Vitamin C and pneumonia & other severe infections

by Harri Hemilä

Department of Public Health
University of Helsinki, Finland
harri.hemila@helsinki.fi
http://www.mv.helsinki.fi/home/hemila
Sept 21, 2021 

1. Pneumonia

2. Tuberculosis

3. Tetanus

4. Other infections and commentaries

Pneumonia

Flaws in a 2020 Cochrane review on vitamin C and pneumonia:
Hemilä H, Chalker E.
Commentary: Vitamin C supplementation for prevention and treatment of pneumonia.
Front Med 2021
https://doi.org/10.3389/fmed.2020.595988
http://www.ncbi.nlm.nih.gov/pmc/articles/pmc7854566/

Three controlled trials have found significant decrease in the incidence of pneumonia and two found treatment benefit for pneumonia patients.
Hemilä H, Louhiala P.
Vitamin C for preventing and treating pneumonia.
Cochrane Database Syst Rev 2013; CD005532

http://dx.doi.org/10.1002/14651858.CD005532.pub3
https://helda.helsinki.fi/handle/10138/225862
http://www.mv.helsinki.fi/home/hemila/CP/2013_Coch_Pneu_CD005532.pdf
http://www.ncbi.nlm.nih.gov/pubmed/23925826


A short review
Hemilä H, Louhiala P.
Vitamin C may affect lung infections.
JRSM 2007;100:495-498
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2099400
https://doi.org/10.1177/014107680710001109


Hemilä H.
Vitamin C intake and susceptibility to pneumonia.
Pediatr Infect Dis J 1997;16:836-837
http://dx.doi.org/10.1097/00006454-199709000-00003
https://helda.helsinki.fi/handle/10138/225875
http://www.ncbi.nlm.nih.gov/pubmed/9306475


Hemilä H.
Vitamin C supplementation and respiratory infections: a systematic review.
Military Medicine 2004;169:920-925
https://doi.org/10.7205/MILMED.169.11.920
https://helda.helsinki.fi/handle/10138/225867
http://www.mv.helsinki.fi/home/hemila/H/HH_2004.pdf
http://www.ncbi.nlm.nih.gov/pubmed/15605943

Hemilä H, Douglas RM.
Vitamin C and acute respiratory infections.
Int J TB Lung Dis 1999;3:756-761
http://www.ingentaconnect.com/content/iuatld/ijtld/1999/00000003/00000009/art00004
http://www.mv.helsinki.fi/home/hemila/H/HH_1999_IJTLD.pdf
http://www.ncbi.nlm.nih.gov/pubmed/10488881

Modification of vitamin E effect by vitamin C also means that vitamin C influences pneumonia risk.
Hemilä H, Kaprio J.
Vitamin E supplementation and pneumonia risk in males who initiated smoking at an early age: effect modification by body weight and vitamin C. Nutr J 2008;7:33
http://dx.doi.org/10.1186/1475-2891-7-33
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2603040
http://www.ncbi.nlm.nih.gov/pubmed/19019244

Comment:
Hemilä H. Vitamin C and Community-acquired Pneumonia.
AJRCCM 2011;184:621-2.
http://dx.doi.org/10.1164/ajrccm.184.5.621a

Tuberculosis

Modification of vitamin E effect by vitamin C also means that vitamin C influences TB risk.
Furthermore, high dietary vitamin C intake was associated with 60% lower TB risk in the participants who were not administered vitamin E.
Hemilä H, Kaprio J.
Vitamin E supplementation may transiently increase tuberculosis risk in males who smoke heavily and have high dietary vitamin C intake. Br J Nutr 2008;100:896-902
http://dx.doi.org/10.1017/S0007114508923709
http://www.ncbi.nlm.nih.gov/pubmed/18279551
    Discussion: BJN 2009;101:145-147
    Comment:
    http://dx.doi.org/10.1017/S0007114508994411
    Reply:
    http://dx.doi.org/10.1017/S0007114508994423

Hemilä H, Kaprio J, Pietinen P, Albanes D, Heinonen OP.
Vitamin C and other compounds in vitamin C rich food in relation to risk of tuberculosis in male smokers.
Am J Epidemiol 1999;150:632-641
http://dx.doi.org/10.1093/oxfordjournals.aje.a010062
http://www.ncbi.nlm.nih.gov/pubmed/10490003

Tetanus

One study in Bangladesh found significant benefit of vitamin C for tetanus patients, see analysis in:
Hemilä H, Koivula TT
Vitamin C for preventing and treating tetanus.
Cochrane Database Syst Rev 2013; CD006665

Summary in
French
https://www.mv.helsinki.fi/home/hemila/TFrench.html
Spanish
https://www.mv.helsinki.fi/home/hemila/CD006665_es_abstract.pdf
https://www.mv.helsinki.fi/home/hemila/TSpanish.html
Japanese
https://www.mv.helsinki.fi/home/hemila/TJapanese.html
Korean
https://www.mv.helsinki.fi/home/hemila/TKorean.html

http://dx.doi.org/10.1002/14651858.CD006665.pub3
https://helda.helsinki.fi/handle/10138/225863
http://www.mv.helsinki.fi/home/hemila/CT/2013_Coch_Tetanus_CD006665.pdf
http://www.ncbi.nlm.nih.gov/pubmed/24226506
References to the review:
http://www.mv.helsinki.fi/home/hemila/CT


Hemilä H. Vitamin C and tetanus. Annals of African Medicine 2010;9:108-109
http://www.annalsafrmed.org/text.asp?2010/9/2/108/64742
https://doi.org/10.4103/1596-3519.64742

Other infections and commentaries

Hemilä H. Infections in animals.
In: Do vitamins C and E affect respiratory infections? Thesis 2006 pp. 7-9
http://hdl.handle.net/10138/20335
http://www.mv.helsinki.fi/home/hemila/animals

Hemilä H.
Vitamin C and infections
Nutrients 2017;9(4):339.
https://doi.org/10.3390/nu9040339

Hemilä H.
Vitamin C and rabies. PLoS Neglected Tropical Diseases 2011
http://www.plosntds.org/annotation/listThread.action?root=6307

Hemilä H.
Vitamin C and SARS coronavirus.
JAC 2003;52:1049-1050
http://dx.doi.org/10.1093/jac/dkh002
https://www.mv.helsinki.fi/home/hemila/H/2003_L_JAC

Hemilä H.
Randomised trials on vitamin C.
Br J Nutr 2011;105:485-487
http://dx.doi.org/10.1017/S000711451000351X

Hemilä H.
Spectacular reduction in the mortality of acutely injured patients by the administration of vitamins C and E and selenium. JPEN 2009;33:447-448
http://dx.doi.org/10.1177/0148607108328520
http://hdl.handle.net/10138/16985

Hemilä H.
The protective effect of vitamins A and C on endotoxin-induced oxidative renal tissue damage in rats.
Tohoku J Exp Med 2006;208:99-100
http://dx.doi.org/10.1620/tjem.208.99