Vitamin C in Sepsis: Exploring Its Role in Modulating Inflammation and Oxidative Stress.

Background Despite improvements in medical treatment, sepsis remains a deadly illness with high fatality rates that is characterized by excessive inflammation and oxidative stress. Objective This study aimed to evaluate the impact of vitamin C supplementation on inflammatory response, oxidative stress, and clinical outcomes in sepsis patients. Methodology A prospective observational study was conducted over one year at Lady Reading Hospital, Peshawar, including 326 adult sepsis cases meeting the Sepsis-3 criteria. To maximize early therapeutic benefits, intravenous vitamin C supplementation (1,500 mg/day) was administered for 14 days, followed by a maintenance regimen of 1,500 mg/day for 14 days every 3-6 months to sustain therapeutic effects. The efficacy of vitamin C was assessed through serial measurements of oxidative stress markers (malondialdehyde) and inflammatory markers (CRP, IL-6, and TNF-α) at baseline and at 3, 6, 9, and 12 months. Clinical outcomes, including ICU stay, organ dysfunction, and mortality, were prospectively recorded. Statistical analysis was performed using SPSS version 25 (IBM Corp., Armonk, NY, USA). Results Vitamin C supplementation in sepsis patients led to significant improvements over 12 months, with reductions in IL-6 (345.16 ± 128.52 to 245.12 ± 83.78 pg/mL), C-reactive protein (CRP) (175.31 ± 62.43 to 114.57 ± 38.67 mg/L), and malondialdehyde (MDA) levels (8.94 ± 3.21 to 5.79 ± 2.18 nmol/mL). Clinical outcomes also improved, including a decrease in the 30-day mortality rate from 14.11% (n=46) to 6.90% (n=22), organ dysfunction score from 9.82 ± 4.03 to 4.83 ± 2.54, and ICU stay from 11.57 ± 3.85 to 7.24 ± 3.01 days. Regression analysis indicated that vitamin C supplementation was significantly associated with better outcomes (β = -2.34, p = 0.012), while chronic kidney disease was associated with worse outcomes (β = 1.75, p < 0.001). Conclusion Supplementing with vitamin C has been shown to significantly improve clinical outcomes in sepsis by lowering oxidative stress and inflammation.