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FOR IMMEDIATE RELEASE
Vitamin C Evidence for Treating Complications of COVID-19 and other Viral Infectionsby Magnus P. F. Rasmussen(OMNS Apr 23, 2020) - For medical professionals, COVID-19 patients and their relatives/families and anyone willing to learn more about vitamin C. A bit of information on vitamin D3, zinc and melatonin is included, too.
Licensing:This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at Creative Commons' website: https://creativecommons.org/licenses/by/4.0/legalcode This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Legal Disclaimer:This document does NOT provide medical advice. This document acts SOLELY for informational purposes and nothing stated in this document, including but not limited to text, URL link, scientific studies and other sources provided, should be considered medical advice. Nor is it intended to be a substitute for ANY professional medical advice, including but not limited to the professional medical advice, diagnosis or treatment of a physician and/or a medical provider. Do NOT disregard any professional medical advice or delay in seeking it because of anything you have read in this document. ALWAYS seek the advice of your physician or other qualified health care providers with any questions you may have regarding a medical condition and/or treatment before undertaking a new health care regimen. Neither is this document to be taken as a reason to stop self isolating and social distancing amid the pandemic. - Reliance on any information appearing in this document is SOLELY at your own discretion. Read this before reading:The document does not substitute reading the sources provided herein. Most of the document is a reading guide for most relevant sources on vitamin C and D for prevention and treatment of complications from COVID-19 and other viral infections. I also highly encourage anyone reading this document, especially the medical professionals, to keep an open mind. I'm therefore hoping you will search for information about other micronutrients, supplements and/or pharmaceutical drugs that play an important role in immune function and possible prevention and treatment of COVID-19 and or other viral respiratory illnesses. A nonexhaustive list of these micronutrients: vitamin C, D, E and A, zinc, selenium, magnesium, vitamin B6, iron and copper. The Google Docs document this article is based on will receive regular updates and can be accessed with the following link: https://docs.google.com/document/d/1uLormkjoKO5JMkQh80-nGiKk-X5Ik5idi3gWqwd_Up4/edit
Abbreviations used:
Table of Contents
1. Vitamin C Safety Oral and Intravenous
1. Vitamin C Safety Oral and IntravenousThis section contains carefully selected and compiled information on the safety of oral and intravenous (IV) vitamin C. 1.1. Safety of Oral Vitamin COral supplementation of vitamin C is safe and well tolerated when not taken beyond bowel tolerance. Bowel tolerance is indicated by mild gastrointestinal symptoms such as: flatulence, belching, mild rumbling from the gastrointestinal tract, increased bowel movement and loose stools. Bowel tolerance is not indicated by severe gastrointestinal issues like diarrhea, abdominal pain, cramping and bloating and nausea. That's taking vitamin C past bowel tolerance, and it's not recommended unless the goal is to cleanse the gastrointestinal tract. When taking very large and frequent (many times per day) oral dosages of vitamin C it could be potentially dangerous not to follow Dr. Robert F. Cathcart's advice on the symptoms of bowel tolerance and titrating vitamin C to bowel tolerance [1]. The original 1981 research paper by Cathcart discussed titrating to bowel tolerance with l-ascorbic acid (AA) - this was Cathcart's preferred variant of vitamin C. Cathcart said AA was the only form of oral vitamin C that could achieve a "clinical ascorbate effect". According to Cathcart the usual bowel tolerance dosage depends on the severity of the disease. The dosage required to hit this level could be anything from 15g/day to +200g/day [1]. The severity of the disease is measured as the amount of inflammation and oxidation caused by reactive oxygen and nitrogen species (ROS/RNS). A 2007 literature review titled "Vitamin C may affect lung infections" reported this about the high bowel tolerance vitamin C dosages Cathcart had observed in his clinical practice [71]: "Furthermore, it has been stated that patients with pneumonia can take up to 100 g/day of vitamin C without developing diarrhoea, possibly because of the changes in vitamin C metabolism caused by the severe infection." 1.2. Safety of IV-CFor nearly all people high dose intravenous vitamin C (HDIV-C) appears to be remarkably safe, well tolerated and without any serious adverse events in clinical trials and clinical practice of practitioners using it. One of the lead National Institute of Health (NIH) nutrient researchers Sebastian J. Padayatty and colleagues came to the following conclusion in a study from 2010 about use of IV-C by integrative medicine practitioners [2]: "Other than the known complications of IV vitamin C in those with renal impairment or glucose 6 phosphate dehydrogenase deficiency, high dose intravenous vitamin C appears to be remarkably safe" The NIH - National Cancer Institute's article titled "High-Dose Vitamin C (PDQ(r))-Health Professional Version" about HDIV-C treatment for cancer had this to say about side effects [3]: "Intravenous (IV) high-dose ascorbic acid has been generally well tolerated in clinical trials. [1-8] Renal failure after ascorbic acid treatment has been reported in patients with preexisting renal disorders. [9] Case reports have indicated that patients with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency should not receive high doses of vitamin C because of the risk of developing hemolysis. [10-12] Vitamin C may increase bioavailability of iron, and high doses of the vitamin are not recommended for patients with hemochromatosis. [13]" The article's section "Human/Clinical Studies" appears to indicate that the NIH has not yet been able to establish an upper limit for dosing & infusion rate for HDIV-C. This applies only to people without existing renal disorders, hemochromatosis or G6PD deficiency, since people suffering from any of these illnesses were excluded from the clinical trials. The current largest dosage and infusion rate investigated for cancer patients in clinical trials is 1.5g/kg/day and infusion rate of 1g/minute. They did not appear to cause any serious adverse events [3]. Hence, no upper limit on dose and infusion rate for vitamin C has been established in clinical trials. A review about critically ill patients with septic shock Markos G. Kashiouris, Alpha A. Fowler and colleagues reported the following about intravenous vitamin C (IV-C) and side effects:[4] "In all the sepsis trials mentioned above, HDIVC was found to be safe and no significant side-effects were identified. Additionally, two studies in non-medical patients did not report adverse side effects." The trials mentioned in the review excluded those with renal impairment, hemochromatosis & G6PD deficiency [4]. 