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.