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.

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.