Combined Metabolic Activators Accelerates Recovery in Mild-to-Moderate COVID-19, Altay et al, 28 June 2021

[forestglip]

I don't know if Long COVID is the correct forum to put this in, since the study was about recovery from acute COVID. But I think it's possible that something that helps people recover from the acute disease could help with LC.

Abstract
COVID-19 is associated with mitochondrial dysfunction and metabolic abnormalities, including the deficiencies in nicotinamide adenine dinucleotide (NAD+) and glutathione metabolism. Here it is investigated if administration of a mixture of combined metabolic activators (CMAs) consisting of glutathione and NAD+ precursors can restore metabolic function and thus aid the recovery of COVID-19 patients. CMAs include l-serine, N-acetyl-l-cysteine, nicotinamide riboside, and l-carnitine tartrate, salt form of l-carnitine. Placebo-controlled, open-label phase 2 study and double-blinded phase 3 clinical trials are conducted to investigate the time of symptom-free recovery on ambulatory patients using CMAs. The results of both studies show that the time to complete recovery is significantly shorter in the CMA group (6.6 vs 9.3 d) in phase 2 and (5.7 vs 9.2 d) in phase 3 trials compared to placebo group. A comprehensive analysis of the plasma metabolome and proteome reveals major metabolic changes. Plasma levels of proteins and metabolites associated with inflammation and antioxidant metabolism are significantly improved in patients treated with CMAs as compared to placebo. The results show that treating patients infected with COVID-19 with CMAs lead to a more rapid symptom-free recovery, suggesting a role for such a therapeutic regime in the treatment of infections leading to respiratory problems.

Each dose of CMA contained 3.73 g l-carnitine tartrate, 2.55 g N-acetylcysteine, 1 g nicotinamide riboside chloride, and 12.35 g serine. All participants [including placebo] also received oral HQ [hydroxychloroquine] or FP [Favipiravir] for 5 d.

In the phase-2 study, we recruited 100 adults with a confirmed positive PCR test for COVID-19.

...

...we observed that the mean recovery time (the primary outcome variable) was shorter in the CMA group than in the placebo group (6.6 vs 9.3 d, p = 0.0001)

In the phase-3 study, we recruited and randomly assigned 309 adult patients with a confirmed positive PCR test for COVID-19.

...

...we observed that the mean recovery time was shorter in the CMA group than in the placebo group (5.7 vs 9.2 d, p<0.0001)

Study

 

[forestglip]

At least two trials are testing nicotinamide riboside (one of the chemicals in the treatment) in long COVID:

Clinical Trial of Niagen to Examine Recovery in People With Persistent Cognitive and Physical Symptoms After COVID-19 Illness (Long-COVID)
- Study completed 2024-02-23

Mental Intervention and Nicotinamide Riboside Supplementation in Long Covid (MINIRICO)
- Recruiting (Lørenskog, Norway), estimated study completion 2025-01

 

[alfons2235]

RC controlled studies with administration of NAC are always avoided because no patent profit will be acquired.
But a lot of earlier cohort studies showed benefit of N-acetylcysteine (NAC) in acute COVID [1-Alam 2023- PMID: 37534078] .
Antiviral H2S in particular has multiple targets for SRS-C0V2 infection [2,3], whereby an acute
decrease of H2S in the airway epithelium also appears to occur. Administration of N-acetylcysteine (NAC) can
supplement this H2S deficiency [2,3 ], which also involves recovery of the lymphopenia, which is seen as a poor
prognosis [4].
Despite older age and more comorbidity, there was significantly less mortality with NAC in a very large cohort
study [5], for which a ratio had previously been described [6,7]. The earlier NAC is administered, the better the
antiviral effect [8]; even the timing for medication could already be determined before the appearance of viral
symptoms. In case of problematic or pandemic corona mutations, RC controlled administration of NAC is
indicated pending the development of adequate vaccines.

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