For several weeks, against the background of the surge of positive cases in COVID-19, the government advocated that patients with mild illness should be monitored at home, and "don't go to the hospital unless necessary". The People's Daily chat is also from "Are you Yang?" It became "Did you get the medicine?" After ibuprofen, Tylenol, Lianhua Qingwen and other antipyretic and analgesic drugs, vitamin C and effervescent tablets are also at the forefront of people's drug list.
Zhang Wenhong, director of infection department of Huashan Hospital affiliated to Fudan University, pointed out that human immunity is the best weapon in the face of COVID-19. A few days ago, in the latest article "Protect your family and get out of the epidemic" published by Huashan infected WeChat official account, the Zhang Wenhong team bluntly said, "As far as people with normal immune function are concerned, who will find nucleic acid kiosks all over the world with a cold and fever? Nothing more than finding some antipyretics, sleeping, drinking more water and taking vitamin C. "
Zhong Nanshan, an academician of China Academy of Engineering, Tong, vice president of Beichao Hospital affiliated to Capital Medical University, and other well-known experts have also suggested to the public that vitamin C can be supplemented after being infected with COVID-19, so as to enhance the body's defense ability and fight the virus.
But whether vitamin C can prevent and treat COVID-19 has been controversial. Many experts suggest that the public can take vitamin C in moderation during the infection period, not exceeding 200mg per day, and never overdosing it. "Vitamin C supplementation is best obtained from fruits and vegetables rich in vitamin C. For drugs or nutrients, eat less if you can eat less." A doctor from the Department of Respiratory and Critical Care Medicine of China-China Friendship Hospital explained to Newsweek.
Vitamin C cannot prevent COVID-19.
Vitamin C is an essential nutrient for human body, and its essence is an antioxidant. Scientific research shows that vitamin C will participate in the synthesis of human immune proteins and regulate the immune response of the body by promoting the activity of white blood cells and phagocytes. For people's daily intake of vitamin C, the EU suggests that the average intake of vitamin C for men is 90 mg/day and that for women is 80 mg/day, so as to maintain the normal plasma level of adults and prevent scurvy. In 2020, a Swiss expert group suggested that people over 65 should take 200 milligrams of vitamin C every day after catching a cold or being invaded by a virus.
Guo Wei, deputy director of the Department of Infectious Diseases of tongji hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology, told China Newsweek that vitamin C is more like a placebo for people infected with COVID-19 virus. Although it can enhance human immunity to a certain extent, it cannot "enhance immunity enough to resist COVID-19 infection" in a short time. In other words, vitamin C can neither prevent COVID-19 nor kill the virus, so it can't replace drugs for symptomatic treatment.
He reminded the public that vitamin C must not be taken blindly in large quantities after infection, because it is an acidic component, which may destroy the acid-base balance in the body after large intake. In addition, vitamin C should be supplemented by fresh fruits and vegetables as much as possible. "In short, you can make up a little, but there is no need to eat a lot of vitamin C."
An infectious disease doctor in Anhui 3A Hospital also told China Newsweek that it is not recommended to take vitamin C every day to prevent COVID-19. Many studies show that the effect of vitamin C on preventing COVID-19 is "limited". After human body is infected by virus, taking vitamin C in proper amount after symptoms appear can shorten the course of disease, reduce the severity of symptoms and help the infection recover as soon as possible. "Drugs have a certain auxiliary effect."
As early as the beginning of the COVID-19 epidemic, many governments listed vitamin C as a preventive drug. On June 22, 2020, at 65438, the Shanghai Municipal Health and Health Commission took the lead in issuing a notice to all medical institutions in Shanghai, suggesting that vitamin C should be listed as a drug to prevent COVID-19 in clinical application; 65438+1On October 26th, Hangzhou Epidemic Prevention and Control Command issued 10 Suggestions for All Citizens, calling on people to "properly supplement vitamin C". Since then, health departments in Shandong and other places have also listed vitamin C as a nutritional supplement to prevent COVID-19.
However, whether vitamin C can prevent and treat colds or respiratory infections has been controversial in the scientific community. Several Italian scholars counted all the research published during the period from June 5438+0 to February 5438+0 in 2026 on the prevention or treatment of COVID-19 with vitamin C, and the results showed that there was no evidence that vitamin C supplementation could prevent COVID-19. Although some clinical observations report that the treatment status of COVID-19 patients treated with vitamin C has improved, for example, the duration of symptoms has been shortened, there are few available data in controlled studies and there is great uncertainty. Generally speaking, the current evidence is not enough to draw the conclusion that vitamin C supplementation is beneficial to the prevention and treatment of COVID-19, and more large-scale and high-quality research is needed.
