Authors: Colunga Biancatelli RM, Berrill M, Marik PE

PMID: 31852327 DOI: 10.1080/14787210.2020.1706483


There is a growing interest in the administration of vitamin C beyond the treatment of hypovitaminosis C in malnourished patients. This has been driven by a 2016 ‘before-after’ study which suggested a substantial survival benefit from a protocol that included hydrocortisone, ascorbic acid (vitamin C) and thiamine (HAT therapy) in the treatment of patients with severe sepsis and septic shock [Citation1]. Currently, Clinical lists 29 ongoing or completed trials investigating vitamin C administration in sepsis. Historically, there has been misguided and erroneous suggestions of the effectiveness of vitamin C in promoting longevity, preventing and treating the common cold [Citation2], and a collection of poorly evidenced health claims, encouraged by a multi-billion dollar over the counter vitamin supplement industry. Many of the misconceptions regarding vitamin C were perpetuated by two-times Nobel Laureate Linus Pauling [Citation3,Citation4]. The revival of interest in vitamin C therapy for acute inflammatory disorders, grounded in sound biological rationale, follows decades of research. The current focus of interest centers on bacterial sepsis and septic shock in critically ill patients. Over 300 basic science and clinical studies provide strong mechanistic data to support the use of vitamin C in this setting [Citation5,Citation6]. There is, however, emerging literature to suggest that vitamin C may play an adjunctive role in the treatment of a variety of viral infections. The purpose of this article is to review the biological rationale and evidence for the administration of vitamin C in viral infections.

Keywords: Vitamin C; ascorbic acid; herpes virus; influenzae; viral illnesses.