A summary of the paradigm-shift in protocol - from respiratory to vascular - highlighting the effectiveness of using Ascorbic Acid as Treatment on COVID-19
2. To be truly wise, self-knowledge
and understanding of
“why you do what you do”
is the core of wisdom.
~ Jane Sturgeon
WHY YOU DO
WHAT YOU DO
3. INTRODUCTION
COVID-19 TREATMENT USING VITAMIN C (ASCORBIC ACID)
When you understand how immune cells like macrophages, neutrophils and lymphocytes depend on
the recycling of Ascorbic Acid to maintain their optimal functioning, you will appreciate why Ascorbic
Acid can keep you out of the ICU if you ever get infected of COVID-19.
COVID-19 destroys heme which in turns shuts down oxygen delivery in your body initiating a cascade
of events that start with the depletion of Ascorbic Acid and Nitric Oxide, leading to the complete
breakdown of the immune response system. This is the primary reason for rapid deterioration resulting
in multiple organ failure and/or ARDS.
~ Doris Loh (April 5, 2020)
3
4. DISCLAIMER
We are not experts but knowledgeable. We read on
topics at least 6 hours a day, get information from
friends and experts, watch latest reliable updates and
occasionally look at the odd and strange.
We believe that there is something wrong in the current
paradigm of ARDS in the treatment of COVID-19 and
this “what-the-heck is happening” lead us to believe
that there must be a need to “re-think”.
Most of the studies and information presented are
based on the work of Ms. Doris Loh – a long-time
independent researcher particularly in the use of
Ascorbic Acid in boosting the immune system.
5. Coronavirus (COVID-19)
Key Numbers as of 29 April 2020
3,130,191
CONFIRMED
217,569
DEATHS
937,571
RECOVERED
“What gets us into
trouble is not what we
don't know.
It's what we know for
sure that just ain't so.”
~ Mark Twain
https://news.google.com/covid19/map?hl=en-US&gl=US&ceid=US:en
6. WHAT WE KNOW
COVID-19 TREATMENT USING VITAMIN C (ASCORBIC ACID) 6
The current paradigm is that COVID-19
causes ARDS.
As there is no “known” cure, there is no
“early” intervention until symptoms of
COVID-19 and/or ARDS appear.
The use of ventilators is the “standard”
treatment of ARDS
WHAT IF COVID-19
IS NOT ONLY ARDS
COVID-19 ARDS is “initially” caused by a form of
oxygen deprivation or “silent hypoxia” where
patients compensate for the “low” oxygen in their
blood by breathing faster and deeper – and this
happens without their knowledge – this causes
more inflammation and more air sacs to collapse,
and the pneumonia worsens until oxygen levels
plummet.
In effect, patients are injuring their own lungs by
breathing harder and harder.
The patient’s condition is similar to high-mountain
climbers (Mr. Everest) who suffers HAPE – high-
altitude pulmonary edema – caused by hypoxia.
7. https://chemrxiv.org/articles/COVID-
19_Disease_ORF8_and_Surface_Glycoprotein_Inhibit_Heme_Metabolism_by_Binding_to_Porphyrin/11938173
Sichuan University of Science & Engineering, China – March 3, 2020
Findings from a new study released by Chinese researchers, Dr. Wenzhong Liu from Sichuan University and Dr.
Hualan Li from Yibin University has revealed that the SARS-CoV-2 coronavirus attacks hemoglobin in the Red
Blood Cells through a series of cellular actions, that ultimately renders the RBCs incapable of transporting
oxygen.
Though the virus is able to attack the ACE2 receptors in the lung tissues and cause damage and also while
cytokine storms are creating more damage, it is most probability of the body’s inability to get enough oxygen
along with carbon dioxide build up, that is creating the ARDS symptoms and stress and current protocols could
be all wrong including the usage of ventilators in a non-proper manner way that could actually aggravate the
already ‘injured’ and inflamed lungs.
Red blood cells are critical oxygen carriers to the various cells in the body. Inside the RBCs is a molecule called
hemoglobin that contains heme groups. Each of these heme groups is molecular “ring” (porphyrin) that holds an
Iron ion or FE ion. It is the FE ions that helps to transport oxygen in the bloodstream depending on states of
oxidation.
