Pak J Pharm Sci. 2026 Jan;39(1):164-173. doi: 10.36721/PJPS.2026.39.1.REG.14162.1.
ABSTRACT
BACKGROUND: Septic shock remains a critical condition with high mortality, necessitating reliable prognostic biomarkers and effective adjunct therapies.
OBJECTIVES: This study explored prognostic biomarkers and the effect of vitamin C in septic shock.
METHODS: This study analyzed 110 patients (January 2023-March 2024), stratified by 28-day outcome into survival (n=90) and death (n=20) groups. Compared to survivors, the death group exhibited significantly lower lymphocyte-to-high-density lipoprotein ratio (LHR), CD3+, CD3+CD4+, CD4+/CD8+ and higher interleukin 6 (IL-6), C-reactive protein (CRP), procalcitonin (PCT), CD3+CD8+.
RESULTS: The receiver operating characteristic analysis showed the combination of LHR, IL-6, CRP, PCT and CD4+/CD8+ predicted death best [area under the receiver operating characteristic curve (AUC) =0.960], outperforming single markers. Patients were randomized to control (hydrocortisone) or observation (hydrocortisone with vitamin C) group. Post-treatment, both groups showed improved mean arterial pressure (MAP), central venous pressure (CVP) (increased), heart rate (HR) (decreased) and reduced PCT, tumor necrosis factor-α (TNF-α), IL-6 and Sequential Organ Failure Assessment (SOFA) score; however, improvements were significantly greater in the vitamin C group.
CONCLUSION: The combination of LHR, IL-6, CRP, PCT and CD4+/CD8+ has prognostic value. Vitamin C adjunct therapy significantly enhances hemodynamic improvement, reduces inflammation, lowers SOFA scores and improves prognosis in septic shock patients.
PMID:41482786 | DOI:10.36721/PJPS.2026.39.1.REG.14162.1
