Shanghai government officially recommends Vitamin C for COVID-19.
, SUMMARY  \nThe article containing this claim was published by the Orthomolecular Medicine News Service (OMNS) in early March 2020 and has been circulated by several outlets, including GreenMedInfo and Waking Times. The claim, which states that the “Shanghai Government officially recommends vitamin C for COVID-19”, has received more than 820,000 views on Facebook at the time of this review’s publication., The OMNS article bases its claim on two sources: an article published in the Chinese Journal of Infectious Diseases by the Shanghai Clinical Treatment Expert Group for COVID-19 and another by the Second Affiliated Hospital of Xi’an Jiaotong University (Xibei Hospital) in China., The article in the Chinese Journal of Infectious Diseases, titled “Expert consensus on the treatment of coronavirus”, details the clinical features of mild and severe coronavirus infection, methods of monitoring patients including specific laboratory tests, and treatment approaches depending on the severity of disease. It is correct that intravenous vitamin C is among the potential treatment approaches for COVID-19 mentioned in the publication, but it is not the only one: the article also emphasizes the importance of the body’s water and electrolyte balance, certain drugs such as antivirals, and interventions such as hemofiltration depending on the patient’s condition., The second article, by the Second Affiliated Hospital of Xi’an Jiaotong University (Xibei Hospital), describes the use of IV high-dose vitamin C to treat COVID-19. However, the OMNS article cherry-picks a specific segment of the article that highlights only the positive effects of the treatment (translated into English from the original Mandarin):, “High-dose vitamin C achieved good results in clinical applications. We believe that for patients with severe neonatal pneumonia and critically ill patients, vitamin C treatment should be initiated as soon as possible after admission… Early application of large doses of vitamin C can have a strong antioxidant effect, reduce inflammatory responses, and improve endothelial function… Numerous studies have shown that the dose of vitamin C has a lot to do with the effect of treatment… High-dose vitamin C can not only improve antiviral levels, but more importantly, can prevent and treat acute lung injury (ALI) and acute respiratory distress (ARDS).”, The OMNS article omits several important sections of the article which describe the adverse effects of intravenous high-dose vitamin C and medical conditions for which high-dose vitamin C is contraindicated or not recommended due to potential harm in certain patients. The English translation:, “This treatment should not last beyond one week. By implementing high-dose vitamin C during the short, key stages of early infection, the treatment is highly effective, and limiting the duration reduces the side effects of long-term high-dose vitamin C treatment such as kidney stones, hematuria blood in the urine, and renal colic, as well as other effects such as nausea, vomiting, low blood pressure, tachycardia et cetera …, As the concentrations used in this treatment protocol are very high, the treatment may cause vascular pain. It is suggested that fluids be provided after treatment to reduce vascular pain. We have also used a slow and intermittent dosing of vitamin C, which helps to maintain an effective concentration of vitamin C in the body, while significantly reducing vascular pain in the area where vitamin C is administered intravenously. Lastly, because vitamin C may interfere with blood sugar tests, such tests should be avoided in diabetic patients immediately after vitamin C treatment., Finally, owing to vitamin C’s pharmacological properties, this treatment is contraindicated in the following clinical conditions:, It is clear that neither of the sources represent an official recommendation by the Shanghai government, as the OMNS article claims. Both articles discuss intravenous vitamin C administration for treating COVID-19, but the OMNS article takes this out of context by relating these findings with oral vitamin C use for prevention as well. As Health Feedback explained in an earlier review, there is absolutely no doubt that maintaining adequate vitamin C levels is important for health, but at the same time, the evidence does not support the claim that oral vitamin C supplementation, beyond the recommended intake, prevents coronavirus infection or other viral respiratory infections. In fact, excess intake of more than 1,000 mg per day of vitamin C can lead to side effects such as diarrhea and stomach pain., A clinical trial is currently underway in China to determine the efficacy and safety of vitamin C infusion in treating pneumonia from COVID-19 infection., The World Health Organization (WHO) has stated that: “To date, there is no specific medicine recommended to prevent or treat the new coronavirus.” No vaccine is yet available. At the moment, the best methods of preventing coronavirus infections, as recommended by the WHO and the U.S. CDC, are:, SCIENTISTS’ FEEDBACK  \nThis comment comes from an evaluation of a related claim.\n Margreet Vissers, Professor, Centre for Free Radical Research, University of Otago:\nThe story of vitamin C and infections, particularly viral infections, is a very hotly contested area, and unfortunately for many years lots of claims have been made both by proponents and skeptical medical doctors that are not founded in fact. Fortunately in the past few years much better scientific data is available and we should concentrate on this and review it carefully. The papers cited in the article are mostly quite old and are criticised for this reason (not always fair). Here’s what I think is pertinent to the coronavirus discussion:, Interestingly, a clinical trial for administration of vitamin C to patients with coronavirus has been registered in China. This will take the hype out of the discussions, hopefully., However, prevention is quite a different matter than treatment. We really have no idea whether having more vitamin C will prevent anyone contracting the coronavirus. However, as it is a viral pneumonia, there is a distinct possibility that additional vitamin C may help with treatment. There are no studies with this virus that show this, but some benefit has been suggested with other severe respiratory illnesses. The clinical trial in China should address this issue., Anitra Carr, Associate Professor, Department of Pathology and Biomedical Science, University of Otago:\nPeople with severe respiratory infections, such as pneumonia, have depleted vitamin C status, partly due to the enhanced oxidative stress that occurs during the inflammatory process3. Administration of recommended dietary intakes (e.g. up to 200 mg/day) of vitamin C to these people is not sufficient to overcome the enhanced utilization of the vitamin1; they instead require intravenous administration of gram doses (i.e. 2,000 mg/day)4., One recent clinical study has indicated that intravenous vitamin C may be able to decrease mortality in patients with severe pneumonia5, which is a major complication of COVID-19. Clinical trials are currently underway to assess the effects of high-dose intravenous vitamin C in patients with COVID-19, however, the results from these studies are not likely to be available until later in the year6., Health Feedback has produced a number of other claim reviews on COVID-19. You can view them here., 2019-nCoV \xa0Coronavirus \xa0COVID-19 \xa0Nutrition \xa0Respiratory infections \xa0Vitamin \xa0Vitamin C, Published on: 20 Mar 2020 | Editor: Flora Teoh, Health Feedback is a non-partisan, non-profit organization dedicated to science education. Our reviews are crowdsourced directly from a community of scientists with relevant expertise. 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No, the Shanghai government has not recommended intravenous vitamin C as a treatment for COVID-19 - Health Feedback