COVID-19 Virus Attacks Hemoglobin in the RBC and
Captures the Porphyrin to Inhibit Human Heme Metabolism
8. https://www.maurizioblondet.it/eparina-funziona-scoperta-del-genio-italico-e-il-suo-contrario/
April 12, 2020
“If this were the case, resuscitations and intubations are of no use because first of all you have to
dissolve, indeed prevent these thromboembolisms.
If you ventilate a lung where blood does not reach, it is not needed! In fact 9 out of 10 die.
Because the problem is cardiovascular, not respiratory!
It is venous microthrombosis, not pneumonia that determines fatality!
And why are thrombi formed? Because inflammation, as per school text, induces thrombosis
through a complex but well-known pathophysiological mechanism.”
COVID-19 Patients As Described by Italian
Medical Doctors
10. https://medium.com/@drhassaballa/what-ive-learned-treating-patients-suffering-from-covid-19-41adc282e973
Dr. Hesham A. Hassaballa: Critical Care Specialist – April 24, 2020
• Frightening Hypoxemia (low oxygen levels) – First of all, almost all of these
patients present with such frighteningly low oxygen levels… I have never seen
that before in my career as either a lung or critical care specialist.
• Frighteningly Quick Deterioration – Secondly, when these patients with COVID-
19 crash, they crash very quickly and crash very hard. Each patient is a ticking
time-bomb, and they could be doing fine for several hours, and then — suddenly
— they are gasping for air with plummeting oxygen levels and a plummeting
blood pressure.
• Not every patient needs a ventilator right away. Early on, clinicians taking care
patients with COVID-19 were recommending “early intubation,” which means
placing patients on a ventilator if conventional oxygen treatment did not work.
• We REALLY need to discuss goals of care with all patients admitted with COVID-
19, BEFORE they go into respiratory failure. It needs to be done sooner.
“What’s more perplexing, sometimes these
patients have oxygen levels that low and have
absolutely no symptoms.”
“As a critical care specialist, I am used to seeing the
sickest of the sick. Never, however, have I seen
patients as sick as those with COVID-19”
11. https://www.youtube.com/watch?v=bp5RMutCNoI
The New York Times – April 14, 2020
“Everything that we believed was right 6 weeks
ago…” ~ Dr. David Farcy
“It’s different than what we’ve seen before…”
~ Dr. Salim Rezaie
“It’s low oxygen levels…” ~ Dr. Colin Pesyna
“It’s extremely confusing… doesn’t make
sense…” ~ Dr. Cameron Kyle-Sidell
Doctors Face Troubling Question: Are They
Treating COVID-19 Correctly?
Some severe COVID-19 cases are pushing many
doctors to “rethink” established medical
protocols
13. https://www.youtube.com/watch?v=-bOmlF6B4yY
Aired on ABC News (Australia) – April 8, 2020
• Most patients suffer lack of oxygen
without even knowing it
• Blood, essentially coming into the
lungs, full of C02 and without much
oxygen
• Problem seems to be vascular (blood
disorder), not respiratory
• 50% chance of survival on ventilator
Professor of Intensive Care at University College London, Hugh Montgomery,
explains what your body actually goes through when you get COVID-19
14. https://www.washingtonpost.com/health/2020/04/22/coronavirus-blood-clots/
The Washington Post – April 22, 2020
• One doctor replied that one of his patients had a strange blood problem. Despite
being put on anticoagulants, the patient was still developing clots. A second said
she’d seen something similar. And a third. Soon, every person on the text chat had
reported the same thing.
• “That’s when we knew we had a huge problem,” said Coopersmith, a critical-care
surgeon. As he checked with his counterparts at other medical centers, he became
increasingly alarmed: “It was in as many as 20, 30 or 40 percent of their patients.”
• Increasingly, doctors also are reporting bizarre, unsettling cases that don’t seem to
follow any of the textbooks they’ve trained on. They describe patients with
startlingly low oxygen levels — so low that they would normally be unconscious or
near death — talking and swiping on their phones.
Craig Coopersmith was up early that morning as usual and typed his daily
inquiry into his phone. “Good morning, Team Covid,” he wrote, asking for
updates from the ICU team leaders working across 10 hospitals in the Emory
University health system in Atlanta.
