• Isaza A

• Ascorbic Acid
• COVID-19
• Hydrocortisone
• Hypertension

Abstract: Over 3 million deaths have been reported worldwide due to COVID-19 according to the World Health Organization.  Even though more and more people are vaccinated around the world, it is vital to remain vigilant in evaluating the pathophysiology and mechanisms of actions for all interventions that show improvement.  Increased cortisol can cause hypertension through several proposed mechanisms including upregulation of alpha 1 receptors on arterioles which would exert a permissive effect by increasing the sensitivity to norepinephrine and epinephrine.  Another proposed mechanism is that at high concentrations cortisol can bind with aldosterone receptors. Hypertension is currently known as a risk factor for critical illness and mortality in patients with COVID-19. Vitamin C is an antioxidant that is involved in collagen synthesis, promotes the conversion of dopamine to noreprinephrine and facilitates the absorption of iron.  Moreover, some research supports that it can boost nitric oxide levels which is involved with smooth muscle relaxation and vasodilation. One potential mechanism for the anti-hypertensive effect of vitamin C was boosting nitric oxide.  Since cortisol increase may raise blood pressure the reduction of cortisol helps its regulation. This commentary will discuss the effect of vitamin C on blood pressure and cortisol in order to evaluate whether vitamin C can be used in hypertensive patients with COVID-19. A search of the PUBMED search engine for double-blind randomized controlled trials and systematic reviews and meta-analysis was performed in this commentary.

Author keywords: Cortisol, Hypertension, Vitamin C, COVID-19

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