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All Studies   Meta Analysis       

Combined Metabolic Activators Accelerates Recovery in Mild-to-Moderate COVID-19

Altay et al., Advanced Science, doi:10.1002/advs.202101222
Jun 2021  
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Hospitalization 80% Improvement Relative Risk Recovery 83% N-acetylcysteine  Altay et al.  EARLY TREATMENT  DB RCT 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) c19early.org Altay et al., Advanced Science, June 2021 FavorsN-acetylcysteine Favorscontrol 0 0.5 1 1.5 2+
14th treatment shown to reduce risk in February 2021, now with p = 0.000028 from 24 studies, recognized in 3 countries.
Lower risk for mortality, hospitalization, and cases.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 112 treatments. c19early.org
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.
This PaperN-acetylcys..All
Combined Metabolic Activators Accelerates Recovery in Mild‐to‐Moderate COVID‐19
Dr Ozlem Altay, Dr Muhammad Arif, Xiangyu Li, Dr Hong Yang, Dr Mehtap Aydın, Dr Gizem Alkurt, Dr Woonghee Kim, Dogukan Akyol, Dr Cheng Zhang, Gizem Dinler‐doganay, Hasan Turkez, Prof Saeed M Shoaie, Jens Nielsen, Jan Borén, Oktay Olmuscelik, Levent Doganay, Mathias Uhlén, Adil Mardinoglu
Advanced Science, doi:10.1002/advs.202101222
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.
Supporting Information Supporting Information is available from the Wiley Online Library or from the author. Conflict of Interest A.M., J.B., and M.U. are the founders and shareholders of ScandiBio Therapeutics and they filed a patent application on the use of CMA to treat COVID-19 patients. The other authors declare no competing interests.
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