15. https://www.washingtonpost.com/health/2020/04/22/coronavirus-blood-clots/
The New York Times – April 20, 2020
• I realized that we are not detecting the deadly pneumonia the virus causes early
enough and that we could be doing more to keep patients off ventilators — and
alive.
• Even patients without respiratory complaints had Covid pneumonia. The patient
stabbed in the shoulder, whom we X-rayed because we worried he had a collapsed
lung, actually had Covid pneumonia. In patients on whom we did CT scans because
they were injured in falls, we coincidentally found Covid pneumonia. Elderly
patients who had passed out for unknown reasons and a number of diabetic
patients were found to have it.
• And here is what really surprised us: These patients did not report any sensation of
breathing problems, even though their chest X-rays showed diffuse pneumonia and
their oxygen was below normal. How could this be?
I have been practicing emergency medicine for 30 years. In 1994 I invented an
imaging system for teaching intubation, the procedure of inserting breathing
tubes. This led me to perform research into this procedure, and subsequently teach
airway procedure courses to physicians worldwide for the last two decades.
16. https://www.straitstimes.com/world/united-states/mysterious-blood-clots-are-covid-19s-latest-lethal-surprise
https://www.dailymail.co.uk/news/article-8264135/UK-says-children-died-syndrome-linked-COVID-19.html
April 28, 2020
The illness appears to be similar to Kawasaki disease - which causes blood vessels to
become inflamed, and toxic shock syndrome - an overreaction by the immune
system which causes the body to attack its own organs.
A number of children with no underlying
health conditions may have died from a
COVID-19-linked inflammatory syndrome,
Health Secretary Matt Hancock revealed
today (Daily Mail – April 28, 2020)
Mysterious blood clots are Covid-19's
latest lethal surprise
Behnood Bikdeli, a doctor at New York-
Presbyterian Hospital, assembled an
international consortium of experts to
study the issue. Their findings were
published in the Journal of The
American College of Cardiology.
The experts found the risks were so
great that Covid-19 patients "may need
to receive blood thinners, preventively,
prophylactically," even before imaging
tests are ordered, said Bikdeli.
(Straits Times – April 28, 2020)
17. https://www.evolutamente.it/covid-19-ards-cell-free-hemoglobin-the-ascorbic-acid-connection/
March 24, 2020
Critically ill COVID-19 patients often develop acute respiratory distress syndrome (ARDS) where alveolar flooding
(edema), interstitial inflammation and compression atelectasis, as well as increase in lung tissue and reduction in
lung gas volume have been observed. ARDS patients have a 30-50% mortality rate due to an uncontrolled
cascading event starting with pulmonary capillary endothelial cell permeability and leakage of fluid into the
pulmonary parenchyma, only to be followed by cytokine storms marked by acute inflammatory responses.
It has been known for a long time that during critical illness, red blood cells undergo deleterious changes that
cause hemolysis. It is only recently that the release of free heme is also associated with alveolar inflammation and
coagulation in ARDS.
Ever since 2015, the role of cell-free heme in nonhemolytic disorders such as acute lung injury and acute
respiratory distress syndrome has been extensively documented. Free heme can scavenge nitric oxide (NO) up to
1,000 times faster than heme bound in red blood cells. The rapid loss of endothelial NO bioavailability leads to
hypertension, coagulation and development of systemic inflammation.
COVID-19, ARDS and Cell-Free Hemoglobin
The Ascorbic Acid Connection
18. ORF3a attacks the oxidized
hemoglobin
● SARS-CoV2 viroprotein Orf3a and other
proteins Orf8, Orf10, Orf1ab attack
hemoglobin to form porphyrins.
● Porphyrins are heme that have lost their
iron centers.