1.3. Vitamin C and Kidney StonesA prospective case series study conducted by Melissa Prior et al., which was the first long term study to examine the relationship between IV-C administration and renal stones, reported the following [5]: "No renal stones were reported by any patients in the study, despite 8% of the patients having a history of renal stones. In addition, the majority of patients investigated had stable renal function during the study period as evidenced by little change in serum creatinine levels and estimated glomerular filtration rate (eGFR) following IVC. In conclusion, IVC therapy was not associated with patient-reported renal stones." In the previously mentioned septic shock article the researchers reported that vitamin C hasn't caused renal stones or hyperoxaluria in any clinical trials [4]: "One proposed side effect of HDIVC is an increased propensity for oxalate kidney stone production, but this has not been shown in any clinical trials to date." In addition, case reports of vitamin C therapy causing renal stones or renal failure are rare [2]. The limited evidence in the medical literature on vitamin C induced renal stones suggests vitamin C will only cause renal stones in patients with renal insufficiency. It's therefore plausible to conclude it's highly unlikely for HDIV-C or daily multigram oral supplementation to cause renal stone precipitation in people without renal insufficiency. 1.4. G6PD Deficiency and Vitamin CWhile IV-C is usually not recommended for patients with G6PD deficiency Ron Hunninghake of the Riordan Clinic Research Institute has said IV-C appears to be safe for patients with G6PD deficiency at moderate infusion dosages of 25g [6] (s. 4 p. 14): "Hemolysis has been reported in patients with G6PD deficiency when given high-dose IVC (Campbell, et al., 1975). The G6PD level should be assessed before beginning IVC. (At the Riordan Clinic, G6PD readings have yielded five cases of abnormally low levels. Subsequent IVC at 25 grams or less showed no hemolysis or adverse effects.)" This evidence, while limited, seems to indicate IV-C at moderate infusion dosages of 25g appears to be safe and well tolerated in patients with G6PD deficiency. The Riordan Clinic recommends checking red blood cell G6PD levels prior to onset of IV-C therapy [6] (s. 3 p. 13.). 1.5. Vitamin C and HemochromatosisThe relationship between vitamin C and hemochromatosis appears to be based on the theory of "iron overload" as stated here by the NIH [3]: "Vitamin C may increase bioavailability of iron, and high doses of the vitamin are not recommended for patients with hemochromatosis. [13]" While there are reports of vitamin C therapy causing "iron overload", these are rare. In addition, no studies on vitamin C supplementation in people with hemochromatosis have been conducted to date. Some evidence from the Riordan Clinic seems to conflict with the theoretical premise of vitamin C and "iron overload". Ron Hunninghake, MD from the Riordan Clinic reported the following [6] (s. 9 p. 15): "There have been some reports of iron overload with vitamin C therapy. We have treated one patient with hemochromatosis with high-dose IVC with no adverse effects or significant changes in the iron status." Steve Hickey PhD had the following to say about high dose vitamin C and hemochromatosis [7]: "There is a theoretical danger but the actual reports are sparse and unclear. I expect that if vitamin C really did have such a side-effect, its detractors would have had a field day. Having read much of the available evidence, I consider the benefits of high dose vitamin C to exceed greatly any (largely theoretical) side-effects." - from the book "Ascorbate: The Science of Vitamin C", by Hickey S and Roberts H. The limited evidence in the medical literature on megadose vitamin C and hemochromatosis suggests vitamin C is fairly safe, and the evidence to discourage its use appears to be weak, largely unfounded and based on theory, not reality. Despite this, caution is still advised for patients with hemochromatosis using IV-C therapy, and blood levels should be monitored during treatment. Another word of caution for oral supplementation: People with hemochromatosis taking large multigram daily doses of oral vitamin C should be taking it between meals. Additionally, they should take measures to lower blood ferritin levels like blood donation or lowering dietary iron intake. 1.6. A Final NoteWe can conclude that vitamin C is a very safe biomolecule, and it can be used in massive dosages by those not suffering from G6PD deficiency, hemochromatosis or renal insufficiency. It also appears vitamin C will only cause renal stones in people with renal insufficiency. For patients with G6PD deficiency, limited patient data from the Riordan Clinic showed that: "Subsequent IV-C at 25 grams or less showed no hemolysis or adverse effects" For people with hemochromatosis, while caution is still advised vitamin C appears to be fairly safe, and the evidence to discourage its use appears to be weak, largely unfounded and based on theory, not reality. Science has proven that Frederick Robert Klenner was right when he said: "Vitamin C is the safest substance available to the physician." 2. Efficacy and Benefits of IV vs Oral Vitamin CIn mainstream medicine and some of the integrative and orthomolecular medicine community there's a strong consensus that oral vitamin C cannot achieve the clinical effects associated with pharmacological ascorbate (1-100mM/L) blood levels but at most blood concentrations of 0.2mM/L. This notion is based on research that investigated vitamin C blood levels following oral supplementation [8]. In mainstream medicine there's also another widely accepted notion that only 200-250mg/day of oral vitamin C can be absorbed. However clinical experience from Robert F. Cathcart, a prominent practitioner advocating for oral megadoses of vitamin C, and new research seems to contradict this notion [9]. Owen Fonorow did a case study on a diabetic 61 year old male. He monitored blood vitamin C concentrations every minute following ingestion - something that's never been done before. Because vitamin C uses the same cell membrane transporters as glucose, a diabetic study participant is ideal. Based on findings from the second experiment Fonorow estimated 4000mg of AA absorption in a short time frame (250mg/minute for 40 minutes) is possible. The paper mentioned that AA absorption was efficient [9]: "Indeed, the initial oral measurements appear slightly greater than were obtained with the IV/C suggesting an efficient absorption through the stomach wall." In a third experiment absorption and blood levels were monitored following ingestion of a 10g gulp of AA or 11.3g of SA. AA had rapid absorption and achieved remarkably high vitamin C blood levels in the millimolar range (>1mM/L), peaking as high as >5mM/L at 3-7 minutes. This effect was not seen for SA which had significantly slower absorption - that was more like a timed release. Fonorow ended the article by stating the following about Cathcart [9]: "Cathcart also reported that he could only obtain 'a clinical ascorbate effect' orally with ascorbic acid, not mineral ascorbates. We might speculate that an increased stomach acidity in the sick can at least in part explain Cathcart's observations." The rapid and early absorption and utilization of AA presented here may help explain what Cathcart reported. While the sample size from this case study is tiny, the remarkable pharmacokinetics of AA observed does seem to confirm the clinical observations of Dr. Cathcart [9] [1]. Some practitioners who have used LEV-C, including Thomas E. Levy, claim that in some instances it can have effects that are similar or superior to IV-C. This could be due to the following unique features of LEV-C [10]:
