Background: Community-acquired pneumonia (CAP) remains a major cause of morbidity and mortality in elderly patients. Vitamin C as an antioxidant agent may prevent excessive pulmonary inflammation and assist the resolution of CAP. A systematic review mentioned vitamin C as potential adjunctive therapy for mild CAP in vitamin C-deficient elderly patients but evidences are still scarce.
Objective: To obtain the prevalence of vitamin C deficiency in elderly patients with CAP and to determine the role of vitamin C status in the resolution of CAP in elderly patients.
Methods: A prospective cohort was conducted on 65 patients above 60 years old who were diagnosed with CAP, received therapy according to guidelines and were not in immunosuppressive therapy in the emergency unit and wards of Cipto Mangunkusumo Hospital, Jakarta during April to June 2012. Subjects were assigned into vitamin C-deficient group and non-deficient group. Resolution and median resolution rate of each group were calculated. The differences between groups were examined using log-rank test. Hazard ratio was determined using Cox regression models. Multivariate analysis of confounding variables was carried out with Cox regression test.
Results: The prevalence of vitamin C deficiency in elderly CAP patients was 76.92% (95%CI 66.68-87.16%). The rate of resolution on tenth day in vitamin C-deficient group was 56% and in non-deficient group was 53%, while the rate of resolution on fourth day in deficient group was 20% and in non-deficient group was 40%. Median resolution rate in deficient and non-deficient group was 9 days and 5 days, respectively. Log-rank test did not reveal statistically significant difference in resolution rate between both groups with crude HR 1.18 (95%CI 0.54-2.58; p=0.69). Conclusion: The prevalence of vitamin C deficiency in elderly CAP patients in Cipto Mangunkusumo Hospital was
76.92% (95%CI 66.68-87.16%). There was no significant difference in the resolution of CAP between vitamin C-deficient and non-deficient elderly patients.
Key words: Vitamin C deficiency, community-acquired pneumonia, resolution, elderly.