L-carnitine is an amino acid that plays a crucial role in cellular energy production. It is also involved in a number of other important biological processes, including fatty acid metabolism, mitochondrial function, and immune response.
In recent years, L-carnitine has been investigated for its potential therapeutic effects in a variety of conditions, including heart disease, diabetes, and cancer.
Previous research has suggested that LC may play a role in inhibiting viral infections, particularly through its impact on the angiotensin-converting enzyme-2 (ACE2) receptor, which is crucial for the entry of the SARS-CoV-2 virus into host cells.
In this article, we delve into the scientific evidence surrounding the safety and potential protective effects of daily LC supplementation in individuals at risk of SARS-CoV-2 infection or already affected by COVID-19.
Study Design and Findings
The study comprised two cohorts: Cohort 1 consisted of COVID-19 negative volunteers living with infected individuals, while Cohort 2 included patients with mild COVID-19. Although the primary endpoints of the study were not met, the analysis of secondary endpoints revealed interesting results.
Cohort 1: Preventive Effects of L-Carnitine on COVID-19 Transmission
To assess the preventive effects of L-carnitine supplementation, the study enrolled COVID-19 negative volunteers living in households with infected individuals. However, due to the low infectivity rate at the study’s location, only two participants in each group (LCLT or placebo) tested positive for COVID-19 during the study period.
While C-reactive protein (CRP) levels significantly increased in the placebo group, the low infection rate hindered the correlation with disease progression. Therefore, the study could not conclude whether L-carnitine supplementation reduces the rate of SARS-CoV-2 infection in this cohort.
Cohort 2: L-Carnitine Supplementation in Patients with Mild COVID-19
The second cohort consisted of patients with mild COVID-19. The study results showed that L-carnitine (LCLT) supplementation was well-tolerated and safe in this group. Although the primary endpoint of SARS-CoV-2 infection rates in Cohort 1 and disease progression in Cohort 2 were not met, the analysis of secondary endpoints provided valuable insights.
Additionally, a subgroup analysis of 23 subjects in Cohort 2 demonstrated striking differences in lung CT scan images between the LCLT and placebo groups. The LCLT group showed less progression of lung lesions, such as ground glass opacities (GGOs) and consolidations, indicating potential protection against COVID-19 pneumonia.
Results and Findings:
- Coagulation Modulating Effects: In Cohort 2, L-carnitine supplementation led to a decrease in coagulation disturbance markers, potentially indicating an anticoagulant effect. Moreover, the increase in platelet levels and decrease in fibrinogen levels suggest a trend towards normalizing these coagulation parameters, particularly in COVID-19 pneumonia patients.
- Clinical Improvement and Lung Alterations: Patients with COVID-19 who received LCLT supplementation showed clinical improvement between days 7 and 14, which is the period when lung effects are usually observed. A sub-group analysis of 23 patients demonstrated a significant difference in lung computed tomography (CT) scan images, suggesting that LCLT may offer protection against COVID-19 pneumonia.
- Correlation with Previous Studies: Previous studies have also reported positive effects of L-carnitine supplementation in COVID-19 patients, including improvements in O2 saturation, erythrocyte sedimentation rate (ESR), CRP, alkaline phosphatase (ALP) activity, lactate dehydrogenase (LDH), and serum creatine phosphokinase (CPK) levels. These findings align with the beneficial effects observed in the current study.
L-Carnitine and its Potential Cardioprotective Effects
L-Carnitine is a vital molecule responsible for transporting long-chain fatty acids into the mitochondria for fat oxidation. Derived primarily from dietary intake, LC has been found to have anti-inflammatory effects, reducing inflammatory cytokines. Additionally, LC has been implicated in minimizing oxidative stress and myocyte necrosis, contributing to its potential cardioprotective effects.
By mitigating inflammation and coagulation disturbances, LC holds promise as a potential therapeutic agent in the context of COVID-19.
COVID-19 and the Role of Inflammation
Patients with COVID-19 often experience inflammatory cytokine storms, leading to severe organ failure. The SARS-CoV-2 virus gains entry into host cells through the ACE2 receptor, which is upregulated during exacerbated inflammatory responses. The virus’s spike protein binds to the ACE2 receptor, facilitated by transmembrane serine protease 2 (TMPRSS2) and furin peptidase.
Previous Research on LC and SARS-CoV-2 Inhibition
Earlier studies have indicated that LC may inhibit hepatitis C virus propagation and exhibit antioxidant activity. In a study on human lung epithelial cells, LC supplementation resulted in a dose-dependent reduction in SARS-CoV-2 infection. Moreover, LC supplementation in humans was associated with decreased ACE2, TMPRSS2, and furin levels. These findings provide initial evidence of the potential therapeutic role of LC in COVID-19.
Corroborating Studies and Further Exploration
Other recent studies have also supported the beneficial effects of L-carnitine in improving clinical parameters and reducing mortality in COVID-19 patients. However, more research is required to better understand the mechanism by which LCLT impacts SARS-CoV-2 pathogenicity, particularly concerning serum ACE1 levels.
Conclusion
L-Carnitine supplementation shows promise as a coagulation modulator and a potential mitigator of disease progression in COVID-19 patients. The study’s results suggest that LCLT supplementation may be well-tolerated and may improve clinical outcomes in mild COVID-19 cases.
Nevertheless, larger studies are necessary to validate the efficacy and safety of L-carnitine supplementation as a potential therapeutic option for COVID-19 management. In the ongoing battle against the pandemic, exploring new treatment avenues such as L-carnitine supplementation may offer hope for improving patient outcomes and alleviating the burden on healthcare systems worldwide.
reference link : https://www.frontiersin.org/articles/10.3389/fnut.2023.1134162/full
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