"Introduction
... The aim of this publication is to provide a feasibility analysis of whether the use of intravenous (IV) vitamin C in post-viral fatigue, particularly after COVID-19, should be further investigated.
Discussion
... High-dose IV vitamin C combats overwhelming oxidative stress and restores endothelial and organ function. In the case of COVID-19, oxidative stress not only triggers organ damage but also causes immune thrombosis via the formation of neutrophil extracellular traps (NETs). This results in embolisms and dysfunction of microcirculation. The situation is aggravated by the fact that SARS-CoV-2 also penetrates endothelial cells via ACE receptors and triggers a chain reaction of endothelial damage, infiltration of neutrophils, and resulting NETs. As for vitamin C, it is essential for the phagocytosis of consumed neutrophils by macrophages. If this clearance does not take place, necrosis of the neutrophils occurs, leading to NETs and thus to circulatory disorders. Therefore, an early application of high-dose vitamin C is proposed to possibly prevent the development of severe COVID-19 courses. Indeed, in a first pilot study in COVID-19 patients requiring intensive care, high-dose IV vitamin C significantly improved oxygenation, reduced organ-damaging cytokine storm (IL-6), and showed a trend towards reduced mortality in severely ill patients. A significant reduction in mortality and improvement of oxygen status by high-dose vitamin C was observed in a recent retrospective cohort study. From these findings, it can be hypothesized that vitamin C administration may also be associated with a therapeutic post-viral benefit in the case of persistent symptoms."
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