Effect of High Dose Intravenous Vitamin C in Severe Pneumonia

Inclusion Criteria:

• Patients who are aged 18 and above

• Patients who are diagnosed with severe pneumonia

• Patients who are mechanically ventilated

Exclusion Criteria:

• Known allergy to Vitamin C

• Pregnancy

• Known history of ongoing concomitant infection

• Participation in another clinical trial and/or receipt of investigational drugswithin 4 weeks prior to enrollment

• Moribund patient with multiorgan failure to the judgement of the treating physician,who is not expected to survive 24 hours

• Patient who requires home oxygen therapy or mechanical ventilation, includingtracheostomy or non-invasive ventilation, except for CPAP/BIPAP for sleep-disorderedbreathing

• Known history of previous or current diagnosis of renal stones

• Known diagnosis of glucose-6-phosphate dehydrogenase (G6PD) deficiency

• Known diagnosis of hemochromatosis

• Known diagnosis of poorly controlled chronic pulmonary disease, including:

• Chronic obstructive pulmonary disease with oxygen therapy

• Chronic restrictive pulmonary disease with oxygen therapy

• Bronchial asthma on Step 5 of treatment ladder as shown in Pocket Guide forAsthma Management and Prevention

• Lung cancer in Stage IV of disease

• Known diagnosis of heart failure on anti-failure treatment or requiring mechanicalhemodynamic support (e.g. LVAD), with recent hospitalization within 3 months (90days) from the date of current admission.

• Immunocompromised state

• Known diagnosis of malignancy and ongoing chemotherapy or radiotherapy as there isevidence that antioxidant supplement before and during treatment was associated withan increased hazard of recurrence

• Known diagnosis of malignancy who had completed chemotherapy or radiotherapy withabsolute neutrophil count ≤100 cells/mm3

• Known diagnosis of Stage 4 and above chronic kidney disease (GFR <30 ml/min/1.73m2)and end-stage renal disease on regular dialysis (including peritoneal dialysis orhemodialysis)

• Known history of renal transplantation

• Absence of family members or next of kin for informed consent