The Role and Efficacy of Vitamin C in Sepsis: A Systematic Review and Meta-Analysis

source extracted confidence: high 2026-04-09
#ascorbic-acid #critical-care #humans #organ-dysfunction-scores #sepsis

The Role and Efficacy of Vitamin C in Sepsis: A Systematic Review and Meta-Analysis

Muhammad et al., 2022 | Adv Respir Med | Meta Analysis

Citation

Muhammad Marwah, Jahangir Ahmad, ... Chalhoub Michel. The Role and Efficacy of Vitamin C in Sepsis: A Systematic Review and Meta-Analysis. Adv Respir Med. 2022-Jul-28;90(4):281-299. doi:10.3390/arm90040038

Abstract

Clinical rationale for study: Despite advancements in critical care, the mortality rate of sepsis remains high, with an overall poor prognosis. There is a complex pathophysiology of a lethal cascade of cytokines and inflammatory proteins underlying sepsis. The use of vitamin C can theoretically suppress the inflammatory cascade but remains a questionable practice due to a lack of conclusive evidence. Aims of the study: To appraise the therapeutic role of vitamin C in sepsis. Materials and methods: A systematic review was conducted on PubMed, Embase, and the Central Cochrane Registry. The study included randomized clinical trials (RCTs) with vitamin C as an intervention arm in the septic patient population. For continuous variables, the difference in means (MD) and for discrete variables, the odds ratio (OR) was used. For effect sizes, a confidence interval of 95% was used. A p-value of less than 0.05 was used for statistical significance. The analysis was performed using a random-effects model irrespective of heterogeneity. Heterogeneity was evaluated using the I2 statistic. Results: 23 studies were included with the total sample size of 2712 patients. In patients treated with vitamin C, there was a statistically significant reduction in the mortality: OR = 0.778 (0.635 to 0.954), p = 0.016; the sequential organ failure assessment score (SOFA): MD = −0.749 (−1.115 to −0.383), p < 0.001; and the duration of vasopressor requirement: MD = −1.034 days (−1.622 to −0.445), p = 0.001. No significant difference was found in the hospital or ICU length of stay. Conclusions and clinical implications: Vitamin C treatment regimens were associated with reduced mortality, SOFA score, and vasopressor requirement compared to the control in sepsis. Given its low cost and minimal adverse effects, we strongly encourage further large, randomized trials to establish vitamin C as a standard of care in sepsis management.

Key Findings

23 studies were included with the total sample size of 2712 patients. In patients treated with vitamin C, there was a statistically significant reduction in the mortality: OR = 0.778 (0.635 to 0.954), p = 0.016; the sequential organ failure assessment score (SOFA): MD = −0.749 (−1.115 to −0.383), p < 0.001; and the duration of vasopressor requirement: MD = −1.034 days (−1.622 to −0.445), p = 0.001. No significant difference was found in the hospital or ICU length of stay. Conclusions and clinica

Outcomes Measured

  • inflammatory markers

Population

Field Value
Population See abstract
Sample Size 2712
Age Range See abstract
Condition See abstract

MeSH Terms

  • Ascorbic Acid
  • Critical Care
  • Humans
  • Organ Dysfunction Scores
  • Sepsis

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: vitamin-c

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09