However, Guo Wei said that in COVID-19, emergency rooms often give patients intravenous vitamin C when treating critically ill patients. Vitamin c can play two roles at this time. First, it can enhance the stability of blood vessels, because inflammation caused by infection will lead to the rupture and exudation of a large number of capillaries in the body; Second, it has a certain liver protection effect, and the injection of vitamin C can reduce the damage of body cells such as liver cells. "But there is no objective evidence-based medical evidence to support how good the effect is after this. It can only be said that everyone is used to this, and it is quite safe and has no side effects. "
In February 2020, Peng Zhiyong, director of the Department of Critical Care Medicine of Zhongnan Hospital of Wuhan University, told the media that his team was conducting a clinical trial of "high dose vitamin C" in the treatment of COVID-19. He said that whether it was SARS in the past, Middle East respiratory syndrome or COVID-19 now, the main causes of death of patients were acute respiratory distress and other complications caused by multiple organ failure. Antioxidants such as vitamin C can play an active role when the virus leads to increased oxidative stress and patients suffer from multiple organ failure such as acute respiratory distress.
The related research results of Peng Zhiyong's team were published in the Journal of Intensive Care Yearbook 202 1 1. The paper points out that "vitamin C deficiency" is very common in critically ill patients, and about 40% patients are seriously deficient. In the experiment, patients with severe acute respiratory syndrome in COVID-19 were injected with high dose of vitamin C, 24 grams a day, and it was found that serious cases had potential improvement signals. However, due to the rapid control of the early epidemic in Hubei Province, the sample size of this study was very small, and only 56 critically ill patients were recruited.
Guo Wei explained that this treatment is not to improve patients' immunity in a short time, but is mainly used to treat severe patients in COVID-19. Generally, it is a large dose, which can reach 12 ~ 24 grams a day. "It is much larger than the daily intake, and if most mild patients want to supplement vitamin C at home,100 ~ 200mg per day is enough. Excessive dosage may have side effects. "
Many experts warned that the role of vitamin C should not be exaggerated, especially for people who are not infected with COVID-19 virus. It is not necessary to take a large amount of vitamin C for prevention, as long as the recommended daily dietary amount is guaranteed.
Beijing residents always have medicines at home. Photo courtesy of respondents
Antipyretics and cold medicines cannot be used together.
Behind the myth of vitamin C is people's anxiety and helplessness after being infected with COVID-19. The same psychology will also lead people to "take more medicine" after discovering their fever and pain. Experts pointed out that this is a misunderstanding. Many drugs can't be combined, mixed and used for multiple purposes, so people must be vigilant, otherwise it may cause more serious consequences than COVID-19.
How to use drugs rationally and scientifically after COVID-19 infection?
Guo Wei pointed out that there are two kinds of antipyretic and analgesic drugs at present, one is simple antipyretic drugs, such as ibuprofen and acetaminophen, and the other is cold medicine, such as Tylenol and BaiKaga, which are mostly compound preparations, and the main ingredients also include acetaminophen. He reminded that the two drugs must not be used together, otherwise it would be equivalent to "increasing the dose of acetaminophen", which may lead to liver damage and even liver failure.
He suggested that you must carefully check the ingredient list before selecting drugs. If you have fever symptoms, antipyretics and cold medicines "must only choose one", and it is forbidden to use them together and repeatedly. "It is even harder to change the medicine after eating one."
At the press conference of the State Council Joint Prevention and Control Mechanism held on February 8th, 65438, Wang Guiqiang, director of the Department of Infectious Diseases of the First Hospital of Peking University, also suggested that if you have symptoms such as fever and cough after being infected with COVID-19, you can take medicine according to the symptoms, but you don't need to hoard drugs or buy a lot of drugs. It is important to note that although many analgesics have different names, they have the same ingredients, so they can't be taken together, and only one can be used. If you use too much or eat too much, it may cause adverse reactions.
Wang Guiqiang also suggested not to abuse drugs. Various drugs also have side effects, and the interaction may increase the adverse reactions of drugs. "Especially antibacterial drugs, can't literally use. For example, antibiotics themselves are prone to secondary flora imbalance and secondary infection, so the use of antibacterial drugs should be strictly controlled. "
The two most popular antipyretics, ibuprofen or acetaminophen?
Guo Wei said that for most adults, both drugs have good effects, but relatively speaking, acetaminophen is safer for pregnant women and children, because it has fewer side effects, and children can also use diclofenac sodium and other drugs. However, it should be noted that ibuprofen and acetaminophen should be used with caution in people with a history of gastric diseases, especially gastric ulcers, because these drugs may destroy gastric mucosa and lead to gastrointestinal bleeding. "When we use antipyretic and analgesic drugs in clinic, we will pay attention to whether patients have stomach problems and use them very cautiously, because we see that some people have black stools after taking a large number of these drugs, that is, gastrointestinal bleeding."
In addition, patients with cerebrovascular diseases, diabetes, heart disease, tumors and other complex diseases, what are the taboos when choosing these two drugs?
Wang Yang, chief physician of neurosurgery in Chaoyang Hospital, Beijing, pointed out in an interview that patients with cerebrovascular diseases generally take aspirin or warfarin. These two drugs have synergistic effects with ibuprofen, which will increase the risk of bleeding. Therefore, these patients try to use acetaminophen to reduce adverse reactions. Diabetics also give priority to acetaminophen. However, if you only have ibuprofen on hand, it is recommended to take it 2 hours apart from commonly used drugs. Patients with heart disease, especially those with severe cardiac insufficiency and heart failure, do not recommend taking ibuprofen, but also advocate choosing acetaminophen.
