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0 0.5 1 1.5 2+ Hospitalization 80% Improvement Relative Risk Recovery 83% Altay et al. N-acetylcysteine for COVID-19 RCT EARLY Is early treatment with N-acetylcysteine+combined treatments beneficial for COVID-19? Double-blind RCT 305 patients in Turkey Improved recovery with N-acetylcysteine+combined treatments (p<0.000001) Altay et al., Advanced Science, doi:10.1002/advs.202101222 Favors N-acetylcysteine Favors control
Combined Metabolic Activators Accelerates Recovery in Mild-to-Moderate COVID-19
Altay et al., Advanced Science, doi:10.1002/advs.202101222
Altay et al., Combined Metabolic Activators Accelerates Recovery in Mild-to-Moderate COVID-19, Advanced Science, doi:10.1002/advs.202101222
Jun 2021   Source   PDF  
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RCT 304 low-risk outpatients, 229 treated with N-acetylcysteine, l-carnitine tartrate, nicotinamide riboside chloride, and serine, showing significantly faster recovery with treatment. Plasma levels of proteins and metabolites associated with inflammation and antioxidant metabolism were significantly improved in treated patients.
risk of hospitalization, 80.1% lower, RR 0.20, p = 0.25, treatment 0 of 229 (0.0%), control 1 of 76 (1.3%), NNT 76, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
risk of no recovery, 82.7% lower, RR 0.17, p < 0.001, treatment 229, control 75, inverted to make RR<1 favor treatment, multivariate Cox regression.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Altay et al., 28 Jun 2021, Double Blind Randomized Controlled Trial, placebo-controlled, Turkey, peer-reviewed, 18 authors, this trial uses multiple treatments in the treatment arm (combined with l-carnitine tartrate, nicotinamide riboside chloride, serine) - results of individual treatments may vary.
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Abstract: RESEARCH ARTICLE Combined Metabolic Activators Accelerates Recovery in Mild-to-Moderate COVID-19 Ozlem Altay, Muhammad Arif, Xiangyu Li, Hong Yang, Mehtap Aydın, Gizem Alkurt, Woonghee Kim, Dogukan Akyol, Cheng Zhang, Gizem Dinler-Doganay, Hasan Turkez, Saeed Shoaie, Jens Nielsen, Jan Borén, Oktay Olmuscelik, Levent Doganay, Mathias Uhlén, and Adil Mardinoglu* 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. Dr. O. Altay, M. Arif, Dr. X. Li, H. Yang, Dr. W. Kim, Dr. C. Zhang, Dr. S. Shoaie, Prof. M. Uhlén, Prof. A. Mardinoglu Science for Life Laboratory KTH—Royal Institute of Technology Stockholm, SE-100 44, Sweden E-mail: Dr. O. Altay Department of Clinical Microbiology Dr Sami Ulus Training and Research Hospital University of Health Sciences Ankara 06080, Turkey The ORCID identification number(s) for the author(s) of this article can be found under © 2021 The Authors. Advanced Science published by Wiley-VCH GmbH. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. DOI: 10.1002/advs.202101222 Adv. Sci. 2021, 8, 2101222
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