Vitamin C Does Not Affect Platelet Counts in Patients With Sepsis: A Post hoc Analysis of the Lessening Organ Dysfunction With Vitamin C Randomized Trial.

2025-09
Critical care explorations 7(9)
- Mattia M Müller
- Ruxandra Pinto
- François Lamontagne
- Neill K J Adhikari
- Lorenzo Del Sorbo

PubMed: 40927646
DOI: 10.1097/cce.0000000000001310

Study Design

Type: Randomized Controlled Trial (RCT)
Sample size: n = 863
Population: Patients with an ICU stay of more than 24 hours, confirmed or suspected infection, vasopressor requirement, and availability of platelet count data
Methods: Post hoc analysis of the LOVIT randomized trial, vitamin C (50 mg/kg body weight) every 6 hours for 4 days, or placebo
Duration: 4 days
Funding: Unclear

Large Human Trial

Objective

Vitamin C has been linked to alterations in platelet count and aggregation behavior. Given recent findings suggesting an association between vitamin C and adverse outcomes in patients with septic shock, we aimed to investigate whether vitamin C influences mortality in septic patients through its impact on platelets.

Design

Post hoc analysis of the Lessening Organ Dysfunction With Vitamin C (LOVIT) randomized trial (clinicaltrials.gov NCT03680274).

Setting

Multicenter international study.

Patients

Patients were included with an ICU stay of more than 24 hours, confirmed or suspected infection, vasopressor requirement, and availability of platelet count data.

Intervention

Vitamin C (50 mg/kg body weight) every 6 hours for 4 days, or placebo.

Measurements and main results

Of the 863 patients enrolled in the LOVIT trial, 859 had available platelet count data at any time. Although the longitudinal trajectory of platelet count was significantly associated with 28-day mortality (hazard ratio 0.97 per 10 × 10⁹/L increase, 95% CI, 0.96-0.98), there was no interaction between the effect of vitamin C on mortality and either platelet count at baseline or over time.

Conclusions

These results do not support the hypothesis that vitamin C administration increases mortality risk by affecting platelet count.

Research Insights

Vitamin C→Reduced Mortality Risk
Although the longitudinal trajectory of platelet count was significantly associated with 28-day mortality (hazard ratio 0.97 per 10 × 10^9/L increase, 95% CI, 0.96-0.98), there was no interaction between the effect of vitamin C on mortality and either platelet count at baseline or over time.
Effect
Neutral
Effect size
Small
Dose
50 mg/kg body weight every 6 hours for 4 days
Vitamin C→Reduced Platelet Count
These results do not support the hypothesis that vitamin C administration increases mortality risk by affecting platelet count.
Effect
Neutral
Effect size
Small
Dose
50 mg/kg body weight every 6 hours for 4 days

Adverse Events Reported

Vitamin C→mortality
there was no interaction between the effect of vitamin C on mortality and either platelet count at baseline or over time
Finding
No significant difference
Severity
Serious adverse event
Significant
No