Cheng Richard Z, Kogan Mikhail, Davis Devra
Cheng Integrative Health Center, Columbia, South Carolina.
GW Center for Integrative Medicine, Washington, District of Columbia.
Glob Adv Health Med. 2020 Jul 20;9:2164956120934768. doi: 10.1177/2164956120934768. eCollection 2020.
No validated treatments have been identified for the COVID-19 pandemic virus; several are currently in randomized clinical trials. Diagnostic instruments are rapidly evolving. Symptoms range from those of a common cold to acute respiratory distress syndrome (ARDS), to sepsis arising from the flood of inflammatory bacterial and viral pathogens in the blood. Mortality generally arises from cytokine storms of uncontrolled inflammation, oxidative injury, and damage to the alveolar-capillary barrier, with secondary bacterial infection. To address the indisputably urgent need for therapeutics for COVID-19, a specialized interdisciplinary medical panel convened in Shanghai in March 2020 to consider all relevant clinical and experimental evidence on the possible utility of intravenous (IV) ascorbate in the treatment of COVID-19-related ARDS.
The panel convened multidisciplinary medical experts and reviewed all relevant in vitro, in vivo, clinical studies and randomized controlled trials on IV ascorbate and issued a consensus report on 23 March 2020 noting that substantial differences in serum concentrations of ascorbate are achieved through IV administration in contrast with the oral route.
The Shanghai panel, and a parallel medical group in Guangzhou, are advising the use of high-dose IV ascorbate for the treatment of ARDS, along with other supportive therapies, including Vitamin D and zinc. We report preliminary progress in using this treatment for 50 consecutive cases treated in Shanghai hospitals, consistent with earlier reports from a meta-analysis of the use of IV ascorbate to treat sepsis. We provide an instructive clinical anecdote regarding a single family where one elderly member with cardiac and other major comorbidities developed and survived ARDS-related sepsis following daily treatments that included 15 g of IV ascorbate. None of her adult caregivers who had ingested between 2 and 10 g of ascorbate daily developed COVID-19.
对于新型冠状病毒肺炎大流行病毒,尚未确定经过验证的治疗方法;目前有几种正在进行随机临床试验。诊断工具正在迅速发展。症状范围从普通感冒到急性呼吸窘迫综合征(ARDS),再到因血液中炎性细菌和病毒病原体大量涌入而引发的败血症。死亡率通常源于不受控制的炎症、氧化损伤和肺泡 - 毛细血管屏障受损引发的细胞因子风暴,以及继发性细菌感染。为满足新型冠状病毒肺炎治疗药物的迫切需求,2020年3月在上海召开了一个专门的跨学科医学小组会议,审议关于静脉注射维生素C治疗新型冠状病毒肺炎相关急性呼吸窘迫综合征可能效用的所有相关临床和实验证据。
该小组召集了多学科医学专家,审查了所有关于静脉注射维生素C的相关体外、体内、临床研究和随机对照试验,并于2020年3月23日发布了一份共识报告,指出与口服途径相比,静脉给药可使血清维生素C浓度产生显著差异。
上海小组以及广州的一个平行医学小组建议使用大剂量静脉注射维生素C治疗急性呼吸窘迫综合征,同时采用其他支持性疗法,包括维生素D和锌。我们报告了上海医院连续治疗的50例患者使用该疗法的初步进展,这与之前关于静脉注射维生素C治疗败血症的荟萃分析报告一致。我们提供了一个有启发性的临床案例,涉及一个家庭,其中一位患有心脏疾病和其他主要合并症的老年成员,在每日接受包括15克静脉注射维生素C的治疗后,患上并存活了与急性呼吸窘迫综合征相关的败血症。她每天摄入2至10克维生素C的成年护理人员均未感染新型冠状病毒肺炎。