● SARS-CoV2 oxidizes the ferrous iron, then
releases and displaces the iron. The Orf8
protein then docks into the space vacated
by the iron ion.
https://www.evolutamente.it/covid-19-ards-cytokine-storms-
the-recycling-of-ascorbic-acid-by-macrophages-neutrophils-
and-lymphocytes/
April 5, 2020
19. https://www.evolutamente.it/covid-19-ards-cytokine-storms-the-recycling-of-ascorbic-acid-by-
macrophages-neutrophils-and-lymphocytes/
April 5, 2020
• The Liver is the Master Regulator of Whole-Body Iron – the iron sensor that stores and regulates iron
metabolism
• It controls the release of recycled iron from macrophages to maintain iron homeostasis
• The Liver produces HAPTOGLOBIN that binds free, toxic, oxidized heme. Haptoglobin is predominantly
found in hepatic macrophages which engulf free heme and metabolize them so that the ferric iron can be
incorporated into ferritin
• Liver injury is found to be more prevalent in severe cases than mild cases – both AST and ALT are elevated
• The Liver will “overdrive” to restore the iron balance and if the liver is not 100% healthy – like in the case of
diabetics, obese, with fatty liver or hepatitis infection – the liver will be severely damaged due to “exhaustion”
COVID-19 – Extensive Liver Injury and
The Role of Free Heme
20. https://www.evolutamente.it/covid-19-ards-cytokine-storms-the-recycling-of-ascorbic-acid-by-
macrophages-neutrophils-and-lymphocytes/
April 5, 2020
• The Malaria parasite infects hosts by digesting hemoglobin and releasing oxidized free heme
• Chloroquine can bind to toxic free heme, enhancing its toxicity, while interfering with the ability of the
malaria parasite to sequester and neutralize toxic free heme
• In severe malaria, multi-organ failure is the result of liver toxicity caused by excess accumulation of free
heme in the liver
• Liver damage and heme destruction means perfect cytokine storm
• COVID-19 patients often have elevated ferritin levels – possibly the result of increased free heme
• Excess free heme means excess ferritin and macrophages – excess macrophages means cytokine storms
Chloroquine is an Effective Anti-Malaria Drug
for COVID-19
21. https://www.evolutamente.it/covid-19-ards-cell-free-hemoglobin-the-ascorbic-acid-connection/
March 24, 2020
The landmark study published by Shaver et. al in 2016 showed conclusively that elevated cell-
free hemoglobin (CFH) in the air space is the essential driver of lung barrier permeability,
inflammation and epithelial injury in human and experimental animal models of ARDS. The most
important revelation in that paper was the involvement of iron ions in the pathology of CFH in
ARDS. Free heme with chloride centers only was able to increase alveolar permeability. Unlike
heme with iron ions, chloride containing free heme were UNABLE to induce proinflammatory
cytokine expression nor inflict epithelial cell injuries.
The recent work of Habbeger et al. (2019) also demonstrated that cell-free hemoglobin in
airspace of ARDS patients were definitely associated with lung epithelial injury, airspace
inflammation and alveolar permeability.
COVID-19, ARDS and Cell-Free Hemoglobin
The Ascorbic Acid Connection
22. https://www.evolutamente.it/covid-19-ards-cell-free-hemoglobin-the-ascorbic-acid-connection/
March 24, 2020
• All mechanisms used by COVID-19 to attack the body involve the depletion of Ascorbic
Acid – which results in the failure of immune system, leading to severe and often lethal
pathologies such as ARDS, sepsis and multiple organ failure.
• The depletion of ascorbic acid in immune cells like macrophages, neutrophils and
lymphocytes results in their dysfunctions – producing cytokine storms – which contributes
to the collapse of the immune system – the ultimate cause of fatality in COVID-19.
• Critically ill COVID-19 patients often develop ARDS – reducing ARDS will dramatically
lower the mortality and reduce the burden on the healthcare system, including ICU care
for those hospitalized.
COVID-19, ARDS and Cytokine Storms
The Recycling of Ascorbic Acid by Macrophages, Neutrophils and Lymphocytes
23. https://www.evolutamente.it/covid-19-ards-cell-free-hemoglobin-the-ascorbic-acid-connection/
March 24, 2020
• Oral Ascorbic Acid increases Nitric Oxide
• Endogenous nitric oxide can suppress viral replication. Nitric Oxide production is dependent on
the rate-limiting cofactor called tetrahydrobiopterin (BH4) – which must be maintained in a
reduced redox state during Nitric Oxide production. If BH4 is oxidized by free radicals and not
subsequently regenerated, biosynthesis of nitric oxide cannot proceed
• BH4 regeneration is dependent upon Ascorbic Acid. Lack of ascorbic acid will lower
endogenous nitric oxide production
• There is NO substitution for Ascorbic Acid in Nitric Oxide production.
