LOVIT-COVID and REMAP-CAP (critically ill)
Trial question
What is the role of intravenous vitamin C in critically ill patients hospitalized with COVID-19?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
36.0% female
64.0% male
N = 1569
1569 patients (564 female, 1005 male).
Inclusion criteria: critically ill patients hospitalized with COVID-19.
Key exclusion criteria: pregnancy; healthcare-associated pneumonia; imminent death; known allergy to vitamin C.
Interventions
N=1037 vitamin C (IV dose of 50 mg/kg of body weight over 30-60 minutes every 6 hours for 96 hours).
N=532 control (no vitamin C or placebo).
Primary outcome
Median organ support-free days to 21 days
7 days
10 days
10.0 days
7.5 days
5.0 days
2.5 days
0.0 days
Vitamin
C
Control
No significant
difference ↔
No significant difference in median organ support-free days to 21 days (7 days vs. 10 days; OR 0.88, 95% CI 0.73 to 1.06).
Secondary outcomes
No significant difference in survival without persistent organ dysfunction at day 28 (57.1% vs. 60.7%; OR 0.9, 95% CI 0.72 to 1.12).
No significant difference in the rate of survival to day 28 (65% vs. 67.2%; OR 0.94, 95% CI 0.75 to 1.19).
Significant decrease in the rate of endotracheal intubation through day 28 (35.5% vs. 32.5%; OR 0.74, 95% CI 0.56 to 0.99).
Conclusion
In critically ill patients hospitalized with COVID-19, vitamin C was not superior to control with respect to median organ support-free days to 21 days.
Reference
LOVIT-COVID Investigators, on behalf of the Canadian Critical Care Trials Group, and the REMAP-CAP Investigators et al. Intravenous Vitamin C for Patients Hospitalized With COVID-19: Two Harmonized Randomized Clinical Trials. JAMA. 2023 Nov 14;330(18):1745-1759.
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