Vitamin C supplementation is necessary for patients with coronavirus disease: An ultra-high-performance liquid chromatography-tandem mass spectrometry finding

Abstract

\n To administer vitamin C (VC) with precision to patients with the coronavirus disease (COVID-19), we developed an ultra-high-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method to assess plasma VC concentrations. 31 patients with COVID-19 and 51 healthy volunteers were enrolled. VC stability was evaluated in blood, plasma, and precipitant-containing stabilizers. A proportion of 7.7% of VC was degraded in blood at room temperature (RT) (approximately 20 – 25\u2009°C) at 1.5\u2009h post administration with respect to the proportion degraded at 0.5\u2009h, but without statistical difference. VC was stable in plasma for 0.75\u2009h at RT, 2\u2009h at 4\u2009°C, 5 days at −40\u2009°C, and 4\u2009h in precipitant-containing stabilizer (2% oxalic acid) at RT. The mean plasma concentration of VC in patients with COVID-19 was 2.00\u2009mg/L (0.5 - 4.90) (n\u2009=\u20098), which was almost 5-fold lower than that in healthy volunteers (9.23\u2009mg/L (3.09. 35.30)) (n\u2009=\u200951). After high-dose VC treatment, the mean VC concentration increased to 13.46\u2009mg/L (3.93. 34.70) (n\u2009=\u200936), higher than that in healthy volunteers, and was within the normal range (6 – 20\u2009mg/L). In summary, we developed a simple UPLC-MS/MS method to quantify VC in plasma, and determined the duration for which the sample remained stable. VC levels in patients with COVID-19 were considerably low, and supplementation at 100\u2009mg/kg/day is considered highly essential.\n