COVID-19, ARDS and Cytokine Storms
The Recycling of Ascorbic Acid by Macrophages, Neutrophils and Lymphocytes
24. https://www.evolutamente.it/covid-19-ards-cytokine-storms-the-recycling-of-ascorbic-acid-by-
macrophages-neutrophils-and-lymphocytes/
April 5, 2020
• SARS-Cov2 infects and replicates in lungs using spike protein that binds to ACE2 receptors
• SARS-Cov2 attacks heme, using porphyrins as Trojan Horses to infect cells. Cell-free heme in lungs cause damage to
cell lining. Ascorbic Acid can reverse and inhibit these damages inflicted by cell-free heme in lung tissues
• Cell-free heme do not carry oxygen. Lack of oxygen activates the hypoxia pathways that can increase furin enzymes
that will activate more COVID-19 virus as well as pro-inflammatory cytokines. Heme damage causes hypoxemia
that cannot be reversed by intubation. ONLY Ascorbic Acid can prevent the stabilization of the HIF-1a complex to
maintain furin enzyme homeostasis.
• Cell-free heme destroys Nitric Oxide at rates 1000 times faster that normal heme. Destruction of Nitric Oxide will lead
to depletion of Ascorbic Acid, as it is required for BH4 regeneration. That is why cell-free heme has been observed to
deplete intracellular ascorbate.
• Depletion of Ascorbic Acid will affect ALL immune white blood cells including macrophages, neutrophils and
lymphocytes that depend on Ascorbic Acid recycling to produce Nitric Oxide, NADPH and glutathione.
How Oral Ascorbic Acid can Neutralize the
Mechanism of COVID-19
25. https://www.evolutamente.it/covid-19-ards-cell-free-hemoglobin-the-ascorbic-acid-connection/
March 24, 2020
Initial onset of symptoms:
3 g initial dose, followed by 1 to 2 g every hour. Repeat this cycle every 8 hours until
symptoms subside.
Milder cases:
3 to 5 g in one dose – depending on severity – followed by 1 to 2 g every 30 to 60
minutes. Repeat this cycle every 12 hours until symptoms subside.
Severe/critical cases:
10 g in one dose, followed by 3 to 5 g every 30 minutes. Repeat this cycle every 12
hours until symptoms improve.
A Call for Immediate Attention To The Use of
Oral Ascorbic Acid in COVID-19 Patients (ADULT)
26. https://www.evolutamente.it/covid-19-ards-cell-free-hemoglobin-the-ascorbic-acid-connection/
March 24, 2020
Initial onset of symptoms:
1 g initial dose, followed by 0.5 g every hour. Repeat this cycle every 8 hours until
symptoms subside.
Milder cases:
1 to 2 g in one dose – depending on severity – followed by 0.5 g every 30 to 60
minutes. Repeat this cycle every 12 hours until symptoms subside.
Severe/critical cases:
3 to 4 g in one dose, followed by 1 g every 30 minutes. Repeat this cycle every 12
hours until symptoms improve.
A Call for Immediate Attention To The Use of Oral Ascorbic
Acid in COVID-19 Patients (CHILDREN under 12)
27. RECOMMENDATIONS – A PARADIGM SHIFT
COVID-19 TREATMENT USING VITAMIN C (ASCORBIC ACID) 27
Determine the Levels of Ferritin and Liver
Enzymes – AST/ ALT – and blood clotting factors
to assess the condition of the patient
Also, consider getting the HbA1c to know if the
patient is susceptible to becoming severe
Early Intervention using Oral Vitamin
C Ascorbic Acid – with or without
symptoms – to prevent Cytokine Storm
Increase the dose depending on the
symptoms or severity
Use a combination of Oral Ascorbic
Acid and IV C (a powerful two-pronged
attack on COVID-19) to more severe
and/or critical patients
Oral Ascorbic Acid stops cytokine
storms and returns oxygen levels in
cells
IV Sodium Ascorbate supports
haptoglobin regeneration and provides
electrons as antioxidant
Hypoxemia from Heme Destruction by
COVID-19 CANNOT be attenuated by
Intubation
Oral Ascorbic Acid MUST be used to
address cell-free heme pathologies
Initial onset of symptoms: 1 g initial dose, followed by 0.5 g every
hour. Repeat this cycle every 8 hours until symptoms subside.
