All year we’ve been feeding government agencies studies on vitamin C showing benefit for covid. On November 1st we published a review of 12 intervention trials. Following our recent letter NICE and RAPID C19 have confirmed they will consider ALL vitamin C trials we informed them about. This is the first sign of real engagement in the emerging science on vitamin C. It could be a big step forward but we have to make sure they follow through.
Their full reply to our recent exchange is shown below.
In summary, they say “On 18 November 2021, we sent a revised list of 18 potentially relevant studies to SACN (the Scientific Advisory Board of Nutrition).”
What exactly SACN, who advise Public Health England will do with this evidence is the next hurdle. They maintain their only brief is ‘prevention’ and these trials are ‘treatment’ so we need to make sure there isn’t simply more ball passing back and forth.
I have written to PHE/SACN saying “ So, we have a potential situation here where the agency, Public Health England, entrusted to Is it PHE’s view that if a trial shows faster recovery rate giving oral vitamin C, as the Thomas et al study re-analysis shows, this would not within PHE’s/SACN’s remit since it classifies as a ‘treatment’ trial? If so, would it then be in NICE/RAPID C-19’s remit?
Then, if any agency were to confirm that there is a beneficial effect of vitamin C would it be in PHE’s remit to advise the public accordingly given that its mission is “to protect and improve the health and wellbeing of the population.”
Will PHE put pharma interests or public interests first? If you have written to your MP, and they’ve responded saying there’s no evidence you could write again and forward them NICE’s response. The evidence is now acknowledged. Let’s see what they do with it. We’ll keep the pressure up through our vitaminC4covid.com campaign.
Here's the letter:
From: Katy, Communications Executive, National Institute for Health and Care Excellence
Thank you for contacting the National Institute for Health and Care Excellence (NICE).
We hope the following detail helps in response to the queries for NICE on inclusion of particular studies.
On 18 November 2021, we sent a revised list of 18 potentially relevant studies to SACN:
* Zhang, Jing, Rao, Xin, Li, Yiming et al. (2021) Pilot trial of high-dose vitamin C in critically ill COVID-19 patients. Annals of intensive care 11(1): 5
* Kumari, Poona, Dembra, Suman, Dembra, Pariya et al. (2020) The Role of Vitamin C as Adjuvant Therapy in COVID-19. Cureus 12(11): e11779
* Hakamifard A, Soltani R, Maghsoudi A et al. (2021) The effect of vitamin E and vitamin C in patients with COVID-19 pneumonia; a randomized controlled clinical trial. Immunopathologia Persa 8(1): 1-6
* Holford P, Carr A C, Zawari M et al. (2021) Vitamin C Intervention for Critical COVID-19: A Pragmatic Review of the Current Level of Evidence. Life 11(11): 1166
* Gao, Dengfeng, Xu, Min, Wang, Gang et al. (2021) The efficiency and safety of high-dose vitamin C in patients with COVID-19: a retrospective cohort study. Aging 13
* Xia, Guozhi, Fan, Di, He, Yanru et al. (2021) High-dose intravenous vitamin C attenuates hyperinflammation in severe coronavirus disease 2019. Nutrition (Burbank, Los Angeles County, Calif.) 9192: 111405
* Zhao, Bing, Liu, Min, Liu, Ping et al. (2021) High Dose Intravenous Vitamin C for Preventing The Disease Aggravation of Moderate COVID-19 Pneumonia. A Retrospective Propensity Matched Before-After Study. Frontiers in pharmacology 12: 638556
* Suna, Kavurgaci, Melahat, Uzel Sener, Murat, Yildiz et al. (2021) Effect of high-dose intravenous vitamin C on prognosis in patients with SARS-CoV-2 pneumonia. Medicina clinica
* Li, Matthew, Ching, Tsung Han, Hipple, Christopher et al. (2021) Use of Intravenous Vitamin C in Critically Ill Patients With COVID-19 Infection. Journal of pharmacy practice: 8971900211015052
We did not share the following study as we do not believe it is relevant to the topic area. Groups are those without and those with ameliorated cardiac injury, rather than with and without vitamin C. Therefore, results are association between ameliorated cardiac injury and vitamin C.
* Xia, G.; Qin, B.; Ma, C.; Zhu, Y.; Zheng, Q. High-dose vitamin C ameliorates cardiac injury in COVID-19 pandemic: A retrospective cohort study. Aging Al. N.Y. 2021, 13, 20906–20914, doi:10.18632/aging.203503.
We can confirm that we have identified the study by Tehrani et al and we have flagged this study to be shared with SACN.
Based on the feedback below, we have revisited the previous exclusion decision for the Thomas et al study. Although the study was terminated early, it does compare vitamin C to standard of care, using a randomised methodology. The main outcomes are related to reduction in symptoms. We have therefore flagged this study to be shared with SACN. We had previously not included the Hemila et al paper as it is a secondary analysis of the data published by Thomas et al. However, for completeness we will also share the Hemila et al paper so the SACN are aware that some authors have reanalysed the data in a different way.
Finally, thank you for flagging the University of Otago Vitamin C and COVID-19 research resource. We will consider how best to use it in our evidence surveillance process going forward.
We can also confirm that RAPID C-19 has reviewed the RAPID C-19 briefing against the RCTs that have been flagged to make sure all are included.
I hope the above information is useful for you.
National Institute for Health and Care Excellence
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