COVID patient with sepsis makes ‘remarkable’ recovery following megadose of vitamin C
By national medical reporter Sophie Scott and the specialist reporting team’s Lucy Kent and Loretta Florance
Thursday 3 DecDecember 2020 at 4:01am, updated Thursday 3 DecDecember 2020 at 11:05am
A young Australian man who was critically ill with COVID-19 and suffering early stages of sepsismade a remarkable recovery after being given massive doses of vitamin C, according to his doctors.
- Sepsis is a common cause of death for people gravely ill with COVID-19
- Researchers at the Florey Institute used megadoses of vitamin C to treat sepsis in animals
- Doctors at Austin Hospital tried the technique on a critically ill patient, who then made a “remarkable” recovery
Professor Rinaldo Bellomo, director of Intensive Care at Melbourne’s Austin Health, said the 40-year-old’s health had started to deteriorate significantly from COVID-19, with the man losing kidney function, and his blood pressure plummeting.
Sepsis — a life-threatening condition which occurs when the body damages its own organs while responding to an infection— was starting to take hold of his body and time was running out.
“We were dealing with somebody who was very unwell. We felt we were in a very difficult situation, and the patient’s life was under serious threat,” he said.
Professor Bellomo knew researchers at the Florey Institute had some promising experimental findings using megadose vitamin C to treat sepsis.LIVE UPDATES: Read our blog for the latest news on the COVID-19 pandemic.
With the family’s consent, doctors gave the patient the same treatment the Florey researchers had trialled in animals.
The man was given an initial dose of 30 grams of sodium ascorbate (vitamin C) over 30 minutes, then a maintenance dose of 30 grams over six and a half hours.
“This is the equivalent of 5,000 oranges pumping through his veins,” Professor Bellomo said.
An over-the-counter vitamin C supplement is 500mg, meaning this megadose was 60 times the normal dosage, and had to be administered under hospital conditions.
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Organs start to fail and the patient goes into septic shock.
It’s the most common cause of death in intensive care units, and a common cause of death for people gravely ill with COVID-19.
Often patients need to have limbs amputated to survive.
Professor Bellomo said after the patient had the megadose of vitamin C, the changes were “‘remarkable”.
“In a short period of time, we saw improved regulation of blood pressure, arterial blood oxygen levels and kidney function,” he said.
His temperature also improved.
“The patient was able to be taken off machine ventilation 12 days after starting sodium ascorbate treatment and discharged from hospital without any complications 22 days later,” he said.
‘This can’t be true’
The Florey Institute’s Professor Clive May had collaborated with Professor Bellomo for many years, keeping him up to date with the promising results they were seeing in the lab with the sepsis treatment.
“He didn’t believe us. He said ‘this can’t be true’,” Professor May said.
Colleague Dr Yugeesh Lankadeva sent the intensive care doctor videos of what was happening in the lab.
“Professor Bellomo literally rocked up at the laboratory door the next day … because he was just like, ‘I need to see this for my own eyes’,” he said.
“When he came and when they saw it, they were all very amazed at how quickly the disease just reversed by doing this treatment.”
Professor May has been studying sepsis for almost two decades.
His research, which has just been published in the journal Critical Care Medicine, showed giving megadose vitamin C to animals with sepsis could reverse the effects of the disease.
“I have never seen any treatment before this being able to do that,” he said.
“Giving this dose of vitamin C is just totally revolutionary. The response was quite remarkable.”
He said the function of the animal’s heart, kidneys, liver, lungs and brain began to significantly improve just three hours after getting the megadose of the vitamin.
“If the treatment works as well in patients as it does in our animal studies, I think it’s going to totally revolutionise the treatment of septic patients in intensive care units all over the world,” Professor May said.
But he stressed people with COVID-19 or any other illness should not try the same treatment at home.
“We don’t want people going out and buying ten bottles of Vitamin C and think it’s going to solve their problems — that would just make them feel very sick.”
Experts urge caution
While the result seems promising for the seriously ill Melbourne patient, and the animal studies, experts said previous studies using large doses of vitamin C to treat sepsis have been mixed.
Professor Simon Finfer, from the George Institute for Global Health, has been researching sepsis for more than 25 years.
“We have seen so many treatments that seem to work in animal models and case reports but haven’t proven effective in big studies,” he said.
“The pharmaceutical industry has spent $10 billion trying to find a magic bullet for sepsis.”
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But also he said it was important to keep an open mind.
“If something is proving useful, we need to conduct trials to determine if there is a benefit or not.”
A 2020 review of scientific evidence published in the Journal of the American Medical Association found high dose vitamin C given on its own or with steroids did not provide “significant survival benefit” for patients with sepsis or septic shock.
The review found giving high dose Vitamin C “just in case” or “as a measure of last resort” could have negative consequences such as delaying proven therapies, such as prompt use of antibiotics.
New trial could bring answers
Professor Bellomo said many of the previous trials used a lower dose of vitamin C than the researchers did in both the animal study and the Austin did in the COVID-19 patient.
The amount of vitamin C given in this trial was 50 times greater than any other tried before for sepsis.
Doctors at Melbourne’s Austin Health have now begun a randomised controlled trial, giving some patients with septic shock a megadose of vitamin C and some a placebo.
Blood samples will be collected to gauge the patients’ immune response.
Researcher Dr Yugeesh Lankadeva said the trial would help establish the “optimal dose and treatment” that could be used by intensive care doctors in treating sepsis as a “potential life-saving option for patients with multi-organ failure”.
As for the Melbourne man who was able to walk out of hospital after the experimental treatment, his doctor Professor Bellomo said it’s an incentive to keep trialling this approach.
“We were encouraged, of course,” he said.
“This has provided us with further ammunition to investigate this intervention, to understand what the mechanisms might be and the extent of the achievement that might come from it.”
While Australia is doing well keeping COVID-19 under control, he said doctors from around the world have already been in touch to find out more about the megadose treatment.