Current evidence from published systematic reviews indicate that oral intake of vitamin C may assist with symptoms of acute viral respiratory infections (ARI) by reducing fever and chills, relieving chest pain and assist in reducing symptoms of common cold-induced asthma. Intravenous (IV) vitamin C administration may reduce the need for vasopressor support and the duration of mechanical ventilations in critically ill patients in hospital. COVID-19 has similar signs and symptoms of ARI. Further studies involving patients with COVID-19, either through administration of oral vitamin C in mild cases or IV vitamin C in critical cases, would be advantageous to examine if it is safe and efficacious. Oral vitamin C may assist with the symptoms of acute respiratory viral infections (ARI) and common cold-induced asthma but no studies have been identified justifying oral vitamin C for the prevention or treatment of coronavirus infections including COVID-19. When taken at onset of ARI, oral vitamin C may reduce the duration of symptoms including fever, chest pain, chills and bodily aches and pains. It may also reduce the incidence of hospital admission and duration of hospital stays. For individuals admitted to hospital with community-acquired pneumonia, vitamin C may improve respiratory function in more severe cases. No major adverse events nor interactions were reported by either method of administration. However, there is an absence of high quality, contemporary clinical research examining this topic. Current evidence suggests further studies are needed to better understand the value of both oral and IV vitamin C for ARI, including COVID-19.
INTRODUCCIÓN: Cada año, los niños sufren hasta 5 resfriados y adultos quedan dos o tres infecciones, lo que el tiempo fuera de la escuela o el trabajo, y un considerable malestar. La mayoría de los síntomas se resuelven dentro de 1 semana, pero la tos a menudo persisten por más tiempo.
MÉTODOS Y RESULTADOS: Se realizó una revisión sistemática y tuvo como objetivo responder a la siguiente pregunta clínica: ¿Cuáles son los efectos de los tratamientos para el resfriado común? Se hicieron búsquedas en Medline, Embase, la Biblioteca Cochrane, y otras bases de datos importantes hasta enero de 2010 (comentarios evidencia clínica son actualizados periódicamente, por favor visite nuestro sitio web para la versión más actualizada de esta revisión). Se incluyeron daña alertas de organizaciones pertinentes tales como la Food and Drug Administration (FDA) y el Reino Unido de Medicamentos y la Agencia Reguladora de Productos Sanitarios (MHRA).
Resultados: Se encontraron 21 revisiones sistemáticas y ECA que cumplieron los criterios de inclusión. Se realizó una evaluación de grado de la calidad de las pruebas para las intervenciones.
CONCLUSIONES: En esta revisión sistemática se presenta información relativa a la efectividad y seguridad de las siguientes intervenciones: analgésicos o antiinflamatorios, antibióticos, antihistamínicos, descongestionantes para corto plazo y de alivio a largo plazo, descongestionantes, además de antihistamínicos, la equinácea, vapor la inhalación, la vitamina C, y zinc (gel intranasal o pastillas).
OBJETIVO: Presentar una evaluación crítica de la evidencia actual en relación con el valor terapéutico de la vitamina C para la profilaxis y el tratamiento del resfriado común.
FUENTES DE DATOS: Cochrane, PubMed, Natural Standard, y el Centro Nacional de bases de datos de medicina complementaria y alternativa se realizaron búsquedas para identificar y adquirir informes primarios de investigación, revisiones bibliográficas y análisis secundarios relacionados con el objetivo clínico. Los ensayos publicados clínicos, revisiones bibliográficas, meta-análisis, revisiones sistemáticas y se evaluaron para determinar las implicaciones prácticas basadas en la evidencia.
Conclusiones: La vitamina C se utiliza con frecuencia para el tratamiento y la profilaxis del resfriado común; Sin embargo, no hay recomendaciones publicadas fueron encontrados en una revisión de la literatura profesional de enfermería que abordan específicamente la eficacia de la vitamina C para el resfriado común. Nuestra revisión de la literatura reveló que la vitamina C no es eficaz en la prevención del resfriado común en la población general adulta; Sin embargo, es eficaz en la prevención de los resfriados cuando se consume regularmente por los atletas que entrenan en condiciones subárticas. También se encontró que el consumo regular de vitamina C puede reducir la duración de los síntomas del resfriado en los adultos y los niños, pero no disminuir la gravedad de los síntomas del resfriado.
