One of my student doctors asked my opinion on the management of coronavirus. Here follows my suggestions gleamed from the literature.
1. Vitamin C is still my favorite antiviral agent most certainly for the more serious forms of the infection especially the pneumonia (Acute respiratory distress syndrome-ARDS). It seems that this is due to an underlying ‘cytokine storm’ causing the high mortality. This ‘storm’ can also happen with the influenza virus.
Vitamin C is well placed to deal with this scenario. It is a powerful antioxidant protecting cells from oxidative stress. It has immune cell stimulating functions, increasing phagocytosis. It supports endothelial cell function and improves microcirculation. It supports wound healing and collagen synthesis. One of the doctors working at the epicentre of the virus outbreak has published the following information:
We call upon all those in the leadership, and those providing direct assistance patients, to bravely and rapidly apply large dose intravenous vitamin C (IVC) to help those patients and to stop this epidemic.
Coronaviruses and influenza are among the pandemic viruses that can cause lethal lung injuries and death from ARDS. Viral infections cause a “cytokine storm” that can activate lung capillary endothelial cells leading to neutrophil infiltration and increased oxidative stress (reactive oxygen and nitrogen species) that further damages lung barrier function. ARDS, which is characterized by severe hypoxemia, is usually accompanied by uncontrolled inflammation, oxidative injury, and the damage to the alveolar-capillary barrier. The increased oxidative stress is a major insult in pulmonary injury such as acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), two clinical manifestations of acute respiratory failure with substantially high morbidity and mortality.
Dr Mao is the chief of emergency medicine department in a major Shanghai hospital and already had lots of experience with the use of vitamin C in life threatening diseases. He co-authored the Shanghai Guidelines for the treatment of Covid-19 infection, an official document endorses by the Shanghai Medical Association and Shanghai city government. They treated 50 cases of moderate to severe cases of Covid-19 infection with high dose IV vitamin C. The dose was in the range of 10-20 grams a day for 7-10 days. All patients who received IV vitamin C improved and there was no mortality. Those receiving vitamin C has a shorter hospitalisation by 3-5 days. One very serious patient received 50 grams over 4 hours with a dramatic recovery. No side effects reported.
Expert consensus on comprehensive treatment of coronavirus disease in Shanghai 2019. Chinese journal of Infectious Diseases 2020,38. Wang D et al
The following is an article from the Orthomolecular Association, who have much experience in the use of high dose vitamin C:
How Vitamin C Reduces Severity and Deaths from Serious Viral Respiratory Diseases
by Andrew W. Saul, Editor
Orthomolecular Medicine News Service, Feb 10, 2020
Vitamin C and its application to the treatment of nCoV Coronavirus
Most deaths from coronavirus are caused by pneumonia. Vitamin C has been known, for over 80 years, to greatly benefit pneumonia patients.
In 1936 Gander and Niederberger found that vitamin C lowered fever and reduced pain in pneumonia patients. 
Also in 1936, Hochwald independently reported similar results. He gave 500 mg of vitamin C every ninety minutes. 
McCormick gave 1000 mg vitamin C intravenously, followed by 500 mg orally every hour. He repeated the injection at least once. On the fourth day, his patient felt so well that he voluntarily resumed work, with no adverse effects. 
In 1944 Slotkin and Fletcher reported on the prophylactic and therapeutic value of vitamin C in bronchopneumonia, lung abscess, and purulent bronchitis. “Vitamin C has greatly alleviated this condition and promptly restored normal pulmonary function.” 
Slotkin further reported that “Vitamin C has been used routinely by the general surgeons in the Millard Fillmore Hospital, Buffalo, as a prophylactic against pneumonia, with complete disappearance of this complication.” 
According to the US Centers for Disease Control, there are about 80,000 dead from annual influenzas, escalating to pneumonia, in the USA. Coronavirus is a very serious contagious disease. But contagion to a virus largely depends on the susceptibility of the host. It is well established that low vitamin C levels increase susceptibility to viruses. 
Vitamin C lowers mortality
It is one thing to be sick from a virus and another thing entirely to die from a viral-instigated disease. It must be emphasized that a mere 200 mg of vitamin C/day resulted in an 80% decrease in deaths among severely ill, hospitalized respiratory disease patients. 
A single, cheap, big-box discount store vitamin C tablet will provide more than twice the amount used in the study above.
And yes, with vitamin C, more is better.
Frederick R. Klenner and Robert F. Cathcart successfully treated influenza and pneumonia with very high doses of vitamin C. Klenner published on his results beginning in the 1940s;  Cathcart beginning in the 1970s.  They used both oral and intravenous administration.
“Vitamin C is effective in reducing duration of severe pneumonia in children less than five years of age. Oxygen saturation was improved in less than one day.” 
