Utilización de altas dosis de ácido ascórbico en el tratamiento del SARS Covid-19: Soporte Científico y Clínico para su aplicación en terapéutica

Autores/as

  • Cristian Alan Rossetti National University of Córdoba, Córdoba,Argentina.
  • Juan Pablo Real National University of Córdoba, Córdoba,Argentina.
  • Santiago Daniel Palma National University of Córdoba, Córdoba,Argentina.

Palabras clave:

Covid-19, Tratamiento, Vitamina C

Resumen

El coronavirus 2019 (SARS-CoV-2) ha sido declarado una emergencia de salud pública de impacto internacional por la Organización Mundial de la Salud. Debido a la aparición repentina de este proceso pandémico asociado con alta morbilidad y la mortalidad en todo el mundo, se han implementado varios tratamientos en los pacientes aquejados con esta dolencia. En este marco, comenzaron a usarse en pacientes críticos altas dosis de vitamina C.

En este trabajo, analizamos los ensayos clínicos y / o trabajos de investigación disponibles en la literatura. Aunque se necesita más evidencia sobre su efectividad, es importante que el especialista comprendala lógica clínica de este uso para determinar si es correcto como tratamiento concomitante.

Conclusiones: El uso de altas dosis de vitamina C por vía parenteral parece ser una alternativa segura,disponible y económica, especialmente para pacientes críticos.

Descargas

Los datos de descargas todavía no están disponibles.

Biografía del autor/a

Cristian Alan Rossetti, National University of Córdoba, Córdoba,Argentina.

Research and Development Unit in Pharmaceutical Technology (UNITEFA),CONICET and Department of Pharmaceutical Sciences, Faculty of Sciences Chemistry, National University of Córdoba.

INVESTIGACION Y DOCENCIA

Juan Pablo Real, National University of Córdoba, Córdoba,Argentina.

Research and Development Unit in Pharmaceutical Technology (UNITEFA),CONICET and Department of Pharmaceutical Sciences, Faculty of Sciences Chemistry, National University of Córdoba.

INVESTIGACION Y DOCENCIA

Santiago Daniel Palma, National University of Córdoba, Córdoba,Argentina.

Research and Development Unit in Pharmaceutical Technology (UNITEFA),CONICET and Department of Pharmaceutical Sciences, Faculty of Sciences Chemistry, National University of Córdoba.

INVESTIGACION Y DOCENCIA

Citas

WHO | SARS (Severe Acute Respiratory Syndrome) [Internet]. WHO. World Health Organization; [cited 2020 Apr 7]. Available from: https://www.who.int/ith/diseases/sars/en/

Rubin EJ, Baden LR, Morrissey S. Audio Interview: Making Decisions about Covid- 19 Testing and Treatment for Your Patients. N Engl J Med. 2020; 382(11):e25. DOI: 10.1056 / NEJMe2004856.

Jin Y-H, Cai L, Cheng Z-S, Cheng H, Deng T, Fan Y-P, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil Med Res. 2020; 6(1):4. DOI:10.1186 / s40779-020-0233-6.

Tóth SZ, Lőrincz T, Szarka A. Concentration Does Matter: The Beneficial and Potentially Harmful Effects of Ascorbate in Humans and Plants. Antioxid Redox Signal. 2018; 29(15):1516-1533. DOI:10.1089 / ars.2017.7125.

Nemet I, Monnier VM. Vitamin C degradation products and pathways in the human lens. J Biol Chem. 2011; 286(43):37128-36. DOI:10.1074 / jbc.M111.245100.

Lobo V, Patil A, Phatak A, Chandra N. Free radicals, antioxidants and functional foods: Impact on human health. Pharmacogn Rev. 2010; 4(8):118-126. DOI:10.4103 / 0973-7847.70902.

Chambial S, Dwivedi S, Shukla KK, John PJ, Sharma P. Vitamin C in disease prevention and cure: an overview. Indian J Clin Biochem IJCB. 2013; 28(4):314-328. DOI:10.1007 / s12291-013-0375-3.

Rajendran P, Nandakumar N, Rengarajan T, Palaniswami R, Gnanadhas EN, Lakshminarasaiah U, et al. Antioxidants and human diseases. Clin Chim Acta Int J Clin Chem. 2014; 436:332-347. DOI:10.1016 / j.cca.2014.06.004.

Tabatabaei-Malazy O, Nikfar S, Larijani B, Abdollahi M. Influence of ascorbic acid supplementation on type 2 diabetes mellitus in observational and randomized controlled trials; a systematic review with meta-analysis. J Pharm Pharm Sci Publ Can Soc Pharm Sci Soc Can Sci Pharm. 2014; 17(4):554-582. DOI: 10.18433 / J3ZG6R.

Wilson JX. Mechanism of action of vitamin C in sepsis: Ascorbate modulates redox signaling in endothelium. BioFactors Oxf Engl. 2009; 35(1):5-13. DOI:10.1002 / biof.7.

Borrelli E, Roux-Lombard P, Grau GE, Girardin E, Ricou B, Dayer J, et al. Plasma concentrations of cytokines, their soluble receptors, and antioxidant vitamins can predict the development of multiple organ failure in patients at risk. Crit Care Med. 1996; 24(3):392-7. DOI:10.1097 / 00003246-199603000-00006.

Galley HF, Davies MJ, Webster NR. Ascorbyl radical formation in patients with sepsis: Effect of ascorbate loading. Free Radic Biol Med. 1996; 20(1):139-143. DOI: 10.1016 / 0891-5849 (95) 02022-5.

Evans J. Antioxidant supplements to prevent or slow down the progression of AMD: a systematic review and meta-analysis. Eye. 2008; 22(6):751-760. DOI:10.1038 / ojo.2008.100.

