In the early days of the pandemic, many of us were reassured by the sense that we were all in this together. Homemade masks were offered to neighbors; we exercised deference to government leaders; and most of us were free with praise for grocery store employees and others working long hours and at great risk to themselves and their loved ones. Even as we lamented lost wages, the loss of contact and worst of all the loss of loved ones, many offered innovative ideas in an attempt to stem the tide of misery.
Within this storm, a team of researchers at Penn Medicine Lancaster General Health saw the opportunity to pursue the hypothesis that certain supplements might alter the course of COVID-19. The results of the team’s study were published in the July/August issue of the Journal of the American Board of Family Medicine, detailing the outcomes of two parallel investigations. The results demonstrate that vitamin C has no effect on disease course; patients taking melatonin may derive only minimal benefit.
Preliminary metadata and systematic reviews released in the summer of 2020 had suggested that patients who are already on agents like melatonin and high-dose vitamin C may experience milder symptoms and speedier recovery during some related viral infections. So the time seemed right for a study of whether treatment with vitamin C and other supplements such as melatonin — the former famed for its presence in fruits and vegetables, the latter an agent commonly used to help with acute insomnia — could help patients with mild COVID-19 recover.
Indeed, many took note that President Donald Trump was treated with a protocol that included melatonin and other over-the-counter supplements when he was infected with COVID-19 in October 2020. (The monoclonal antibodies he received at the time were likely the most important element of his recovery regimen.)
Enter a team of Lancaster General Health family physicians and pharmacists and a group of dedicated Lancaster General Health Research Institute professionals who pored through the medical literature. What was known was the body’s own inflammatory response to infection with SARS-CoV-2 results in a cascade of symptoms. What was still in question was whether this response could be slowed by dietary and herbal supplements.
What the researchers found was patients taking 1,000 milligrams of vitamin C saw no change in the course of their infection, compared to those taking a placebo. While those given 10 milligrams of melatonin at bedtime did recover faster than those on a placebo, their benefit may only have been statistical. At best, these researchers conclude that melatonin should be further studied.
Certainly we know by now that many things actually have helped those with mild disease: prevention with masks and vaccines and breakthrough treatments including monoclonal antibodies and oral agents such as nirmatrelvir/ritonavir (brand name: Paxlovid).
But the real story here? The heroes within Lancaster County who stepped up to be a part of this research.
Community volunteers came forward to screen thousands of patients, hundreds of whom offered and agreed to be a part of this research. In the end, more than 120 patients followed through on their supplement regimens, submitted daily surveys and ultimately helped contribute to the medical knowledge regarding the pandemic.
This was real commitment by those who were already feeling pretty lousy, especially knowing that as participants they were being offered agents available over the counter. (The easily accessible nature of such supplements can serve as a barrier to rigorous study.)
Their participation reflects an understanding that advances in science require commitment, and it is not surprising to find that Lancaster County is indeed home to so many who were, and are, willing to step forward. Theirs is a dedication to a higher cause that I remain heartened to discover still beats strong within our community.
So I offer my appreciation to the people of Lancaster County. Good research is being done here, and we extend thanks not only for what you did to help this study, but what you have done to help the community. You have been willing to chip in, duty-bound to a higher cause. Your contributions have not gone unnoticed; in fact, your efforts reassure us that we will get through this pandemic and future crises together.
Corey D. Fogleman, M.D., is deputy director of Penn Medicine Lancaster General Health Family and Community Medicine residency; medical director of Gaudenzia Vantage House; and assistant medical editor of the journal American Family Physician. He’s also vice president of the Lancaster City Board of Health.