Literature Review
Volume 4 Issue 6 - 2020
Using Vitamin C as Pre-Exposure Prophylaxis and Treatment to Strengthen the Immune System against COVID-19: A Review of Current Literature
Jonathan Lukusa Tshimwanga1*, Jacques Lukenze Tamuzi2, Nuru Kaddu Mgori3 and Jacques WA Nsenda Kamangu3
1Department of Disaster Management, Faculty of Agriculture and Natural Sciences, University of the Free State, South Africa
2Division of Epidemiology, Faculty of Medicine and Community Health, Stellenbosch University, South Africa
3Independent Researcher, Senior HIV Clinical Mentor, South Africa
*Corresponding Author: Jonathan L Tshimwanga, PhD Candidate, Department of Disaster Management, Faculty of Agriculture and Natural Sciences, University of the Free State, South Africa.
Received: March 20, 2020; Published: May 15, 2020


The coronavirus 19 (COVID-19) is a life-threating disease of public health importance. It is caused by the outbreak of a new coronavirus, leading to community-acquired pneumonia, as well as respiratory and multiple organ failure. The disease has spread across the globe, affecting numerous health systems and illustrating the prevailing gap in preventive and curative measures against disease outbreak and severe acute respiratory syndrome (SARS). More than 209,839 confirmed cases have been documented and 8778 deaths have been recorded within the first three months of the emergence of the disease. The high case fatality rate is due to the lack of a curative treatment or availability of a proven vaccine against SARS-CoV-2. Moreover, it is anticipated that the discovery of effective interventions might take longer; meanwhile, the COVID-19 pandemic is skyrocketing.

It is therefore imperative for the use of cost-effective, preventive and readily available interventions to be implemented instantly to curb the disease morbidity and mortality rate - for example, the use of vitamin C against numerous forms of influenza.

Vitamin C has shown a potent antimicrobial property in reducing the pathogenicity of viruses. Previous studies have illustrated the role of vitamin C in the treatment of the severe acute respiratory syndrome (SARS) outbreak during 2002 and the Middle East respiratory syndrome (MERS) outbreak during 2012.

In addition, there is an ongoing randomised control trial study in the Republic of China on the consumption of high-dose vitamin C in the treatment of COVID-19. Based on its pharmacodynamic, vitamin C is an essential adjuvant in the treatment of viral pneumonia and is also a cost-effective measure which can be given while waiting to prevent and treat COVID-19. In contrast, there are a few studies that contradict the effectiveness of vitamin C versus the recovery against influenza viruses. More research is, therefore warranted in order to evaluate the contradicting roles of vitamin C in the management of viral respiratory illnesses.

In this literature review, the authors emphasise the role of vitamin C in preventive and curative measures during the management of COVID-19.

