The impact of vitamin C-containing treatment on the mortality of patients with sepsis: A systematic review and meta-analysis of randomized controlled trials

Abstract

Objective: To investigate the clinical efficacy of vitamin C-containing therapy for patients with sepsis.

Methods: PubMed, Embase, Cochrane Library, and ClinicalTrials.gov were searched from inception to July 27, 2022. Only randomized controlled trials (RCTs) comparing vitamin C-containing therapy and placebo or alternative treatment for patients with sepsis were included, and the primary outcome was all-cause mortality.

Results: Sixteen RCTs involving a total of 2985 patients were included in this meta-analysis. Overall, no significant difference in 28-day mortality was observed between the study group, who received vitamin C-containing treatment, and the control group (odds ratio [OR], 0.87; 95% confidence interval [CI]: 0.71-1.08; P = .20). In subgroup analysis of eight RCTs focusing on patients with septic shock, there was no significant difference in 28-day mortality between the study and control groups (OR, 1.09; 95% CI: 0.89-1.34; P = .41). In addition, no significant difference was observed between the study and control groups in intensive care unit-mortality (OR, 1.03; 95% CI: 0.84-1.25; P = .81), in-hospital mortality (OR, 1.06; 95% CI: 0.85-1.13; P = .60), and 90-day mortality (OR, 1.23; 95% CI: 0.75-2.02; P = .40).

Conclusions: The results of this systematic review and meta-analysis indicated that adjunctive vitamin C-containing therapy did not help improve the clinical outcomes of patients with sepsis/septic shock. Our findings do not support the additional use of vitamin C for septic patients.

Keywords: Mortality; Sepsis; Septic shock; Vitamin C.