While the oral AA findings from the case study and the unique features of LEV-C sound impressive, HDIV-C can achieve much higher and more stable vitamin C blood levels (>20mM/L) than oral vitamin C [3]. Furthermore IV-C is more viable than oral SA and AA for hospitalized patients for multiple reasons. First, titrating to bowel tolerance isn't possible for many ICU patients, some of whom are in critical condition. Second, it could be more convenient for hospitalized patients than oral vitamin C. Third, IV-C allows for higher and more effective doses of vitamin C. Fourth, the uptake into the bloodstream is 100%, and the rate of infusion can be controlled and fine tuned. And fifth, IV-C can be given to patients no matter how sick they're as long as they don't suffer from renal failure or preexisting renal disorders. In addition, as previously mentioned, one 25g IV-C infusion can safely be used in patients with G6PD deficiency. Many integrative medicine vitamin C advocates have recommended combining IV-C with oral supplementation when possible. The LEV-C - because of its aforementioned unique features - seems to be the best candidate for hospitalized patients [10]. Oral AA is the second best candidate. If the clinician wants to use massive doses of vitamin C orally as an adjunct til IV-C, AA should be used instead of SA due to its superior pharmacokinetics and nonexistent sodium load, which makes titrating to bowel tolerance an easier and more effective strategy [9]. A word of caution: Hospitalized patients should not take oral vitamin C past bowel tolerance. 3. IV-C Protocols, Administration, Cost and DosingGiven the relatively novel nature of IV-C in mainstream medical research, most of the information in the articles listed here is based on clinical experience of medical practitioners using megadose vitamin C. The safety aspect of vitamin C was explained in a previous section titled "1. Vitamin C Safety Oral and Intravenous". The recommended IV-C dosages for treating COVID-19 infection in hospitalized patients varies. The lowest dosages are 6gram/day, 50-100mg/kg/day [11] [12] [17]. Moderate dosages are 200mg/kg/day, 12gram/day and 25gram/day [11] [12] [14] [17]. The HDIV-C are 30-60g/day [18], and as high as >1g/kg/day for mild and moderate cases and >3g/kg/day for severe cases [14]. The IV-C administration strategies are different in other aspects. Some protocols have used multiple hour continuous infusion of IV-C two times per day [85], while others have used 1-2x 30-60minute infusions per day [14]. Most of the protocols use IV-C infusions every 6-8 hours [14] [17]. The duration of IV-C treatment and dosages required depends on the severity and progression of the COVID-19 infection. Hence, the course of the illness should be closely monitored and IV-C dosages should be adjusted accordingly. Below are included some IV-C articles explaining how to best administer it. Articles with useful information about how to make IV-C solutions and dosage recommendations for treating COVID-19 in hospitalized patients are listed too:
4. Significant RCT's, Reviews, Meta-analyses and Articles on Vitamin CNote: Research material by integrative and orthomolecular medicine practitioners and advocates have been excluded from this section. These studies can be found under the section titled "6. Orthomolecular Clinical Experience, Studies and Articles on Vitamin C". Ongoing research announced investigating IV-C for treating COVID-19 can found under the section titled "5. Studies and Trials on Vitamin C for Treatment of COVID-19". For articles on safety, efficacy and administration of vitamin C go to references or the previous sections titled: "1. Vitamin C Safety Oral and Intravenous", "2. Efficacy and Benefits of IV vs Oral Vitamin C" and "3. IV-C Protocols, Administration, Cost and Dosing". It should be noted that the vitamin C research listed here is built upon a mountain of in vitro and in vivo studies and clinical research. In addition, it builds upon decades of clinical experience from medical doctors who at some point began using orthomolecular medicine in their clinical practice. These doctors were Frederick R. Klenner, Robert F. Cathcart, Archie Kalokerinos, Hugh Riordan, Ron Hunninghake, Thomas E. Levy and many more. 4.1. RCT's and StudiesAlpha A. Fowler III et al., Effect of vitamin C Infusion on Organ Failure and Biomarkers of Inflammation and Vascular Injury in Patients With Sepsis and Severe Acute Respiratory Failure - The CITRIS-ALI Randomized Clinical Trial, Journal of the American Medical Association (JAMA), 2019;322(13):1261-1270 (Epub 2019 October 1), doi:10.1001/jama.2019.11825 Description [21]: This is the first RCT to date to investigate the effects of moderate dosages (>200mg/kg/day) of IV-C on patients with sepsis and severe acute respiratory failure (ARDS). The trial could not detect any significant or noticeable differences in the primary end point outcomes between the vitamin C and placebo group. Primary end points were: SOFA scores, C-reactive protein levels and thrombomodulin levels. However, there were some encouraging results in of many of the secondary end point outcomes. Some of these were statistically significant:
- This RCT faced criticism due to alleged survivorship bias.
Alpha A. Fowler et al., Phase I safety trial of intravenous ascorbic acid in patients with severe sepsis, Journal of Translational Medicine, 2014; 12: 32 (Epub 2014 January 31), doi:
10.1186/1479-5876-12-32
Mohadeseh H. Zabet et al., Effect of high-dose Ascorbic acid on vasopressor's requirement in septic shock, Journal of Research in Pharmacy Practice, 2016 Apr-Jun: 5(2): 94-100, doi:
10.4103/2279-042X.179569
Paul E. Marik et al., Hydrocortisone, Vitamin C, and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Before-After Study, Chest, 2017 Jun;151(6):1229-1238 (Epub December 6, 2016), doi: 10.1016/j.chest.2016.11.036
Eric Wald et al., Hydrocortisone-Ascorbic Acid-Thiamine Use Associated with Lower Mortality in Pediatric Septic Shock, American Journal of Respiratory and Critical Care Medicine, 2020 April 1, Volume 201, Issue 7 (Epub January 9, 2020), doi: 10.1164/rccm.201908-1543LE
Tomoko Fujii et al., Effect of Vitamin C, Hydrocortisone, and Thiamine vs Hydrocortisone Alone on Time Alive and Free of Vasopressor Support Among Patients With Septic Shock - The VITAMINS Randomized Clinical Trial, Journal of the American Medical Association (JAMA), 2020;323(5):423-431 (Epub 2020 January 17), doi:10.1001/jama.2019.22176
Ping Chang et al., Combined treatment with hydrocortisone, vitamin C, and thiamine for sepsis and septic shock (HYVCTTSSS): A randomized controlled clinical trial, Chest, 2020 Mar 31. pii: S0012-3692(20)30552-3, doi: 10.1016/j.chest.2020.02.065.
