trial had patients that were infinitely sicker (the current trial subjects weren’t sick) with a greater vitamin C requirement and already on death’s doorstep (15% of the patients died in the first week), and also is in contrast to other trials that showed benefit from similar doses.
In any event, the contention that this study shows that hydroxychloroquine doesn’t work but actually causes harm may actually just be showing that vitamin C even at modest doses is more beneficial than the medicine. Since they haven’t actually done a trial with a real inactive placebo, the outcome is still not clear, but at a minimum vitamin C isn’t going to hurt and might help. There have been other case reports showing benefit to large doses of vitamin C in people with active COVID-19 disease, but the response from the medical establishment has largely been silence.
