Effect of Vitamin C Supplementation on Leukocyte Count, C-Reactive Protein, and Procalcitonin Levels in Children with Severe Community-Acquired Pneumonia

Abstract

Background and Objectives. Pneumonia continues to be a major cause of death among children globally, especially those under five years old. Severe cases of community-acquired pneumonia (CAP) are linked to systemic inflammation, as indicated by biomarkers such as leukocyte count, C-reactive protein (CRP), and procalcitonin (PCT). Vitamin C, known for its antioxidant and immune-modulating properties, might help alleviate oxidative stress during infections. Nonetheless, there is still limited evidence supporting its efficacy in treating severe CAP in children.

Materials and Methods. A double-blind randomized controlled trial took place at Dr. Wahidin Sudirohusodo Hospital in Makassar, Indonesia, between April and November 2025. In this study, 66 children aged 1 to 5 years with severe CAP were randomly assigned to receive either standard treatment along with oral vitamin C (200 mg/day) or standard treatment with a placebo for a duration of seven days. Measurements of leukocyte count, CRP, and PCT levels were taken at the start of the study and again on day 7. Statistical analyses were conducted using suitable parametric or non-parametric tests.

Results. Baseline demographic characteristics were similar across the groups. After a week of treatment, there was no significant difference in leukocyte counts between the groups (p = 0.442). Both groups experienced a significant decrease in CRP levels, with the vitamin C group showing a more pronounced reduction. The most significant observation was the notably greater decrease in PCT levels in the vitamin C group compared to the placebo group (p < 0.01). Analysis within the vitamin C group revealed significant reductions in leukocyte count, CRP, and PCT.

Conclusions. Adding vitamin C to the usual treatment regimen might help lower inflammatory markers, especially procalcitonin, in children suffering from severe community-acquired pneumonia. More extensive research is needed to verify its clinical advantages.