Obi J, Pastores SM, Ramanathan LV, Yang J, Halpern NA. Treating sepsis with vitamin C, thiamine, and hydrocortisone: Exploring the quest for the magic elixir. J Crit Care [Internet]. 2020 [cited 2020 Apr 7]; Available from: http://www.sciencedirect.com/science/article/pii/S0883944119316107. DOI:10.1016 / j.jcrc.2019.12.011.

Zhang L, Liu Y. Potential interventions for novel coronavirus in China: A systematic review. J Med Virol. 2020; 92(5):479-490. DOI:10.1002 / jmv.25707.

Fowler AA, Truwit JD, Hite RD, Morris PE, DeWilde C, Priday A, et al. Effect of Injury in Patients With Sepsis and Severe Acute Respiratory Failure: The CITRIS- ALI Randomized Clinical Trial. JAMA. 2019; 322(13):1261-1270. DOI:10.1001 / jama.2019.11825.

Fowler AA, Syed AA, Knowlson S, Sculthorpe R, Farthing D, DeWilde C, et al. Phase I safety trial of intravenous ascorbic acid in patients with severe sepsis. J Transl Med. 2014; 12:32. DOI:10.1186 / 1479-5876-12-32.

Aleatorizador de investigación [Internet]. [cited 2020 Apr 7]. Available from: https://www.randomizer.org/

Nathens AB, Neff MJ, Jurkovich GJ, Klotz P, Farver K, Ruzinski JT, et al. Randomized, prospective trial of antioxidant supplementation in critically ill surgical patients. Ann Surg. 2002; 236(6):814-822. DOI: 10.1097 / 00000658-200212000-00014.

Tanaka H, Matsuda T, Miyagantani Y, Yukioka T, Matsuda H, Shimazaki S. Reduction of resuscitation fluid volumes in severely burned patients using ascorbic acid administration: a randomized, prospective study. Arch Surg Chic Ill 1960. 2000; 135(3):326-331. DOI:10.1001 / archsurg.135.3.326.

Hoffer LJ, Levine M, Assouline S, Melnychuk D, Padayatty SJ, Rosadiuk K, et al. Phase I clinical trial of i.v. ascorbic acid in advanced malignancy. Ann Oncol Off J Eur Soc Med Oncol. 2008; 19(11):1969-1974. DOI:10.1093 / annonc / mdn377.

Padayatty SJ, Sun AY, Chen Q, Espey MG, Drisko J, Levine M. Vitamin C: intravenous use by complementary and alternative medicine practitioners and adverse effects. PloS One. 2010; 5(7):e11414. DOI:10.1371 / journal.pone.0011414.

Welsh JL, Wagner BA, van’t Erve TJ, Zehr PS, Berg DJ, Halfdanarson TR, et al. Pharmacological ascorbate with gemcitabine for the control of metastatic and node- positive pancreatic cancer (PACMAN): results from a phase I clinical trial. Cancer Chemother Pharmacol. 2013; 71(3):765-775. DOI:10.1007 / s00280-013-2070-8.

Padayatty SJ, Sun H, Wang Y, Riordan HD, Hewitt SM, Katz A, et al. Vitamin C pharmacokinetics: implications for oral and intravenous use. Ann Intern Med. 2004; 140(7):533-7. DOI:10.7326 / 0003-4819-140-7-200404060-00010.

Ma Y, Chapman J, Levine M, Polireddy K, Drisko J, Chen Q. High-dose parenteral ascorbate enhanced chemosensitivity of ovarian cancer and reduced toxicity of chemotherapy. Sci Transl Med. 2014; 6(222):222ra18. DOI:10.1126 / scitranslmed.3007154.

Efecto de altas dosis de ácido ascórbico en el requerimiento de vasopresores en shock séptico [Internet]. [cited 2020 Apr 7]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4843590/

Zhang M, Jativa DF. Vitamin C supplementation in the critically ill: A systematic review and meta-analysis. SAGE Open Med 2018; 6: 2050312118807615.DOI:10.1177 / 2050312118807615.

Hemilä H, Chalker E. Vitamin C may reduce the duration of mechanical ventilation in critically ill patients: a meta-regression analysis. J Intensive Care. 2020; 8:15. DOI:10.1186 / s40560-020-0432-a.

Hemilä H, Chalker E. Vitamin C Can Shorten the Length of Stay in the ICU: A Meta-Analysis. Nutrients [Internet]. 2019 Mar 27 [cited 2020 Apr 7];11(4). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6521194/.DOI:10.3390 / nu11040708.

Wei X, Wang Z, Liao X, Guo W, Wen J-Y, Qin T, et al. Efficacy of vitamin C in patients with sepsis: An updated meta-analysis. Eur J Pharmacol [Internet]. 2020 [cited 2020 Apr 7];868. Available from: insights.ovid.com. DOI:10.1016 / j.ejphar.2019.172889.

Use of Ascorbic Acid in Patients With COVID 19 - Full Text View -ClinicalTrials.gov [Internet]. [cited 2020 Apr 7]. Available from: https://clinicaltrials.gov/ct2/show/NCT04323514

Descargas

Publicado

2020-06-20

Cómo citar

1.
Rossetti CA, Real JP, Palma SD. Utilización de altas dosis de ácido ascórbico en el tratamiento del SARS Covid-19: Soporte Científico y Clínico para su aplicación en terapéutica. Ars Pharm [Internet]. 20 de junio de 2020 [citado 18 de noviembre de 2024];61(2):145-8. Disponible en: https://revistaseug.ugr.es/index.php/ars/article/view/15164

Número

Sección

Notas Clínicas