Clinical trials investigating use of two widely available products — vitamin C and the statin drug simvastatin — in critically ill COVID patients have yielded far different results.

Simvastatin had a 96% likelihood of improving outcomes, including a 92% chance of improving survival at three months.

Vitamin C was not found to be beneficial in these patients and, researchers said, may even be harmful.

The studies were part of an ongoing trial dubbed REMAP-CAP.

“These results are really encouraging as they have shown that treatment with simvastatin is highly likely to improve outcomes in critically ill patients with COVID-19,” Danny McAuley, lead investigator for the simvastatin arm of REMAP-CAP, said in a news release from the Global Coalition for Adaptive Research, the U.S. trial sponsor.

“This research will help health care professionals internationally to improve the treatment of patients with COVID-19,” he said.

For simvastatin, which is widely available and cheap, researchers calculated that the benefits were equal to about one life saved for every 33 patients.

The study included more than 2,600 critically ill patients at 141 hospitals in 13 countries.

The study on vitamin C was the largest to examine high doses of the vitamin in COVID. It combined the REMAP-CAP trial with another — dubbed LOVIT-COVID. More than 2,500 hospitalized COVID patients in 20 countries — some critically ill, others not — were included.

“Harnessing the power of global collaboration, the harmonized REMAP-CAP and LOVIT-COVID trials have investigated vitamin C, a potential therapy for COVID-19, and have shown it to be ineffective and probably harmful,” said co-lead investigator Dr. Neill Adhikari, an associate scientist at Sunnybrook Health Sciences Center in Toronto.

“The results from this trial suggest that the use of vitamin C in hospitalized COVID-19 patients should be de-adopted,” he said in the release.

Co-lead investigator François Lamontagne of the University of Sherbrooke in Quebec, said the results underscore the health and economic benefits of identifying and abandoning readily available interventions that don’t help and may harm patients.

Since March 2020, REMAP-CAP has investigated treatments for hospitalized patients with respiratory tract infection. It continues to evaluate multiple interventions for COVID, influenza and other severe respiratory infections. 

A total of 290 U.S. patients participated in the vitamin C study at the University of Pittsburgh Medical Center (UPMC), Ohio State University Wexner Medical Center and Oregon Health & Science University.

“To have both of these results from REMAP-CAP published simultaneously is testament to the ability of this trial to efficiently evaluate multiple interventions,” said Dr. Derek Angus, head of critical care medicine at UPMC and principal U.S. investigator of REMAP.

“Through this horrific pandemic, we’ve pioneered a new way to rapidly address some of the biggest treatment questions, caring for patients today and preparing to respond more nimbly in the future,” Angus said in the release.

Study findings were published Oct. 25 in the Journal of the American Medical Association and the New England Journal of Medicine, and were also presented at a meeting of the European Society of Intensive Care Medicine in Milan, Italy.

More information

The U.S. Centers for Disease Control and Prevention has more on COVID-19.

SOURCE: Global Coalition for Adaptive Research, news release, Oct. 25, 2023

Source: HealthDay