Guo Wei also stressed that the elderly should be cautious when taking oral antiviral drugs such as Pfizer and Paciclovir. One component of Paxlovid will interact with many drugs, so try not to take other drugs at the same time when taking this drug. Some elderly people with hypertension and heart disease are at greater risk when taking antiviral drugs, which must be carried out under the guidance of a doctor.
In addition, many experts suggest that antipyretics should not be taken in excess, and the interval of medication is generally 4~6 hours, no more than 4 times a day, otherwise it will also lead to organ damage. Moreover, the drug should be stopped immediately after the body temperature drops, and the use of antipyretics generally does not exceed 3 days. If the symptoms are still not relieved, it is recommended to go to the hospital in time. Generally speaking, we should adhere to the principle of "not taking medicine unless necessary".
Guo Wei explained that the human body will get fever after being infected with the virus because the immune response of the body is mobilized to resist killing the virus. Therefore, if the fever temperature is not too high, it will be forced to lower the body temperature by drugs, which may be unfavorable to the immune system of the whole human body, "because the body always faces the virus." It is recommended to take medicine for high fever, because high body temperature will cause cell damage in the body, so it is generally recommended to take medicine when the fever exceeds 38.5℃.
"If the body temperature is below 38.5℃, it is not recommended to take medicine to reduce fever clinically. You can cool down by physical means such as ice compress. For example, wrap some ice cubes with towels near the carotid artery to cool down, and be sure to drink plenty of water. " Guo Wei said.
In addition to ibuprofen, acetaminophen and other commonly used western medicines, another drug that has been out of stock in many hospitals is Lianhua Qingwen. Can Chinese and western medicine be mixed after COVID-19 infection?
Zhang Boli, academician of China Academy of Engineering and honorary president of Tianjin University of Traditional Chinese Medicine, suggested that western medicine antipyretics and traditional Chinese medicine cold medicines should not be taken together as far as possible. Such as Lianhua Qingwen, Jinhua Qinggan, Xuanfei Baidu Granules and other Chinese patent medicines with antipyretic effects, should not be taken together with ibuprofen or acetaminophen. Other traditional Chinese medicines and western medicines should be taken at intervals of 1 hour to avoid mutual influence. Guo Wei also pointed out that many Chinese patent medicines contain western medicine ingredients, and it is recommended not to mix them with antipyretic and analgesic western medicines.
Many experts emphasize that the most important thing in family therapy in COVID-19 is to treat the symptoms. If you have a high fever, you shouldn't take antipyretics. If you have a sore throat or cough, you can use some drugs to stop cough and resolve phlegm. When using, be sure to read the instructions carefully and take it according to the prescribed dose.
Guo Wei said that some patients' throat was "like a knife" after infection. Don't worry too much after the symptoms appear. You can take throat-moistening tablets such as watermelon frost and Jinsizi Houbao to relieve local inflammation, and try not to take any more medicine. If you cough with phlegm, you can take some expectorants, but you should try to avoid central antitussive drugs, such as dextromethorphan. The mechanism of action of these drugs is to inhibit the central nervous system and not make people cough, but cough is actually the body's own protective mechanism, which excretes inflammatory substances through expectoration. "It is suggested that you can take some non-central antitussive drugs, such as eucalyptus globulus enteric-coated capsules, and you can also drink some Chuanbei loquat cream."
What symptoms do you need to see a doctor in time during family therapy?
Guo Wei pointed out that the first and most important signal is that the fever has been above 38.5℃ for three consecutive days, or it will rebound immediately after taking antipyretic drugs for two or three hours, indicating that the infected virus has a large load and the drugs cannot play a role in the human body. "Generally speaking, it is rare to have a fever above 38.5 C for three or four consecutive days." Second, patients should seek medical attention immediately when they feel short of breath and suffocate and have difficulty breathing. Thirdly, after the elderly with underlying diseases are infected with COVID-19, the symptoms of underlying diseases, such as hyperglycemia and uncontrollable hypertension, are difficult to control. It is recommended to seek medical advice in time.
Fourth, pregnant women have symptoms such as abdominal pain, bleeding, and decreased fetal movement. The child has lost appetite for two or three days, showing irritability and noise. "In theory, the symptoms of children infected with COVID-19 virus are very mild. Although you will have a fever, you will generally recover quickly. Therefore, if the child continues to have symptoms of discomfort, he should seek medical advice promptly. "
The doctor of infectious diseases in Anhui 3A Hospital also reminded that the younger the child, the more attention should be paid to his emotional changes. "Clinically, many children are just sore throats at first after infection, and then tonsils are swollen and even edema. This situation may eventually lead to breathing difficulties and even suffocation and death, especially for children who can't talk. Symptoms will change very quickly and you must be extra vigilant. "
Author: Holsey