Won-Young Kim et al., Combined vitamin C, hydrocortisone, and thiamine therapy for patients with severe pneumonia who were admitted to the intensive care unit: Propensity score-based analysis of a before-after cohort study, Journal of Critical Care, 2018 Oct;47:211-218 (Epub 2018 July 5). doi:
10.1016/j.jcrc.2018.07.004
Anitra C. Carr et al., Hypovitaminosis C and vitamin C deficiency in critically ill patients despite recommended enteral and parenteral intakes, Critical Care, 2017 Dec 11;21(1):300, doi:
10.1186/s13054-017-1891-y
Tae K. Kim et al., Vitamin C supplementation reduces the odds of developing a common cold in Republic of Korea Army recruits: randomised controlled trial, BMJ Military Health, 2020 Mar 5. pii: bmjmilitary-2019-001384 (Epub ahead of print), doi:
10.1136/bmjmilitary-2019-001384
H. Clay Gorton and Kelly Jarvis, The effectiveness of vitamin C in preventing and relieving the symptoms of virus-induced respiratory infections, Journal of Manipulative and Physiological Therapeutics, 1999 Oct;22(8):530-3, DOI:
10.1016/s0161-4754(99)70005-9
Clare Hunt et al., The clinical effects of vitamin C supplementation in elderly hospitalised patients with acute respiratory infections, International Journal for Vitamin and Nutrition Research, 1994;64(3):212-9., PMID: 7814237
Imran M. Khan et al., Efficacy of Vitamin C in Reducing Duration of Severe Pneumonia in Children, Journal Of Rawalpindi Medical College (JRMC), 2014;18(1):55-57, at Journalrmc.com.
Ren Shiguang et al., Observation on the therapeutic effect of intravenous large dose of vitamin C on infants and young children with viral pneumonia, Hebei Medicine, 1978,4:1-3.
4.2. Meta-analysesHarri Hemilä and Elizabeth Chalker, Vitamin C may reduce the duration of mechanical ventilation in critically ill patients: a meta-regression analysis, Journal of Intensive Care, 2020; 8: 15 (Epub 2020 February 7), doi:
10.1186/s40560-020-0432-y
Vitamin C Can Shorten the Length of Stay in the ICU: A Meta-Analysis, Harri Hemilä and Elizabeth Chalker, Nutrients, 2019 Apr; 11(4): 708 (Epub 2019 March 27), doi:
10.3390/nu11040708.
Harri Hemilä and Elizabeth Chalker, Vitamin C for preventing and treating the common cold, Cochrane Database of Systematic reviews, 2013 Jan 31;(1):CD000980, doi:
10.1002/14651858.CD000980.pub4.
They concluded the following in the abstract:
4.3. ReviewsMarkos G. Kashiouris et al.,The Emerging Role of Vitamin C as a Treatment for Sepsis, Nutrients, 2020 Feb; 12(2): 292 (Epub 2020 January 22), doi:
10.3390/nu12020292
Harri Hemilä, Vitamin C and Infections, Nutrients, 2017 Apr; 9(4): 339 (Epub 2017 March 29), doi:
10.3390/nu9040339
Anitra C. Carr and Silvia Maggini, Vitamin C and Immune Function, Nutrients, 2017 Nov; 9(11): 1211 (Epub 2017 November 3), doi:
10.3390/nu9111211
Harri Hemilä and Robert M. Douglas, Vitamin C and acute respiratory infections, International Journal of Tuberculosis and Lung Disease, 1999 Sep;3(9):756-61, PMID: 10488881
Harri Hemilä and Pekka Louhiala, Vitamin C may affect lung infections, Journal of the Royal Society of Medicine, 2007 Nov; 100(11): 495-498, doi: 10.1258/jrsm.100.11.495
Harri Hemilä and Pekka Louhiala, Vitamin C for preventing and treating pneumonia, Cochrane Database Systematic Review, 2013 Aug 8;(8):CD005532, doi:
10.1002/14651858.CD005532.pub3.
Yin Li and Guoping Li., Is Vitamin C Beneficial to Patients with CAP, Current Infectious Disease Reports, 2016 Aug;18(8):24. doi:
10.1007/s11908-016-0530-0.
Pramath Kakodkar et al., A Comprehensive Literature Review on the Clinical Presentation, and Management of the Pandemic Coronavirus Disease 2019 (COVID-19), Cureus, Cureus 12(4): e7560, 2020 April 6, doi:
10.7759/cureus.7560
Sebastian J. Padayatty and Mark Levine, Vitamin C physiology: the known and the unknown and Goldilocks, Oral Diseases, 2016 Sep; 22(6): 463-493 (Epub 2016 April 14), doi:
10.1111/odi.12446
4.4. Miscellaneous ArticlesMichael A. Matthay et al., Treatment of severe acute distress syndrome from COVID-19, The Lancet Respiratory Medicine, 2020 March 20, doi:
https://doi.org/10.1016/S2213-2600(20)30127-2
iSepsis - Vitamin C, Hydrocortisone and Thiamine - The "Metabolic Resuscitation Protocol", Paul Marik, EMCrit.org - iSepsis Project (EMCrit), July, 16 2017.
Adnan Erol, High-dose intravenous vitamin C treatment for COVID-19, preprint (not yet peer reviewed), 2020 February, doi:
10.31219/osf.io/p7ex8.
Paul E. Marik and Michael H. Hooper, Doctor-your septic patients have scurvy!, Critical Care, 2018 Jan 29;22(1):23, doi:
10.1186/s13054-018-1950-z
Salim Surani and Munish Sharma, Revisiting the Role of Vitamin C in Sepsis. Is it a Forlorn Hope or is there Still Dearth of data?, The Open Respiratory Medicine Journal, Bentham Open, Benthamopen.com, 2019 Dec 31;13:55-57, doi:
10.2174/1874306401913010055
5. Studies and Trials on Vitamin C for Treatment of COVID-19As of today (April 15, 2020) 6 trials on vitamin C have been announced, and three of them are currently recruiting patients. Four are active, while two have been cancelled. A brief overview of the current vitamin C trials can be found under the section "Nutrients" in the following document from the Danish Medicines Agency titled "Overview of planned or ongoing studies of drugs for the treatment of COVID-19" [84]. ZhiYong Peng, Vitamin C Infusion for the Treatment of Severe 2019-nCoV Infected Pneumonia, Date of registration: February 11, 2020, ClinicalTrials.gov.
