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Review
. 2020 Oct 28:11:574029.
doi: 10.3389/fimmu.2020.574029. eCollection 2020.

The Long History of Vitamin C: From Prevention of the Common Cold to Potential Aid in the Treatment of COVID-19

Giuseppe Cerullo  1 , Massimo Negro  2 , Mauro Parimbelli  2 , Michela Pecoraro  3 , Simone Perna  4 , Giorgio Liguori  1 , Mariangela Rondanelli  5   6 , Hellas Cena  6   7 , Giuseppe D'Antona  2   6
Affiliations
Review

The Long History of Vitamin C: From Prevention of the Common Cold to Potential Aid in the Treatment of COVID-19

Giuseppe Cerullo et al. Front Immunol. .

Abstract

From Pauling's theories to the present, considerable understanding has been acquired of both the physiological role of vitamin C and of the impact of vitamin C supplementation on the health. Although it is well known that a balanced diet which satisfies the daily intake of vitamin C positively affects the immune system and reduces susceptibility to infections, available data do not support the theory that oral vitamin C supplements boost immunity. No current clinical recommendations support the possibility of significantly decreasing the risk of respiratory infections by using high-dose supplements of vitamin C in a well-nourished general population. Only in restricted subgroups (e.g., athletes or the military) and in subjects with a low plasma vitamin C concentration a supplementation may be justified. Furthermore, in categories at high risk of infection (i.e., the obese, diabetics, the elderly, etc.), a vitamin C supplementation can modulate inflammation, with potential positive effects on immune response to infections. The impact of an extra oral intake of vitamin C on the duration of a cold and the prevention or treatment of pneumonia is still questioned, while, based on critical illness studies, vitamin C infusion has recently been hypothesized as a treatment for COVID-19 hospitalized patients. In this review, we focused on the effects of vitamin C on immune function, summarizing the most relevant studies from the prevention and treatment of common respiratory diseases to the use of vitamin C in critical illness conditions, with the aim of clarifying its potential application during an acute SARS-CoV2 infection.

Keywords: COVID-19; athletes; frail elderly subjects; immune function; non-communicable diseases; pneumonia; viral infections; vitamin C supplementation.

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Figures

Figure 1
Figure 1
Schematic mechanism in which an IA of vitamin C could modulate specific functions of neutrophils (ROS and TNFα, IL-1β mediated), inhibiting pathways involved in the Neutrophil Extracellular Trap formation (NETosis) and reducing the uncontrollable inflammatory cytokine production in the alveolar space. Potential effects on reducing cytokine production have also been speculated in lymphocytes and macrophages. ROS, reactive oxygen species; NFkB, nuclear transcription factor kappa B; ┴, inhibition stimulus; dashed arrow, reduced effect or production.
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