Vitamin C deficiency in Australian hospitalised patients: an observational study

Yogesh Sharma, Michelle Miller, Rashmi Shahi, Adrienne Doyle, Chris Horwood, Paul Hakendorf, Campbell Thompson

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)


Background: Vitamin C has anti-oxidant properties and acts as a cofactor for several enzymes. Hypovitaminosis C has been associated with bleeding, endothelial dysfunction and death. The prevalence of hypovitaminosis C is unknown in Australian hospitalised patients, and its clinical relevance is uncertain. Aims: To determine the prevalence, characteristics and clinical outcomes of hospitalised patients with hypovitaminosis C. Methods: This observational study included general-medical inpatients in a tertiary-level hospital in Australia. High-performance liquid chromatography (HPLC) was used to determine plasma vitamin C levels. As per Johnston’s criteria, vitamin C levels of ≥28 μmol/L were classified as normal and <28 μmol/L as low. Clinical outcomes determined included length of hospital stay (LOS), nosocomial complications, intensive care unit admission and in-hospital mortality. Results: A total of 200 patients participated in this study, and vitamin C levels were available for 149 patients, of whom 35 (23.5%) had normal vitamin C levels, and 114 (76.5%) had hypovitaminosis C. Patients with hypovitaminosis C were older and had higher C-reactive protein (CRP) levels. Median LOS was 2 days longer in patients with hypovitaminosis C (6 days (interquartile range (IQR) 4, 8) vs 4 days (IQR 3, 6), P = 0.02), and they had fourfold higher odds of staying in hospital for >5 days than those with normal vitamin C levels. Other clinical outcomes were similar between the two groups. Conclusions: Hypovitaminosis C is common in hospitalised patients and is associated with prolonged LOS. Further research is needed to ascertain the benefits of vitamin C supplementation in vitamin C-depleted patients.

Original languageEnglish
Pages (from-to)189-196
Number of pages8
JournalInternal Medicine Journal
Issue number2
Early online date3 Jul 2018
Publication statusPublished - Feb 2019


  • clinical outcomes
  • hospitalised patients
  • prevalence
  • vitamin C


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