PDF(Pubmed)
Abstract：
Community-acquired pneumonia (CAP) poses a significant global health challenge, prompting exploration of innovative treatments. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of vitamin C supplementation in adults undergoing treatment for CAP. A comprehensive search of the MEDLINE, Embase, CINAHL, the Cochrane Central Register of Controlled Trials, and Clinical Trials.gov databases from inception to 17 November 2023 identified six randomized-controlled-trials (RCTs) meeting inclusion criteria. The primary outcome analysis revealed a non-significant trend towards reduced overall mortality in the vitamin C group compared to controls (RR 0.51; 95% CI 0.24 to 1.09; p = 0.052; I2 = 0; p = 0.65). Sensitivity analysis, excluding corona-virus-disease 2019 (COVID-19) studies and considering the route of vitamin C administration, confirmed this trend. Secondary outcomes, including hospital length-of-stay (LOS), intensive-care-unit (ICU) LOS, and mechanical ventilation, exhibited mixed results. Notably, heterogeneity and publication bias were observed in hospital LOS analysis, necessitating cautious interpretation. Adverse effects were minimal, with isolated incidents of nausea, vomiting, hypotension, and tachycardia reported. This meta-analysis suggests potential benefits of vitamin C supplementation in CAP treatment. However, inconclusive findings and methodological limitations warrants cautious interpretation, emphasising the urgency for high-quality trials to elucidate the true impact of vitamin C supplementation in CAP management.
摘要：
社区获得性肺炎（CAP）构成了重大的全球卫生挑战，促使探索创新的治疗方法。本系统评价和荟萃分析旨在评估接受CAP治疗的成人补充维生素C的有效性和安全性。全面搜索MEDLINE，Embase,CINAHL,Cochrane中央受控试验登记册,和ClinicalTrials.gov数据库从开始到2023年11月17日确定了六项符合纳入标准的随机对照试验（RCT）。主要结果分析显示，与对照组相比，维生素C组的总死亡率下降趋势不显着（RR0.51;95％CI0.24至1.09;p=0.052;I2=0;p=0.65）。敏感性分析,不包括2019年冠状病毒病（COVID-19）研究，并考虑维生素C的给药途径，证实了这一趋势。次要结果，包括住院时间(LOS)，重症监护病房(ICU)LOS,机械通气,表现出混合的结果。值得注意的是,在医院LOS分析中观察到异质性和发表偏倚，需要谨慎的解释。副作用很小，孤立的恶心事件，呕吐,低血压,和心动过速报告。这项荟萃分析表明补充维生素C在CAP治疗中的潜在益处。然而,不确定的发现和方法上的局限性值得谨慎解释，强调迫切需要高质量的试验来阐明补充维生素C在CAP管理中的真正影响.