Milder cases: 1 to 2 g in one dose – depending on severity –
followed by 0.5 g every 30 to 60 minutes. Repeat this cycle every 12
hours until symptoms subside.
Severe/critical cases: 3 to 4 g in one dose, followed by 1 g every 30
minutes. Repeat this cycle every 12 hours until symptoms improve.
30. https://m.facebook.com/story.php?story_fbid=661796657943632&id=409037702805561&_rdr
Streamed Live – The HighWire with Del Bigtree – April 16, 2020
FB Live with Del Bigtree – Doctors Successfully Treating COVID-19
Since March 2020, these MDs are using high-dose of
Oral Vitamin C based on Doris Loh’s protocol – with
100% success – Zero Fatality – over 100 patients
Watch beginning at 1 hour, 12 minutes – how they use Vitamin C in
treating COVID-19 patients – including severe ones – mentioned at
1:18:00 – citing the lecture of Ms. Doris Loh and her protocol
31. https://www.sciencedirect.com/science/article/pii/S2590098620300154
Medicine in Drug Discovery – Dr. Richard Z. Cheng – Mar 24, 2020
Vitamin C and other antioxidants are among currently available agents to
mitigate COVID-19 associated ARDS
High-dose intravenous VC has also been successfully
used in the treatment of 50 moderate to severe
COVID-19 patients in China. The doses used varied
between 10 g and 20 g per day, given over a period
of 8–10 h.
Additional VC bolus may be required among
patients in critical conditions. The oxygenation
index was improving in real time and all the
patients eventually cured and were discharged.
Given the fact that high-dose VC is safe, healthcare
professionals should take a close look at this
opportunity.
32. https://mp.weixin.qq.com/s/bF2YhJKiOfe1yimBc4XwOA
Shanghai 2019 Coronary Disease Comprehensive Treatment Expert Consensus
Shanghai Medical Association – March 1, 2020
Shanghai COVID-19 Comprehensive Treatment Expert Consensus –
Recommends High-Dose of Vitamin C to Prevent Cytokine Storm
On March 1, the "Chinese Journal of Infectious
Diseases" network hosted by the Shanghai
Medical Association pre-published the
"Shanghai 2019 Coronary Virus Disease
Comprehensive Treatment Expert Consensus“
This consensus was formed by 30 experts (18
authors and 12 consultants) representing the
strongest medical force in the treatment of
Shanghai's new coronavirus pneumonia,
through a summary of the clinical research of
more than 300 patients.
34. https://www.express.co.uk/life-style/health/1264190/Vitamin-C-can-Vitamin-C-prevent-coronavirus
Express UK – April 14, 2020
Similarly, ZhiYong Peng, MD of
the Department of Critical Care
Medicine at Zhongnan Hospital
of Wuhan University registered
a phase 2 clinical trial on
ClinicalTrials.gov in March to
test the efficacy of vitamin C
infusions for the treatment of
severe acute respiratory
infection associated with the
novel coronavirus.
41. https://drhoffman.com/article/coronavirus-treatment-and-prevention-strategies/
Dr. Ronald Hoffman – March 27, 2020
Vitamin C: Unquestionably, vitamin C deficiency undermines
immune defenses, as in scurvy. Studies are +/- about high dose
vitamin C for colds and flus. Keep in mind that it’s better to
dose moderate amounts of vitamin C (500 mg) several times a
day than a big dose all at once (the body limits the amount of
vitamin C that can be absorbed at one time). More intriguing
is the potential benefit of mega-dosing vitamin C via the
intravenous route, which bypasses the limits of oral
absorption. Vitamin C at these high concentrations may have a
direct antiviral effect. This is being explored in small clinical
trials in China, and some U.S doctors are putting extra vitamin
C in the IV bags of their sickest COVID-19 patients.
Coronavirus Treatment and
Prevention Strategies
42. THANK YOU!
Many Thanks to Ms. Doris Loh for her
hard work and brilliant research about
Ascorbic Acid and COVID-19.
Please send your question to:
◂ alcura@yahoo.com
Thanks to:
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