Two Major Sepsis Stories in the News – Burden of Sepsis and Vitamin C Results

January 17, 2020

This week brought us the results of two sepsis studies, both of which provide important findings for the healthcare community and the general public. The first study, published earlier this week in The Lancet, reaffirms that sepsis is a major health issue, causing one out of every five deaths world-wide – that is more than 20 deaths every minute. Twice as many people die from sepsis than experts previously thought, with 48.9 million cases across the globe, causing 11 million deaths in 2017 alone. More than 40% of all cases affect children.

These numbers are actually lower than they were three decades ago. In 1990, there were over 60.2 million cases of sepsis and 15.7 million deaths. Despite this improvement, however, sepsis is still a major problem, particularly in middle- and lower-income countries. You can read more about the study findings here.

The second study, published today in JAMA, examined the use of vitamin C to treat septic patients in the intensive care unit (ICU). This theory was brought forth two years ago by Dr. Paul Marik, a critical care physician at Eastern Virginia Medical School. Dr. Marik treated some patients with severe sepsis with a combination of vitamin C, thiamine, and corticosteroids. The first patients who received this medication cocktail seemed to improve, so Dr. Marik wrote up his findings for publication. The news of Dr. Marik’s new treatment hit mainstream media and hopes were raised among sepsis survivors and those who lost someone to sepsis.

Whenever a doctor finds a new treatment, researchers try to replicate (copy) the doctor’s findings. The studies look at safety, efficacy, dosing, outcome, and more. The first completed study results using Dr. Marik’s treatment were published in JAMA last October. This study included 167 patients, 84 of whom were given vitamin C and 83 who received a placebo. The results did not show that the vitamin C made a difference in reducing or limiting organ failure or dysfunction, or other markers the researchers were looking at. While there was an improvement in 2 out of 46 markers – the  patients in the vitamin C group didn’t spend as long in the ICU and in the hospital overall – the study wasn’t designed to take into account other factors that could have also contributed to the shorter stays.

The study published today involved patients who were in septic shock; 109 patients received vitamin C, hydrocortisone, and thiamine by IV (treatment group) and 107 patients received only hydrocortisone by IV (control group). Two hundred and eleven patients completed the study. The researchers found there were no differences between the patients in how long they survived nor for other markers they watched for. The patients who received vitamin C and thiamine did not do better than the control group. “…[M]ortality during any observation period and artificial organ support were not significantly different,” the authors wrote.

Other studies are still in progress around the world, including Egypt, Spain, South Korea, and Mexico. These studies are listed on the ClinicalTrials.gov website.