Effects of L-carnitine supplementation in patients with mild-to-moderate COVID-19 disease: a pilot study.

Seyed Saman Talebi, Mehran Ghasemi, Maryam Etminani-Esfahani, Younes Mohammadi, Rasool Haddadi

Journal: Pharmacological reports : PR 2022;74(6):1296-1305

PMID: 35997951

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Plain Language Summary

Coronavirus is an enveloped single-stranded-RNA positive-sense virus that includes four subgroups called alpha, beta, delta, and gamma, of which beta type is responsible for coronavirus disease 2019 (COVID-19). Due to the nature of COVID-19, L-carnitine may be considered a suitable therapeutic supplement as it has shown promising results in some viral infections related to the respiratory system. The aim of this study was to evaluate the extent of changes in inflammatory factors, such as c-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), following L-carnitine supplementation. This study is a single-centre, prospective, randomised, double-blind, and pilot clinical trial. Seventy-six patients who were hospitalised with mild-to-moderate COVID-19 symptoms were enrolled for the study. They were randomly divided into intervention (n=33) and control (n=43) groups. Results show that L-carnitine supplementation can decrease inflammation caused by infection, increase oxygen saturation levels through improvements in oxygen delivery and decrease liver enzymes levels. Furthermore, the mean CRP and ESR levels in patients receiving L-carnitine were significantly reduced. Authors conclude that L-carnitine can be suggested as a pharmacological supplement in patients with COVID-19, but further research and clinical studies with larger sample sizes are needed to confirm and extend their findings.

Abstract

BACKGROUND

The present single-center clinical trial was designed to evaluate the potential benefits of L-carnitine supplementation in patients with COVID-19 disease.

METHODS AND PATIENTS

The study was conducted on 75 patients with mild-to-moderate COVID-19 hospitalized in Shahid Beheshti Hospital-Hamadan, IRAN. The participants were randomly divided into intervention (n = 32) and control groups (n = 43). The control group received their standard hospital treatment only. In addition to standard medications, the intervention group received 3000 mg oral L-carnitine daily in three divided doses for five days. The blood samples were collected and para-clinical parameters were measured at the beginning and end of the treatment. Clinical outcomes were also recorded, and data were analyzed using χ and t-tests.

RESULTS

Higher means of O2 saturation were observed in the intervention rather than in the control group. Mean erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were significantly lower in the intervention group. Furthermore, mean alkaline phosphatase (ALP) activity and lactate dehydrogenase (LDH) were lower in the intervention group. Also, lower mean serum creatine phosphokinase (CPK) was observed in the intervention group. No significant differences were observed in terms of clinical symptoms; however, six patients (14%) in the control group died due to the complications of COVID-19, while all patients in the intervention group survived.

CONCLUSION

Taken together, L-carnitine can be considered as a drug supplement in patients with COVID-19.

Address: Department of Internal Medicine, School of Medicine, Shahid Beheshti Medical Educational Center, Hamadan University of Medical Sciences, Hamadan, Iran.; Department of Pharmacology and Toxicology, School of Pharmacy, Herbal Medicine and Natural Product Research Center, Hamadan University of Medical Sciences and Health Services, Hamadan, Iran.; Department of Clinical Pharmacy and Services, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran.; Department of Epidemiology, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran.; Department of Pharmacology and Toxicology, School of Pharmacy, Herbal Medicine and Natural Product Research Center, Hamadan University of Medical Sciences and Health Services, Hamadan, Iran. [email protected].

DOI: 10.1007/s43440-022-00402-y