Implicaciones para la práctica: PN deben aconsejar a sus pacientes que el consumo regular de vitamina C puede disminuir la duración de los síntomas del resfriado, pero no afecta la gravedad de los síntomas o actuar como profilaxis.
Síntesis amplia/ Revisión panorámica de revisiones sistemáticas
OBJECTIVES: To review the seven Cochrane reviews of non-antibiotic treatment for the common cold.
METHODS: Each Cochrane review was read and summarized, and results presented as relative risks and, where possible, numbers needed to treat.
RESULTS: The main theme that runs through these Cochrane reviews is the variable quality of the primary studies. In general, the reviewers are fairly cautious about the benefits of any of the treatments other than first-dose decongestants and antihistamine-decongestant combinations. For antihistamines alone, the reviewers were clear about the lack of efficacy except in the high-quality studies in which a global improvement in symptoms was noted. Some studies were statistically significant, but the Cochrane reviewers were guarded about how clinically significant they were. For Echinacea, problems were found with the quality of the studies and the wide range of different forms of this substance. Heated humidified air seemed to be effective in the UK and Israel, but not the USA, making definitive statements about efficacy difficult. Over-the-counter medication for cough seemed to have no documented benefit in children under the age of 5 years. Letosteine (a mucolytic) may be effective in children but is not available in the UK. Bisolvon (a mucolytic) was found to be effective for cough in only one study. For older children and adults, dextromethorphan may be effective (two out of three studies showed benefit), and guiafenesin (an expectorant) showed mixed benefit in two trials. Dexbrompheniramine (a sedating antihistamine)/pseudoephedrine (6 mg/120 mg twice daily for 1 week) was significantly more effective than placebo for severity of cough, whereas, in another study, loratadine (a non-sedating antihistamine)/pseudoephedrine (5 mg/120 mg twice daily for 4 days) did not show any difference between the study groups. Vitamin C may have a small role in preventing the common cold, with possibly a greater role in high-intensity physical activity and sub-arctic conditions. Zinc lozenges seemed to be effective, but the issue of unblinding due to taste was a methodological issue of concern to the reviewers. The benefits and harms are calculated as numbers needed to treat for one person to benefit (NNTB) and numbers needed to treat for one person to harm (NNTH), and were calculated by the author.
CONCLUSION: Most non-antibiotic treatments for the common cold are probably not effective. The most promising are dextromethorphan, bisolvon and guiaphenesin for cough, antihistamine-decongestant combinations for a wide range of symptoms, nasal decongestants (at least for the first dose) and possibly zinc lozenges.
Current evidence from published systematic reviews indicate that oral intake of vitamin C may assist with symptoms of acute viral respiratory infections (ARI) by reducing fever and chills, relieving chest pain and assist in reducing symptoms of common cold-induced asthma. Intravenous (IV) vitamin C administration may reduce the need for vasopressor support and the duration of mechanical ventilations in critically ill patients in hospital. COVID-19 has similar signs and symptoms of ARI. Further studies involving patients with COVID-19, either through administration of oral vitamin C in mild cases or IV vitamin C in critical cases, would be advantageous to examine if it is safe and efficacious. Oral vitamin C may assist with the symptoms of acute respiratory viral infections (ARI) and common cold-induced asthma but no studies have been identified justifying oral vitamin C for the prevention or treatment of coronavirus infections including COVID-19. When taken at onset of ARI, oral vitamin C may reduce the duration of symptoms including fever, chest pain, chills and bodily aches and pains. It may also reduce the incidence of hospital admission and duration of hospital stays. For individuals admitted to hospital with community-acquired pneumonia, vitamin C may improve respiratory function in more severe cases. No major adverse events nor interactions were reported by either method of administration. However, there is an absence of high quality, contemporary clinical research examining this topic. Current evidence suggests further studies are needed to better understand the value of both oral and IV vitamin C for ARI, including COVID-19.
