Impact of vitamin C deficiency on imaging patterns and ventilatory function in pulmonary tuberculosis

Background Studies have shown that vitamin C is essential for the immune response to tuberculosis (TB), and that its deficiency may elevate the risk of TB and related complications. This prospective study investigated the association between disease severity, imaging findings and vitamin C levels. Methods This study enrolled 109 patients with confirmed pulmonary tuberculosis based on Mycobacterium tuberculosis culture. Patients were divided into two groups based on serum vitamin C levels: 59 patients (54.13%) with normal levels and 50 (45.87%) with low levels. Results At baseline, patients in the low vitamin C group showed significantly higher bacillar loads, with 86.00% presenting loads of 2+ or higher compared with 59.32% in the normal group ( p p p p = 0.011) and superior left lobe (0.34 vs. 0.14; p = 0.012). After 6 months of treatment, the low vitamin C group exhibited a higher prevalence of bronchiectasis (mean involvement in both lungs: 0.58 vs. 0.16; p p = 0.002), and fibrosis (0.90 vs. 0.36; p p p p = 0.002). Receiver operating characteristic (ROC) analysis indicated that FVC (AUC = 0.826) and forced expiratory flow (AUC = 0.745) were stronger predictors of treatment success in patients with normal vitamin C levels. Conclusion Vitamin C deficiency is correlated with increased disease severity, delayed bacterial clearance, and persistent pulmonary damage in patients with tuberculosis. Vitamin C supplementation can enhance treatment outcomes in tuberculosis therapy.