Jun Lin, A randomized, open, controlled trial for diammonium glycyrrhizinate enteric-coated capsules combined with vitamin C tablets in the treatment of common novel coronavirus pneumonia (COVID-19) in the basic of clinical standard antiviral treatment to evaluate the safety and efficiency, Date of registration: February 12, 2020, Chinese Clinical Trial Registry, Chictr.org.cn.
Gao Defeng, An observational study of high-dose vitamin C in the treatment of severe and critical patients with novel coronavirus pneumonia (COVID-19), Date of registration: February 17, 2020, Chinese Clinical Trial Registry, Chictr.org.cn.
Gao Defeng, A randomized controlled trial for high-dose vitamin C in the treatment of severe and critical novel coronavirus pneumonia (COVID-19) patients, Date of registration: February 24, 2020, Chinese Clinical Trial Registry, Chictr.org.cn.
Salvatore Corrao, Use of Ascorbic Acid in Patients With COVID 19, Date of registration: March 26, 2020, ClinicalTrials.gov.
Markos. G. Kashiouris and Alpha A. Fowler, Early Infusion of Vitamin C for Treatment of Novel COVID-19 Acute Lung Injury (EVICT-CORONA-ALI), Date of registration: April 14, 2020, ClinicalTrials.gov.
6. Orthomolecular Clinical Experience, Studies and Articles on Vitamin CBelow is a compilation of articles relevant to the current COVID-19 pandemic. This includes the clinical experience medical doctors, who are/were using orthomolecular medicine, have had with vitamin C and viral infections. Other miscellaneous articles from orthomolecular medicine practitioners and advocates are provided, too. 6.1. Clinical Experience and Observational StudiesFrederick R. Klenner reported remarkable results using IV-C and high dose oral vitamin C. Here are some of the papers he published and a detailed article about his research:
Frederick R. Klenner, M.D, The Treatment of Poliomyelitis and Other Virus Diseases with Vitamin C, Southern Medicine & Surgery, Volume 111, Number 7, July, 1949, pp. 209-214.
Frederick R. Klenner, M.D, Observations On the Dose and Administration of Ascorbic Acid When Employed Beyond the Range Of A Vitamin In Human Pathology, Journal of Applied Nutrition, Vol. 23, No's 3 & 4, Winter 1971.
And here are two important articles, one by Robert F. Cathcart, MD and one by Thomas E. Levy, MD: Robert F. Cathcart, M.D, VITAMIN C, TITRATING TO BOWEL TOLERANCE, ANASCORBEMIA, AND ACUTE INDUCED SCURVY, Medical hypotheses, 1981, 7:1359-1376, Vitamin C Foundation.
The Clinical Impact of Vitamin C: My Personal Experience as a Physician, Thomas E. Levy, Orthomolecular Medicine News Service, Orthomolecular.org, September 3, 2014. Description [53]: In this commentary Thomas E. Levy, MD compiled what he considered to be the most dramatic anecdotes about the power of megadose vitamin C. The majority of these were from his own practice. 6.2. Miscellaneous Research Papers, Articles and Slideshows on Vitamin CRationale for Vitamin C Treatment of COVID-19 and Other Viruses, Orthomolecular Medicine News Service Editorial Review Board, Orthomolecular Medicine News Service, Orthomolecular.org, April 3, 2020.
Richard Z. Cheng, Can early and high intravenous dose of vitamin C prevent and treat coronavirus disease 2019 (COVID-19)?, Medicine in Drug Discovery, 2020 March 26, doi: 10.1016/j.medidd.2020.100028
Coronavirus Coverup - Vitamin C Dramatic Help against Infection in China, South Korea - Why Aren't We Told, Mara Leverkuhn, Medium.com, March 17, 2020.
Case for Vitamin C for COVID-19, Patrick Halford, PatrickHolford.com, Mar 29, 2020.
And here's a transcript of a video conference where Dr. Enqiang Mao shared his experience with IV-C for treating hospitalized COVID-19 patients: Successful High-Dose Vitamin C Treatment of Patients with Serious and Critical COVID-19 Infection, Richard Cheng, MD, PhD, Orthomolecular Medicine News Service, March 18, 2020.
This is a useful article on how to get IV-C administered to a hospitalized patient: How to Get Intravenous Vitamin C Given to a Hospitalized Patient: A Checklist, Andrew W. Saul, DoctorYourself.com, 2019.
And here are some interesting slideshows: Role of Ascorbic Acid in Covid 19 Management, Dr Yuen Chuen Fong Raymond, DoctorYourself.com.
Colds, Flus and COVID-19: Can Supplements Help?, Prof Kylie O'Brien PhD and Prof Ian Brighthope, Australasian College Of Nutritional And Environmental Medicine (ACNEM), ACNEM.org, 2020.
And furthermore, here's some in-depth research material on COVID-19 by Doris Loh: STOP ARDS NOW WITH ASCORBIC ACID, Doris Loh, Evolutamente.it, March 28, 2020.
COVID-19, ARDS & CYTOKINE STORMS - THE RECYCLING OF ASCORBIC ACID BY MACROPHAGES, NEUTROPHILS AND LYMPHOCYTES, Doris Loh, Evolutamente.it, April 5, 2020.
MITOCHONDRIA & THE CORONAVIRUS - THE VITAMIN C CONNECTION (PART 3), Doris Loh, Evolutamente.it, February 1, 2020.
COVID-19, FURINS & HYPOXIA - THE VITAMIN C CONNECTION, Doris Loh, Evolutamente.it, February 29, 2020.
COVID-19 MUTATIONS, VACCINES & NITRIC OXIDE - THE VITAMIN C CONNECTION, Doris Loh, Evolutamente.it, March 7, 2020.
COVID-19, PNEUMONIA & INFLAMMASOMES - THE MELATONIN CONNECTION, Doris Loh, Evolutamente.it, March 14, 2020.
COVID-19, ARDS & CELL-FREE HEMOGLOBIN - THE ASCORBIC ACID CONNECTION, Doris Loh, Evolutamente.it, March 24, 2020.
6.3. Large Folders (ZIP), Link Collections and Comprehensive Articles on Multifaceted Orthomolecular Treatment of Viral DiseasesBRIGHTHOPE CORONAVIRUS SHARE GENERAL, Dr. Ian Brighthope, available at Dropbox.com.
Safe and Effective Modalities For COVID-19 That Can Not Be 'Proven'", Dr. Charles Chun-En Hsu, M.D, Afternoon Health, April 1, 2020.
