ICU covid patienter har akut vitamin C brist.

Vårdavdelning med säng, patient, dropp slangar, vårdare, mätinstrument

Ett nytt artikel (augusti 2020) i medicinska tidskriften Critical Care är ”Vitamin C levels in patients with SARS-CoV-2-associated acute respiratory distress syndrome”  18 patienter på en ICU, intensivvårdsavdelning, IVA, på ett sjukhus i Barcelona, Spanien, undersöktes. Alla dessa skrivs in i sjukhuset utan sepsis eller chock. Ingen hade någon bakteriell infektion samtidigt. Alla hade fått ARDS, akut andningssvårighets syndrom. 

Vitamin C i blodplasman bestämdes med ”high-performance liquid chromatography with photodiode detector (detection limit 1.5 mg/L 0,15mg/dL)” som alltså kunde detektera nivåer ner till 1,5 mg/L.  Vitamin C referensnivå i allmänhet skall vara över 5 mg/L.

17 patienter (94.4%) hade ospårbara vitamin C nivåer och 1 patient hade låg nivå (2.4 mg/L).

Skörbjubb?

I https://www.physio-pedia.com/Scurvy kan man läsa

Diagnostic Tests/Lab Tests/Lab Values
Plasma levels: A fasting serum ascorbic acid level greater than 0.6 mg/dL rules out scurvy. Scurvy generally occurs at levels below 0.1 mg/dL.[15]  (Jeff: 1.0 mg/L)
Leukocyte levels: The level of vitamin C in leukocytes more accurately correlates to tissue stores compared with serum levels, because these cells are not affected acutely by circadian rhythm or dietary changes. A level of zero indicates latent scurvy. Levels of 0-7 mg/dL reflect a state of deficiency.[15]
Urinary levels: A more commonly used method is the ascorbic acid tolerance test, which quantitates urinary ascorbic acid over the 6 hours following an oral load of 1 g of ascorbic acid in water.[15]

[15] går till medscape scurvy workshop med:

Plasma levels

A fasting serum ascorbic acid level greater than 0.6 mg/dL rules out scurvy. Serum ascorbic acid levels of less than 0.2 mg/dL are deficient. levels of 0.2-0.29 mg/dL are low, and levels greater than 0.3 mg/dL are acceptable. Scurvy generally occurs at levels less than 0.1 mg/dL. [5]

Urinary levels

A more commonly used method is the ascorbic acid tolerance test, which quantitates urinary ascorbic acid over the 6 hours following an oral load of 1 g of ascorbic acid in water. (Jeff: Men ingen beskrivning av hur man mäter och tolkar. Se gärna mitt försök att göra detta)  

Annan uppgift för skörbjugg gräns

healthline : ”Generally, people with scurvy have blood serum levels of vitamin C less than 11 µmol/L.” Då:  Askorbinsyra Molar mass 176.124 g/mol   (Natriumaskorbate  198.11 g/mol) innebär det 1,9 mg/L för askorbinsyra, eller 2,1 mg/L för askorbat.)

Det skulle innebära att 94.4% i studien ovan var UNDER skörbjuggsgränsen och den resterande personen bara aningen över.

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