Keywords: COVID-19; SARS-Cov2; MERS-CoV; Vitamin C; Coronavirus; Immune System


  1. “Coronavirus disease 2019 (COVID-19) Situation report – 59” (2020).
  2. Al-Hazmi A. “Challenges presented by MERS corona virus, and SARS corona virus to global health”. Saudi Journal of Biological Sciences 23 (2016): 507-511.
  3. Akaike T., et al. “Free radicals in viral pathogenesis: molecular mechanisms involving superoxide and NO”. Sage Journals1 (1998): 64-73.
  4. Akaike T. “Role of free radicals in viral pathogenesis and mutation”. Review in Medical Virology2 (2001): 87-101.
  5. Zaki AM., et al. “Isolation of a Novel Coronavirus from a Man with Pneumonia in Saudi Arabia”. The new England Journal of Medicine 19 (2012): 1814-1820.
  6. Park M., et al. “COVID-19: Lessons from SARS and MERS”. European Journal of Immuology 50 (2020): 308-311.
  7. Lobo V., et al. “Free radicals, antioxidants and functional foods: Impact on human health”. Pharmacognosy Reviews8 (2010): 118-126.
  8. Aziz AM., et al. “Antioxidant Categories and Mode of Action” (2019).
  9. Pehlivan FE. “Vitamin C: An Antioxidant Agent”. Intech (2017).
  10. Hui DS., et al. “The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health-The latest 2019 novel coronavirus outbreak in Wuhan, China”. International Journal of Infectious Diseases 91 (2020): 264-266.
  11. Janský L., et al. “Dynamics of cytokine production in human peripheral blood mononuclear cells stimulated by LPS or infected by Borrelia”. Physiological Research 6 (2003): 593-598.
  12. Fowler AA., 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”. JAMA Network14 (2019): 1261-1270.
  13. Kim WY., 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 47 (2018): 211-218.
  14. Wilsher SH., et al. “That is an Awful Lot of Fruit and Veg to Be Eating”. Focus Group Study on Motivations for the Consumption of 5 a Day in British Young Men”. Nutrients 8 (2019).
  15. Thompson RL., et al. “The Health Education Authority’s health and lifestyle survey 1993: who are the low fruit and vegetable consumers?”. Journal of Epidemiology and Community Health5 (1999): 294-299.
  16. Mousavi S., et al. “Immunomodulatory and Antimicrobial Effects of Vitamin C”. European Journal of Microbiology and Immunology3 (2019): 73-79.
  17. Carr AC and Maggini S. “Vitamin C and Immune Function”. Nutrients 9 (2017): 11.
  18. Johnston C S., et al. “Plasma vitamin C is inversely related to body mass index and waist circumference but not to plasma adiponectin in nonsmoking adults”. The Journal of Nutrition7 (2007) :1757-1762.
  19. Johnston C S., et al. “Marginal vitamin C status is associated with reduced fat oxidation during submaximal exercise in young adults”. Nutrition and Metabolism 3 (2006).
  20. Furuya A., et al. “Antiviral effects of ascorbic and dehydroascorbic acids in vitro. International journal of molecular medicine”. International Journal of Molecular Medecine4 (2008): 541-545.
  21. Mikirova NA and Hunninghake R. “Effect of high dose vitamin C on Epstein-Barr Viral infection”. Medical Science Monitor 20 (2014): 725-732.
  22. S Corrao. “Use of ascorbic acid in patient with COVID 19: clinical trial” (2020).
  23. Li W., et al. “Vitamin C Deficiency Increases the Lung Pathology of Influenza Virus-Infected Gulo-/- Mice”. The Journal of Nutrition10 (2006): 2611-2616.
  24. Woo A., et al. “Vitamin C acts indirectly to modulate isotype switching in mouse B cells”. Anatomy and Cell Biology1 (2010).
  25. Xi D. “Vitamin C in Cancer Therapeutics and Metastasis”. Journal of Orthopedic Research and Therapy1 (2019).
  26. Kim H., et al. “Red ginseng and vitamin C increase immune cell activity and decrease lung inflammation induced by influenza A virus/H1N1 infection”. Journal of Pharmacy and Pharmacology3 (2016): 406-420.
  27. Carr A and Frei B. “Does vitamin C act as a pro-oxidant under physiological conditions?”. The FASEB Journal9 (1999): 1007-1024.
  28. Valacchi G., et al. “Vitamin C Compound Mixtures Prevent Ozone-Induced Oxidative Damage in Human Keratinocytes as Initial Assessment of Pollution Protection”. PLoS One8 (2015): e131097.
  29. Goldschmidt MC. “Reduced bactericidal activity in neutrophils from scorbutic animals and the effect of ascorbic acid on these target bacteria In vivo and In vitro”. The American Journal of Clinical Nutrition6 (1991): 214S-1220S.
  30. Hemilä H. “Vitamin C and Infections”. Nutrients1 (2017).
  31. Erol A. “High-dose intravenous vitamin C treatment for COVID-19 (a mechanistic approach”. 16.19 (2020).
  32. Hemilä H and Douglas RM. “Vitamin C and acute respiratory infections”. The International Journal of Tuberculosis and Lung Disease 9 (1999): 756-761.
  33. Atherton JG., et al. “The Effect of Ascorbic Acid on Infection of chick-embryo ciliated trachea organ cultures by Coronavirus”. Archives of Virology3 (1978): 195-199.
  34. Davelaar FG and Van den Bos J. “Ascorbic acid and infectious bronchitis infections in broilers”. Avian Pathology 4 (1992): 581-589.
  35. Drexler JF., et al. “Genomic characterization of severe acute respiratory syndrome-related coronavirus in European bats and classification of coronaviruses based on partial RNA-dependent RNA polymerase gene sequences”. Journal of Virology 84 (2010): 11336-11349.
  36. Peng Z. “Vitamin C Infusion for the Treatment of Severe 2019-nCoV Infected Pneumonia”. U.S. National Library of Medicine (2020).
  37. Rosa SGV and Santos WC. “Clinical trials on drug repositioning for COVID-19 treatment”. Pan American Journal of Public Health 44 (2020).
Citation: Jonathan L Tshimwanga., et al. “Using Vitamin C as Pre-Exposure Prophylaxis and Treatment to Strengthen the Immune System against COVID-19: A Review of Current Literature”. EC Emergency Medicine and Critical Care 4.6 (2020): 85-91.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

October Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the October issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

Ecronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before November 08, 2021.

Certificate of Publication

Ecronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

Ecronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.

Immediate Assistance

The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to