Published Research and Articles on Vitamin C as a Consideration for Pneumonia, Lung Infections, and the Novel Coronavirus (SARS-CoV-2/COVID-19), Graham Player, PhD et al., March 22, 2020, Orthomolecular Medicine News Service, Orthomolecular.org.
7. Alan Smith H1N1 Story and an Enterovirus Case ReportAlan Smith, a New Zealand farmer with severe H1N1 Swine Flu resulting in coma and ECMO intubation, saved by HIDV-C and LEV-C. Watch Part 1
[66] and 2 [67].
Alpha A. Fowler et al., Intravenous vitamin C as adjunctive therapy for enterovirus/rhinovirus induced acute respiratory distress syndrome, World Journal of Critical Care Medicine, 2017 Feb 4; 6(1): 85-90 (Epub 2017 February 4), doi:
10.5492/wjccm.v6.i1.85
8. Immunoregulatory and Antiviral Properties of Vitamin D, Zinc and MelatoninThis section will list important sources for vitamin D and melatonin, and it will include a piece of text on zinc's antiviral properties. Antiviral and immunoregulatory effects of vitamin A, NAC, magnesium and other compounds won't be discussed here or in any other section of this document. Reference no. 55 talks about magnesium and NAC and can be found under subsection "6.3. Large Folders (ZIP), Link Collections and Comprehensive Articles on Multifaceted Orthomolecular Treatment of Viral Disease". Here are four sources on vitamin D3 and COVID-19: Covid-19 and Vitamin D Information, Dr Gareth Davies (PhD), Dr Joanna Byers (MBChB), Dr Attila R Garami (MD, PhD), Google Docs.
Jaykaran Charan et al., Vitamin D for prevention of respiratory tract infections: A systematic review and meta-analysis, Journal of Pharmacology & Pharmacotherapeutics, 2012 Oct-Dec; 3(4): 300-303, doi:
10.4103/0976-500X.103685
Mihnea Zdrenghea et al., Vitamin D modulation of innate immune responses to respiratory viral infections, Reviews in Medical Virology, 2017 Jan;27(1) (Epub 2016 Oct 7), doi:
10.1002/rmv.1909
Former CDC Chief. Dr. Tom Frieden: Coronavirus infection risk may be reduced by Vitamin D, Op-ed by Tom Frieden, M.D, Fox News, March 2020.
And here's a comprehensive piece of research on melatonin as a treatment for COVID-19: Rui Zhang et al., COVID-19: Melatonin as a potential adjuvant treatment, Life Sciences, 2020 June 1; 250: 117583 (Epub 2020 March 23), doi:
10.1016/j.lfs.2020.117583
And now a short word on zinc: Zinc is likely an effective and potent SARS-CoV-2 antiviral. It has been proven in multiple in vitro studies to inhibit viral replication [94] [95] [96] [97]. It's been proven in vitro to inhibit SARS-CoV (2003) [97]. The mechanism of action for zinc in viral infections is similar to remdesivir, because they both inhibit the RNA polymerase enzyme [97]. Zinc on its own won't have the same antiviral effect as when combined with a carrier ionophore. A carrier ionophore catalyzes ion transport across the cell membrane, leading to rapid intracellular ion accumulation and high intracellular concentrations of zinc ions. There are multiple known zinc ionophores, but the ones that get the greatest attention for COVID-19 are the pharmaceutical drugs hydroxychloroquine, chloroquine and the flavonol quercetin [98] [99] [100]. An excellent preprint research hypothesis by Martin Scholz and Roland Derwand from April 8, 2020 titled "Does Zinc Supplementation Enhance the Clinical Efficacy of Chloroquine/Hydroxychloroquine to Win Todays Battle Against COVID-19?" explains this in greater detail [100]. Disclaimer:This document does not provide medical advice. This document acts solely for informational purposes and nothing stated in this document, including but not limited to text, URL link, scientific studies and other sources provided, should be considered medical advice. Nor is it intended to be a substitute for any professional medical advice, including but not limited to the professional medical advice, diagnosis or treatment of a physician and/or a medical provider. Do not disregard any professional medical advice or delay in seeking it because of anything you have read in this document. Always seek the advice of your physician or other qualified health care providers with any questions you may have regarding a medical condition and/or treatment before undertaking a new health care regimen. Neither is this document to be taken as a reason to stop self isolating and social distancing amid the pandemic. Reliance on any information appearing in this document is solely at your own discretion. (Magnus P. F. Rasmussen lives in Copenhagen, Denmark. Already as an undergraduate, he is especially interested in compiling and reviewing research, particularly on the value of orthomolecular medicine to fight COVID-19.) References 1. Robert F. Cathcart, M.D, VITAMIN C, TITRATING TO BOWEL TOLERANCE, ANASCORBEMIA, AND ACUTE INDUCED SCURVY, Medical hypotheses, 1981, 7:1359-1376, Vitamin C Foundation.
2. Sebastian J. Padayatty et al., Vitamin C: Intravenous use by complementary and alternative medicine practitioners and adverse effects, PloS One, 2010; 5(7): e11414 (Epub 2010 Jul 7), doi: 10.1371/journal.pone.0011414
3. High-Dose Vitamin C (PDQ(r))-Health Professional Version, NIH - National Cancer Institute, Adverse Effects section, Cancer.gov.
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6. The Riordan IVC Protocol for Adjunctive Cancer Care Intravenous Ascorbate as a Chemotherapeutic and Biological Response Modifying Agent, Ron Hunninghake et al., Riordan Clinic Research Institute, 2014.
7. Hemochromatosis and vitamin C, Andrew W. Saul, DoctorYourself.com.
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21. Alpha A. Fowler III et al., Effect of Vitamin C Infusion on Organ Failure and Biomarkers of Inflammation and Vascular Injury in Patients With Sepsis and Severe Acute Respiratory Failure - The CITRIS-ALI Randomized Clinical Trial, Journal of the American Medical Association (JAMA), 2019;322(13):1261-1270 (Epub 2019 October 1), doi:10.1001/jama.2019.11825
22. Vitamin C for Sepsis and Severe ARDS, JAMA Network, YouTube, October 28, 2019.
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24. Mohadeseh H. Zabet et al., Effect of high-dose Ascorbic acid on vasopressor's requirement in septic shock, Journal of Research in Pharmacy Practice, 2016 Apr-Jun: 5(2): 94-100, doi: 10.4103/2279-042X.179569
25. Paul E. Marik et al., Hydrocortisone, Vitamin C, and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Before-After Study, Chest, 2017 Jun;151(6):1229-1238 (Epub December 6, 2016), doi: 10.1016/j.chest.2016.11.036
26. Eric Wald et al., Hydrocortisone-Ascorbic Acid-Thiamine Use Associated with Lower Mortality in Pediatric Septic Shock, American Journal of Respiratory and Critical Care Medicine, 2020 April 1, Volume 201, Issue 7 (Epub January 9, 2020), doi: 10.1164/rccm.201908-1543LE
27. Vitamin C-B1-Steroid Combo Linked to Lower Septic Shock Mortality in Kids, Ann & Robert H. Lurie Children's Hospital of Chicago, LurieChildrens.org, January 21, 2020.
