ArticleCritical care (London, England)2022
Vitamin C for ≥ 5 days is associated with decreased hospital mortality in sepsis subgroups: a nationwide cohort study.
Article in Critical care (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.
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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.
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.
Who cites it
27 citing papers in PubMed, 3 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- Mortality among adult patients with sepsis and septic shock in Korea: a systematic review and meta-analysis.Clinical and experimental emergency medicine · 2023Pooled it
- Association of Oral or Intravenous Vitamin C Supplementation with Mortality: A Systematic Review and Meta-Analysis.Nutrients · 2023Pooled it
- The effect of intravenous vitamin C on clinical outcomes in patients with sepsis or septic shock: A meta-analysis of randomized controlled trials.Frontiers in nutrition · 2022Pooled it
- Effect of high-dose intravenous ascorbic acid on microcirculation and endothelial glycocalyx during sepsis and septic shock: a double-blind, randomized, placebo-controlled study.BMC anesthesiology · 2023Trial
- Abrupt termination of vitamin C from ICU patients may increase mortality: secondary analysis of the LOVIT trial.European journal of clinical nutrition · 2023Trial
- Early administration of hydrocortisone, vitamin C, and thiamine in adult patients with septic shock: a randomized controlled clinical trial.Critical care (London, England) · 2022Trial
- Intravenous vitamin C administration to patients with septic shock: a pilot randomised controlled trial.Critical care (London, England) · 2022Trial
- A preclinical randomised controlled dose optimization of megadose sodium ascorbate for reversal of gram-negative sepsis-induced cardiovascular, brain and kidney dysfunction.Critical care (London, England) · 2025Article
- Vitamin C Supplementation During Intensive Care Unit Stay Is Associated With Improved Outcomes in Critically Ill Patients With Sepsis-Induced Coagulopathy: A Cohort Study.Food science & nutrition · 2025Article
- Development of a nomogram to predict 30-day mortality in patients with chronic obstructive pulmonary disease complicated by sepsis: insights from the Medical Information Mart for Intensive Care (MIMIC-IV) database.Journal of thoracic disease · 2025Article
- Early, very high-dose, and prolonged vitamin C administration in murine sepsis.Scientific reports · 2025Article
- Treatment effect of intravenous high-dose selenium in sepsis phenotypes: a retrospective analysis of a large multicenter randomized controlled trial.Journal of intensive care · 2025Article
- Vitamin C for sepsis: from mechanisms to individualized therapy.Frontiers in medicine · 2025Review
- Causality of circulating vitamins on infectious diseases: integrating Mendelian randomization andFrontiers in immunology · 2025Article
- The effects of antioxidant supplementation on short-term mortality in sepsis patients.Heliyon · 2024Article
- Predicting hypovitaminosis C with LASSO algorithm in adult critically ill patients in surgical intensive care units: a bi-center prospective cohort study.Scientific reports · 2024Article
- Vitamin C for patients with sepsis?Frontiers in medicine · 2024Article
- Rebound effect explains the divergence in survival after 5 days in a controlled trial on vitamin C for COVID-19 patients.Frontiers in medicine · 2024Article
- Concerns with the revised Japanese recommendation for administering vitamin C to septic patients.Journal of intensive care · 2023Article
- Causal effects of genetically vitamins and sepsis risk: a two-sample Mendelian randomization study.BMC infectious diseases · 2023Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundPrevious randomized trials of vitamin C, hydrocortisone, and thiamine on sepsis were limited by short-term vitamin C administration, heterogeneous populations, and the failure to evaluate each component's effect. The purpose of this study was to determine whether vitamin C alone for ≥ 5 days or in combination with corticosteroids and/or thiamine was associated with decreased mortality across the sepsis population and subpopulation.
methodsNationwide population-based study conducted using the Korean National Health Insurance Service database. A total of 384,282 adult patients with sepsis who were admitted to the intensive care unit were enrolled from January 2017 to December 2019. The primary outcome was hospital mortality, while the key secondary outcome was 90-day mortality.
resultsThe mean [standard deviation] age was 69.0 [15.4] years; 57% were male; and 36,327 (9%) and 347,955 did and did not receive vitamin C, respectively. After propensity score matching, each group involved 36,327 patients. The hospital mortality was lower by - 0.9% in the treatment group (17.1% vs 18.0%; 95% confidence interval, - 1.3 to - 0.5%; p < 0.001), a significant but extremely small difference. However, mortality decreased greater in patients who received vitamin C for ≥ 5 days (vs 1-2 or 3-4 days) (15.8% vs 18.8% vs 18.3%; p < 0.001). Further, vitamin C was associated with a lower hospital mortality in patients with older age, multiple comorbidities, pneumonia, genitourinary infection, septic shock, and mechanical ventilation. Consistent findings were found for 90-day mortality. Moreover, vitamin C alone or in combination with thiamine was significantly associated with decreased hospital mortality.
conclusionsIntravenous vitamin C of ≥ 5 days was significantly associated with decreased hospital and 90-day mortality in sepsis patients. Vitamin C combined with corticosteroids and/or thiamine in specific sepsis subgroups warrants further study.
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