A recent placebo controlled study concluded that “vitamin C should be included in treatment protocol of children with pneumonia so that mortality and morbidity can be reduced.” In this study, the majority of the children were infants under one year of age. By body weight, the modest 200 mg dose given, to tiny babies, would actually be the equivalent of 2,000-3,000 mg/day for an adult. 
Although many will rightly maintain that the dose should be high, even a low supplemental amount of vitamin C saves lives. This is very important for those with low incomes and few treatment options.
We’re talking about twenty cents’ worth of vitamin C a day to save lives now.
1. Gander and Niederberger. Vitamin C in the handling of pneumonia.” Munch. Med. Wchnschr., 31: 2074, 1936.
2. Hochwald A. Beobachtungen uber Ascorbinsaurewirkung bei der krupposen Pneumonie.” Wien. Arch. f. inn. Med., 353, 1936.
3. McCormick WJ. Have we forgotten the lesson of scurvy? J Applied Nutrition, 1962, 15:1 & 2, 4-12.
4. Slotkin & Fletcher. Ascorbic acid in pulmonary complications following prostatic surgery. Jour. Urol., 52: Nov. 6, 1944.
5. Slotkin GE. Personal communication with WJ McCormick. December 2, 1946.
6. Saul AW. Nutritional treatment of coronavirus. Orthomolecular Medicine News Service, 16:6, Jan 30, 2020. (22 references and 50 recommended papers for further reading)
7. Hunt C et al. The clinical effects of Vitamin C supplementation in elderly hospitalised patients with acute respiratory infections. Int J Vitam Nutr Res 1994;64:212-19.
8. Klenner FR. Observations on the dose and administration of ascorbic acid when employed beyond the range of a vitamin in human pathology. J Applied Nutrition 1971, 23:3&4.
Klenner FR. (1948) Virus pneumonia and its treatment with vitamin C. J South Med Surg 110:36-8.
Klenner, FR. (1951) Massive doses of vitamin C and the virus diseases. J South Med and Surg, 113:101-107.
Klenner, FR. (1971) Observations on the dose and administration of ascorbic acid when employed beyond the range of a vitamin in human pathology. J. App. Nutr., 23:61-88.
All of Dr. Klenner’s papers are listed and summarized in: Clinical Guide to the Use of Vitamin C (ed. Lendon H. Smith, MD, Life Sciences Press, Tacoma, WA, 1988.
9. Cathcart RF. (1981) Vitamin C, titrating to bowel tolerance, anascorbemia, and acute induced scurvy. Med Hypotheses. 7:1359-76.
Cathcart RF. (1993) The third face of vitamin C. J Orthomolecular Med, 7:197-200.
Additional Dr. Cathcart papers are posted at http://www.doctoryourself.com/biblio_cathcart.html
10. Khan IM et al. (2014) Efficacy of vitamin C in reducing duration of severe pneumonia in children. J Rawalpindi Med Col (JRMC). 18(1):55-57.
Oral vs IV vitamin C
One of the most interesting articles I have read recently appeared in the Townsend Letter(march 2020) concerning the very rapid rise in blood ascorbate levels following oral consumption. In fact oral consumption of 4,000mg of ascorbic acid taken my mouth can produce the same rapid increase in plasma concentration as an intravenous infusion. That actually supports my own experience with Influenza, taking one gram vitamin C every hour. While liposomal vitamin C may still be the best approach when using oral vitamin C nevertheless this study suggests that the common cheap vitamin C actually does get well absorbed. Vitamin C does not last in the blood very long so that taking the oral form may even extent the usefulness of IV vitamin C or even replace it.
Dr Klingardt is a very well know Integrative doctor in the USA with lots of experience in treating serious virus infections. In a recent report he advised the following approach to the 2019-nCov virus.
1. Vitamin C IV 50-200mg/kg which works out to 4-15 gms/day for 3 days
2. A mixture of the following tinctures:
- Artemesia Annua
- 2 dropper full 2x/day as preventive or 4x/day if ill.
3. Vitamin D 6000-10,000IU/day
4. Hypochlorous acid spray as a disinfectant.
5. Chloroquine for vey serious cases. 500mg bd for 10 days
6. Switch off WiFi.
Clearly vitamin C is the gold standard right now. I suggest everyone be taking 3-5 grams per day orally and increase to hourly or even more frequently if any symptoms appear.If you can get IV vitamin C then go for it but it does appear that the oral form taken frequently may also do the trick. Vitamin D and some of the tinctures suggested by Dr Klingardt may be useful additions.
This is not a battle we are fighting, but a journey. The earth is calling us back home to pay attention to its needs and be less self centred but caring for the earth we walk on, the plants and animals that surround us and our own fellow participants in the world of human involvement.
By Dr Bernard Brom