Evidence map›Paper›PMID 34910661›Full record

ArticleJMIR research protocols2022

Administration of Parenteral Vitamin C in Patients With Severe Infection: Protocol for a Systematic Review and Meta-analysis.

Arnav Agarwal, John Basmaji, Shannon M Fernando, Fang Zhou Ge, Yingqi Xiao, Haseeb Faisal, Kimia Honarmand, Mathieu Hylands, Vincent I Lau, Kimberley Lewis and 3 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JMIR research protocols, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.2field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 14 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 8 institutions in 2 countries.

Arnav AgarwalDivision of General Internal Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada.ORCID https://orcid.org/0000-0002-0931-7851
John BasmajiDivision of Critical Care, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.ORCID https://orcid.org/0000-0001-9749-1747
Shannon M FernandoDivision of Critical Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.ORCID https://orcid.org/0000-0003-4549-4289
Fang Zhou GeMichael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.ORCID https://orcid.org/0000-0001-5321-2312
Yingqi XiaoDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.ORCID https://orcid.org/0000-0001-8766-5184
Haseeb FaisalFaculty of Medicine, McMaster University, Hamilton, ON, Canada.ORCID https://orcid.org/0000-0002-4749-1754
Kimia HonarmandDivision of Critical Care, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.ORCID https://orcid.org/0000-0002-7583-1445
Mathieu HylandsInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.ORCID https://orcid.org/0000-0001-7931-5846
Vincent I LauDepartment of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.ORCID https://orcid.org/0000-0002-9939-7348
Kimberley LewisDepartment of Medicine, McMaster University, Hamilton, ON, Canada.ORCID https://orcid.org/0000-0001-6610-3369
Rachel CoubanDepartment of Anesthesia, McMaster University, Hamilton, ON, Canada.ORCID https://orcid.org/0000-0001-8672-2845
François Lamontagne *Department of Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada.ORCID https://orcid.org/0000-0002-0360-3427
Neill Kj Adhikari *Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.ORCID https://orcid.org/0000-0003-4038-5382
McMaster University · CAWestern University · CASichuan University · CNSunnybrook Health Science Centre · CAUniversité de Sherbrooke · CAUniversity of Alberta · CAUniversity of Ottawa · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSevere infections are characterized by inflammation and oxidative damage. Ascorbic acid (vitamin C) administration may attenuate oxidative damage and, in turn, reduce vascular endothelial injury in pulmonary and systemic vasculature.

objectiveWe aim to describe a protocol for a living systematic review that will evaluate the effectiveness and safety of parenteral vitamin C administration in adults with severe infections, including those with COVID-19.

methodsWe searched Ovid MEDLINE, Embase, CINAHL, the Centers for Disease Control and Prevention COVID-19 database, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov from inception to March 30, 2021, for randomized controlled trials evaluating parenteral vitamin C versus no parenteral vitamin C in hospitalized adults with severe infection. Eligible studies will include at least 1 arm involving any dose of parenteral vitamin C alone or in combination with other cointerventions and at least 1 arm not involving parenteral vitamin C. The primary outcomes of interest will include in-hospital, 30-day, and 90-day mortality. Title and abstract screening, full-text screening, data extraction, and risk of bias evaluation via a modified Risk of Bias 2.0 tool will be conducted independently and in pairs. We will perform random effects modeling for meta-analyses, in which study weights will be generated by using the inverse variance method. We will assess certainty in effect estimates by using the Grading of Recommendations Assessment, Development and Evaluation methodology. Meta-analyses will be updated iteratively as new trial evidence becomes available.

resultsAmong the 1386 citations identified as of March 30, 2021, a total of 17 eligible randomized controlled trials have been identified as of September 2021. We are in the process of updating the search strategy and associated data analyses.

conclusionsThe results will be of importance to critical care physicians and hospitalists who manage severe infection and COVID-19 in daily practice, and they may directly inform international clinical guidance. Although our systematic review will incorporate the most recent trial evidence, ongoing trials may change our confidence in the estimates of effects, thereby necessitating iterative updates in the form of a living review.

trial registrationPROSPERO CRD42020209187; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=209187. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/33989.

Indexed as

ascorbic acidCOVID-19critical careeffectivenessinfectioninfectious diseaseinflammationmeta-analysisoxidationparenteralprotocolreviewsafetySARS-CoV-2sepsissevere infectiontreatmentvitaminvitamin C

Identifiers

PMID34910661
PMCPMC8734609
OpenAlexW4200191010

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.