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More than a year and a half into the pandemic, therapeutic interventions to treat COVID-19 are still lacking, with few reliable options available to treat infection. The search for new antiviral drugs is in itself quite nuanced, but in a recent study published in Advanced Science, researchers from KTH Royal Institute of Technology in Stockholm, King’s College London, and Umraniye Teaching and Research Hospital in Istanbul, Turkey have found that a cocktail of metabolic activators could improve recovery time of patients with mild to moderate COVID-19.
On a cellular level, COVID-19 has been associated with mitochondrial dysfunction — where mitochondria are the power-house of cells — and subsequent metabolic abnormalities; specifically, deficiencies in nicotinamide adenine dinucleotide (NAD+) and glutathione metabolism.
In the randomized phase III clinical trial, 309 outpatients between 18–66 years of age at Umraniye Teaching and Research Hospital were randomly assigned to receive a placebo or three metabolic activators aimed at improving mitochondria function — nicotinamide riboside, L-serine, N-acetyl-L-cysteine, and L-carnitine tartrate. The results of the study built on findings from phase II clinical data, which included 93 adults with a confirmed positive PCR test for COVID-19.
Patients received the combined activators or placebo twice a day for 14 days and clinical status was evaluated through daily telephone check-ins. Those that received the cocktail experienced a 3.5 day reduction in recovery time compared to the placebo group.
“Our phase III data shows that metabolic activators improved the recovery, liver health, and markers of inflammation of patients with COVID-19,” said the study’s lead author, Adil Mardinoglu, professor at KTH and Kings College and research fellow at Science for Life Laboratory.
This results show promise as many COVID-19 patients are at risk due to a systemic inflammatory response referred to as a cytokine storm — a life-threatening condition that is dependent on several downstream processes. “The results show that treating patients infected with COVID-19 with [combined metabolic activators] leads to a more rapid symptom-free recovery, suggesting a role for such a therapeutic regime in the treatment of infections leading to respiratory problems,” wrote the authors in their paper.
“Dysfunctional mitochondria have been implicated in worsened progression for COVID-19, and we are pleased to find that the combination of these metabolic activators helps to remedy the stress put on the body of an infected patient,” said co-lead investigator Mathias Uhlen of KTH-Royal Institute of Technology, Sweden.
Reference: Ozlem Altay, et al., Combined Metabolic Activators Accelerates Recovery in Mild-to-Moderate COVID-19, Advanced Science (2021). DOI: 10.1002/advs.202101222