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Supplements

vitamin C treats sepsis

In plain terms: Does intravenous vitamin C help treat sepsis?

Leans against Supplements 🔬 Includes disconfirming

Part of: 🧪 vitamin C

RefutedContestedStrong support
consensus score -0.25

No—early hopeful trials were overturned; the landmark LOVIT trial and the largest analyses show no benefit and a possible harm signal.

Evidence ladder

How far up the ladder this claim has climbed. A high consensus on a low rung means "consistent so far," not "proven in people."

Top evidence so far: All trials, pooled (Meta-analysis)

MechanismIn-vitroAnimalObservationalRCTMeta-analysis

How the studies fall

2 support 5 contradict 0 tested null 2 mixed · 9 sources, 7 independent groups

What the evidence shows

High-dose **intravenous** vitamin C is **not** an established sepsis treatment and may be harmful. The evidence is genuinely mixed but nets negative: several *pre-LOVIT* meta-analyses of small trials reported a mortality benefit (e.g. OR 0.60), but the pivotal LOVIT RCT (NEJM 2022) found a higher risk of death or persistent organ dysfunction, and the largest, most rigorous synthesis since — a comp

The evidence (9)

SourceGradeStanceQualityFinding
Chang et al.
2020 · Chest
RCT mixed moderate RCT of HAT (hydrocortisone+vit C+thiamine): no clear mortality reduction (combination therapy — cannot isolate vitamin C).
Xing et al.
2021 · Clin Nutr
meta-analysis supports moderate Pre-LOVIT MA: IV vit C reported beneficial for some critically-ill outcomes (later contradicted by larger trials).
Plummer & Bellomo
2022 · Nat Rev Nephrol
observational contradicts low Analysis of LOVIT + CLASSIC trials: high-dose IV vitamin C might be HARMFUL in severe sepsis (higher risk of death/persistent organ dysfunction).
Brown et al.
2022 · Cureus
meta-analysis contradicts moderate SRMA (18 studies, 4078 pts): no mortality reduction and no effect on SOFA, ICU stay, vasopressor or ventilation duration.
Feng et al.
2021 · Sci Prog
meta-analysis supports moderate Pre-LOVIT MA (9 RCTs, 584 pts): vit C reduced 28-day mortality (OR 0.60) — the earlier optimistic signal, since overturned.
Lee et al.
2023 · Ann Intensive Care
meta-analysis contradicts moderate Updated SRMA + trial-sequential analysis of IV vit C monotherapy: the landmark LOVIT harm signal reverses earlier positive pooled estimates.
Radke et al.
2023 · Curr Opin Crit Care
observational contradicts low Review of high-dose vitamin C monotherapy in critical illness: recent RCT evidence negative — 'end of the story' for routine use.
Fujii et al.
2022 · Intensive Care Med
meta-analysis contradicts high Component NMA (43 RCTs, 10,257 pts, CINeMA): vitamin C alone or in metabolic-resuscitation combos NOT associated with lower longer-term mortality; no effect on organ dysfunction or ICU stay.
Hung et al.
2023 · Front Nutr
meta-analysis mixed moderate MA + TSA of IV vit C monotherapy on mortality: information size insufficient — no firm mortality benefit established.

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