28. Tomoko Fujii et al., Effect of Vitamin C, Hydrocortisone, and Thiamine vs Hydrocortisone Alone on Time Alive and Free of Vasopressor Support Among Patients With Septic Shock - The VITAMINS Randomized Clinical Trial, Journal of the American Medical Association (JAMA), 2020;323(5):423-431 (Epub 2020 January 17), doi:10.1001/jama.2019.22176
29. VITAMINS Trial: Vitamin C and Thiamine for Sepsis and Septic Shock, JAMA Network, YouTube, January 17, 2020.
30. Anitra C. Carr et al., Hypovitaminosis C and vitamin C deficiency in critically ill patients despite recommended enteral and parenteral intakes, Critical Care, 2017 Dec 11;21(1):300, doi: 10.1186/s13054-017-1891-y 31. Tae K. Kim et al., Vitamin C supplementation reduces the odds of developing a common cold in Republic of Korea Army recruits: randomised controlled trial, BMJ Military Health, 2020 Mar 5. pii: bmjmilitary-2019-001384 (Epub ahead of print), doi: 10.1136/bmjmilitary-2019-001384
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33. Clare Hunt et al., The clinical effects of vitamin C supplementation in elderly hospitalised patients with acute respiratory infections, International Journal for Vitamin and Nutrition Research, 1994;64(3):212-9., PMID: 7814237
34. Imran M. Khan et al., Efficacy of Vitamin C in Reducing Duration of Severe Pneumonia in Children, Journal Of Rawalpindi Medical College (JRMC), 2014;18(1):55-57, at Journalrmc.com.
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38. Harri Hemilä and Elizabeth Chalker, Vitamin C may reduce the duration of mechanical ventilation in critically ill patients: a meta-regression analysis, Journal of Intensive Care, 2020; 8: 15 (Epub 2020 February 7), doi: 10.1186/s40560-020-0432-y
39. Vitamin C Can Shorten the Length of Stay in the ICU: A Meta-Analysis, Harri Hemilä and Elizabeth Chalker, Nutrients, 2019 Apr; 11(4): 708 (Epub 2019 March 27), doi: 10.3390/nu11040708.
40. Harri Hemilä and Elizabeth Chalker, Vitamin C for preventing and treating the common cold, Cochrane Database of Systematic reviews, 2013 Jan 31;(1):CD000980, doi: 10.1002/14651858.CD000980.pub4.
41. Vitamin C for preventing and treating the common cold, Hari Hemilä and Elizabeth Chalker, Cochrane, Cochrane.org, January 31, 2013.
42. Harri Hemilä, Vitamin C and Infections, Nutrients, 2017 Apr; 9(4): 339 (Epub 2017 March 29), doi: 10.3390/nu9040339
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44. Harri Hemilä and Robert M. Douglas, Vitamin C and acute respiratory infections, International Journal of Tuberculosis and Lung Disease, 1999 Sep;3(9):756-61, PMID: 10488881
45. Sebastian J. Padayatty and Mark Levine, Vitamin C physiology: the known and the unknown and Goldilocks, Oral Diseases, 2016 Sep; 22(6): 463-493 (Epub 2016 April 14), doi: 10.1111/odi.12446
46. iSepsis - Vitamin C, Hydrocortisone and Thiamine - The "Metabolic Resuscitation Protocol", Paul Marik, EMCrit.org - iSepsis Project (EMCrit), July, 16 2017.
47. Paul E. Marik and Michael H. Hooper, Doctor-your septic patients have scurvy!, Critical Care, 2018 Jan 29;22(1):23, doi: 10.1186/s13054-018-1950-z
48. Salim Surani and Munish Sharma, Revisiting the Role of Vitamin C in Sepsis. Is it a Forlorn Hope or is there Still Dearth of data?, The Open Respiratory Medicine Journal, Bentham Open, Benthamopen.com, 2019 Dec 31;13:55-57, doi: 10.2174/1874306401913010055
49. Clinical Guide to the Use of Vitamin C, Lendon H. Smith. M.D, AscorbateWeb, 1988.
50. Frederick R. Klenner, M.D, The Treatment of Poliomyelitis and Other Virus Diseases with Vitamin C, Southern Medicine & Surgery, Volume 111, Number 7, July, 1949, pp. 209-214.
51. Frederick R. Klenner, M.D, Observations On the Dose and Administration of Ascorbic Acid When Employed Beyond the Range Of A Vitamin In Human Pathology, Journal of Applied Nutrition, Vol. 23, No's 3 & 4, Winter 1971.
52. Publications by Robert F. Cathcart, Orthomed.com (Cathcart's website), Vitamin C Foundation, VitaminCFoundation.org.
53. The Clinical Impact of Vitamin C: My Personal Experience as a Physician, Thomas E. Levy, Orthomolecular Medicine News Service, Orthomolecular.org, September 3, 2014. 54. Richard Z. Cheng, Can early and high intravenous dose of vitamin C prevent and treat coronavirus disease 2019 (COVID-19)?, Medicine in Drug Discovery, 2020 March 26, doi: 10.1016/j.medidd.2020.100028
55. Safe and Effective Modalities For COVID-19 That Can Not Be 'Proven'", Dr. Charles Chun-En Hsu, M.D, Afternoon Health, April 1, 2020.
56. Successful High-Dose Vitamin C Treatment of Patients with Serious and Critical COVID-19 Infection, Richard Cheng PhD, Orthomolecular Medicine News Service, March 18, 2020.
57. How to Get Intravenous Vitamin C Given to a Hospitalized Patient: A Checklist, Andrew W. Saul, DoctorYourself.com, 2019.
