Low Levels of Serum and Intracellular Vitamin C in Hospitalized COVID-19 Patients

Vitamin C is a crucial micronutrient for human immune cell function and has potent antioxidant properties. It is hypothesized that vitamin C serum levels decline during infection. However, the precise mechanisms remain unknown. To gain deeper insights into the true role of vitamin C during infection...

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Published inNutrients Vol. 15; no. 16; p. 3653
Main Authors Boerenkamp, Lara S, Gijsbers, Birgit L M G, Ververs, Erik-Jan, Pijpers, Eva M S, Spaetgens, Bart, de Coninck, Aniek, Germeraad, Wilfred T V, Wodzig, Will K W H, Wieten, Lotte, van Gorkom, Gwendolyn N Y, van Elssen, Catharina H M J
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Published Switzerland MDPI AG 01.08.2023
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Abstract Vitamin C is a crucial micronutrient for human immune cell function and has potent antioxidant properties. It is hypothesized that vitamin C serum levels decline during infection. However, the precise mechanisms remain unknown. To gain deeper insights into the true role of vitamin C during infections, we aimed to evaluate the body's vitamin C storage during a SARS-CoV-2 infection. In this single-center study, we examined serum and intracellular vitamin C levels in peripheral blood mononuclear cells (PBMCs) of 70 hospitalized COVID-19 patients on the first and fifth days of hospitalization. Also, clinical COVID-19 severity was evaluated at these timepoints. Our findings revealed a high prevalence of hypovitaminosis C and vitamin C deficiency in hospitalized COVID-19 patients (36% and 15%). Moreover, patients with severe or critical disease exhibited a higher prevalence of low serum vitamin C levels than those with moderate illness. Serum vitamin C levels had a weak negative correlation with clinical COVID-19 severity classification on the day of hospitalization; however, there was no correlation with intracellular vitamin C. Intracellular vitamin C levels were decreased in this cohort as compared to a healthy cohort and showed further decline during hospitalization, while serum levels showed no relevant change. Based on this observation, it can be suggested that the reduction of intracellular vitamin C may be attributed to its antioxidative function, the need for replenishing serum levels, or enhanced turnover by immune cells. These data give an incentive to further investigate the role of intracellular vitamin C in a larger and more heterogeneous cohort as well as the underlying mechanisms.
AbstractList Vitamin C is a crucial micronutrient for human immune cell function and has potent antioxidant properties. It is hypothesized that vitamin C serum levels decline during infection. However, the precise mechanisms remain unknown. To gain deeper insights into the true role of vitamin C during infections, we aimed to evaluate the body’s vitamin C storage during a SARS-CoV-2 infection. In this single-center study, we examined serum and intracellular vitamin C levels in peripheral blood mononuclear cells (PBMCs) of 70 hospitalized COVID-19 patients on the first and fifth days of hospitalization. Also, clinical COVID-19 severity was evaluated at these timepoints. Our findings revealed a high prevalence of hypovitaminosis C and vitamin C deficiency in hospitalized COVID-19 patients (36% and 15%). Moreover, patients with severe or critical disease exhibited a higher prevalence of low serum vitamin C levels than those with moderate illness. Serum vitamin C levels had a weak negative correlation with clinical COVID-19 severity classification on the day of hospitalization; however, there was no correlation with intracellular vitamin C. Intracellular vitamin C levels were decreased in this cohort as compared to a healthy cohort and showed further decline during hospitalization, while serum levels showed no relevant change. Based on this observation, it can be suggested that the reduction of intracellular vitamin C may be attributed to its antioxidative function, the need for replenishing serum levels, or enhanced turnover by immune cells. These data give an incentive to further investigate the role of intracellular vitamin C in a larger and more heterogeneous cohort as well as the underlying mechanisms.
Audience Academic
Author Boerenkamp, Lara S
Ververs, Erik-Jan
Spaetgens, Bart
Wieten, Lotte
Pijpers, Eva M S
de Coninck, Aniek
Germeraad, Wilfred T V
van Elssen, Catharina H M J
Gijsbers, Birgit L M G
Wodzig, Will K W H
van Gorkom, Gwendolyn N Y
AuthorAffiliation 1 Division of Hematology, Department of Internal Medicine, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
2 Department of Internal Medicine, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
3 Central Diagnostic Laboratory, Department of Clinical Chemistry, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
4 Department of Transplantation Immunology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
AuthorAffiliation_xml – name: 2 Department of Internal Medicine, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
– name: 3 Central Diagnostic Laboratory, Department of Clinical Chemistry, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
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– name: 4 Department of Transplantation Immunology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
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  givenname: Aniek
  surname: de Coninck
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  givenname: Wilfred T V
  surname: Germeraad
  fullname: Germeraad, Wilfred T V
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– sequence: 8
  givenname: Will K W H
  surname: Wodzig
  fullname: Wodzig, Will K W H
  organization: Central Diagnostic Laboratory, Department of Clinical Chemistry, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
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  surname: Wieten
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  givenname: Gwendolyn N Y
  orcidid: 0000-0001-7327-7834
  surname: van Gorkom
  fullname: van Gorkom, Gwendolyn N Y
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  givenname: Catharina H M J
  orcidid: 0000-0003-1784-1765
  surname: van Elssen
  fullname: van Elssen, Catharina H M J
  organization: Division of Hematology, Department of Internal Medicine, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
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Issue 16
Keywords COVID-19
vitamin C
immune cells
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Snippet Vitamin C is a crucial micronutrient for human immune cell function and has potent antioxidant properties. It is hypothesized that vitamin C serum levels...
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StartPage 3653
SubjectTerms Antioxidants
Ascorbic Acid
Colds
COVID-19
Drug dosages
Health aspects
Hospital patients
Humans
immune cells
Infection
Infectious diseases
Leukocytes
Leukocytes, Mononuclear
Neutrophils
Oxidative stress
Pneumonia
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Ventilators
Vitamin C
Vitamin deficiency
Vitamins
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Title Low Levels of Serum and Intracellular Vitamin C in Hospitalized COVID-19 Patients
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Volume 15
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