58. Colds, Flus and COVID-19: Can Supplements Help?, Prof Kylie O'Brien PhD and Prof Ian Brighthope, Australasian College Of Nutritional And Environmental Medicine (ACNEM), ACNEM.org, 2020.Link URL:
59. Colds, Flus and COVID-19: Can Supplements Help?, Prof Kylie O'Brien PhD and Prof Ian Brighthope, Australasian College Of Nutritional And Environmental Medicine (ACNEM), ACNEM.org, 2020. - This is a placeholder since the page is currently restricted.
60. STOP ARDS NOW WITH ASCORBIC ACID, Doris Loh, Evolutamente.it, March 28, 2020.
61. MITOCHONDRIA & THE CORONAVIRUS - THE VITAMIN C CONNECTION (PART 3), Doris Loh, Evolutamente.it, February 1, 2020.
62. COVID-19, FURINS & HYPOXIA - THE VITAMIN C CONNECTION, Doris Loh, Evolutamente.it, February 29, 2020.
63. COVID-19 MUTATIONS, VACCINES & NITRIC OXIDE - THE VITAMIN C CONNECTION, Doris Loh, Evolutamente.it, March 7, 2020.
64. COVID-19, PNEUMONIA & INFLAMMASOMES - THE MELATONIN CONNECTION, Doris Loh, Evolutamente.it, March 14, 2020.
65. COVID-19, ARDS & CELL-FREE HEMOGLOBIN - THE ASCORBIC ACID CONNECTION, Doris Loh, Evolutamente.it, March 24, 2020.
66. Vitamin C the Miracle Swine Flu Cure - 60 minutes Living Proof, LivLong, YouTube, January 8, 2019.
67. NZ Farmer Beats Swine Flu with Vitamin C, Food Matters, YouTube, November 9, 2010.
68. Alpha A. Fowler et al., Intravenous vitamin C as adjunctive therapy for enterovirus/rhinovirus induced acute respiratory distress syndrome, World Journal of Critical Care Medicine, 2017 Feb 4; 6(1): 85-90 (Epub 2017 February 4), doi: 10.5492/wjccm.v6.i1.85
69. Covid-19 and Vitamin D Information, Dr Gareth Davies (PhD), Dr Joanna Byers (MBChB), Dr Attila R Garami (MD, PhD), Google Docs.
70. Former CDC Chief. Dr. Tom Frieden: Coronavirus infection risk may be reduced by Vitamin D, Op-ed by Tom Frieden, M.D, Fox News, March 2020.
71. Harri Hemilä and Pekka Louhiala, Vitamin C may affect lung infections, Journal of the Royal Society of Medicine, 2007 Nov; 100(11): 495-498, doi: 10.1258/jrsm.100.11.495
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73. Won-Young Kim et al., Combined vitamin C, hydrocortisone, and thiamine therapy for patients with severe pneumonia who were admitted to the intensive care unit: Propensity score-based analysis of a before-after cohort study, Journal of Critical Care, 2018 Oct;47:211-218 (Epub 2018 July 5). doi: 10.1016/j.jcrc.2018.07.004
74. Yin Li and Guoping Li., Is Vitamin C Beneficial to Patients with CAP, Current Infectious Disease Reports, 2016 Aug;18(8):24. doi: 10.1007/s11908-016-0530-0.
75. Jaykaran Charan et al., Vitamin D for prevention of respiratory tract infections: A systematic review and meta-analysis, Journal of Pharmacology & Pharmacotherapeutics, 2012 Oct-Dec; 3(4): 300-303, doi: 10.4103/0976-500X.103685
76. Pramath Kakodkar et al., A Comprehensive Literature Review on the Clinical Presentation, and Management of the Pandemic Coronavirus Disease 2019 (COVID-19), Cureus, Cureus 12(4): e7560, 2020 April 6, doi: 10.7759/cureus.7560
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78. Rui Zhang et al., COVID-19: Melatonin as a potential adjuvant treatment, Life Sciences, 2020 June 1; 250: 117583 (Epub 2020 March 23), doi: 10.1016/j.lfs.2020.117583
79. COVID-19, ARDS & CYTOKINE STORMS - THE RECYCLING OF ASCORBIC ACID BY MACROPHAGES, NEUTROPHILS AND LYMPHOCYTES, Doris Loh, Evolutamente.it, April 5, 2020.
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93. Mihnea Zdrenghea et al., Vitamin D modulation of innate immune responses to respiratory viral infections, Reviews in Medical Virology, 2017 Jan;27(1) (Epub 2016 Oct 7), doi: 10.1002/rmv.1909
94. Xiaojiao Zheng, et al., TRIM25 Is Required for the Antiviral Activity of Zinc Finger Antiviral Protein, Journal of Virology, May 1, 2017; 91(9): e00088-17, (Epub: 2017 April 13), doi: 10.1128/JVI.00088-17
95. Nidhi Kaushik, et al., Zinc: A Potential Antiviral Against Hepatitis E Virus Infection?, DNA and Cell Biology, 2018 Jul;37(7):593-599 (Epub 2018 June 13), doi: 10.1089/dna.2018.4175
96. S. A. Read et al., The antiviral role of zinc and metallothioneins in hepatitis C infection, Journal of Viral Hepatitis, 2018 May;25(5):491-501, doi: 10.1111/jvh.12845
97. Aartjan J. W. te Velthuis et al., Zn2+ Inhibits Coronavirus and Arterivirus RNA Polymerase Activity In Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture, PLoS Pathogens, 2010 Nov; 6(11): e1001176 (Epub: 2010 Nov 4), doi: 10.1371/journal.ppat.1001176
98. Jing Xue, et al., Chloroquine is a Zinc Ionophore, PLoS One, 2014; 9(10): e109180 (Epub: 2014 Oct 1), doi: 10.1371/journal.pone.0109180
99. Husam Dabbagh-Bazarbachi et al., Zinc Ionophore Activity of Quercetin and Epigallocatechin-gallate: From Hepa 1-6 Cells to a Liposome Model, Journal of Agricultural and Food Chemistry, 2014, 62, 32, 8085-8093, doi.org/10.1021/jf5014633
100. Martin Scholtz and Roland Derwan, Does Zinc Supplementation Enhance the Clinical Efficacy of Chloroquine/Hydroxychloroquine to Win Todays Battle Against COVID-19?, preprints (not peer yet reviewed) 2020 April 8, doi: 10.20944/preprints202004.0124.v1
101. Published Research and Articles on Vitamin C as a Consideration for Pneumonia, Lung Infections, and the Novel Coronavirus (SARS-CoV-2/COVID-19), Graham Player, PhD et al., March 22, 2020, Orthomolecular Medicine News Service, Orthomolecular.org.
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