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Li Y, Lin J, Gao J, Tang L, Liu Y, Zhang Z. Efficacy and safety of hyperbaric oxygen therapy for long COVID: a protocol for systematic review and meta-analysis. BMJ Open 2024; 14:e083868. [PMID: 38806438 PMCID: PMC11138265 DOI: 10.1136/bmjopen-2024-083868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 04/29/2024] [Indexed: 05/30/2024] Open
Abstract
INTRODUCTION There is still a lack of therapeutic options for long COVID. Several studies have shown the benefit of hyperbaric oxygen therapy (HBOT) on long COVID. However, the efficacy and safety of HBOT for long COVID remain unclear. Therefore, we will conduct this systematic review to assess the feasibility of HBOT as a primary or complemental therapy for long COVID. METHODS AND ANALYSIS Databases such as Web of Science, PubMed, Embase, Cochrane Database of Systematic Reviews, ClinicalTrials.gov, International Clinical Trials Registry Platform, Wanfang Database, China National Knowledge Infrastructure, SINOMED, VIP Database and the Chinese Clinical Trial Registry will be searched systematically from the establishment to 9 December 2023. All articles will be reviewed by two independent reviewers. Cochrane risk of bias tool will be used to assess the risk of bias in the study. We will evaluate heterogeneity using a visual inspection of the funnel plot. If an available number of studies are identified, we will perform a meta-analysis. ETHICS AND DISSEMINATION No ethical approval is required since this study is based on published articles. The findings will be published in a peer-reviewed journal or disseminated through conference presentations. PROSPERO REGISTRATION NUMBER CRD42023482523.
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Affiliation(s)
- Yuxin Li
- Guangzhou University of Chinese Medicine, Guangzhou, China
- Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jingnan Lin
- Guangzhou University of Chinese Medicine, Guangzhou, China
- Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiazhu Gao
- Guangzhou University of Chinese Medicine, Guangzhou, China
- Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lijuan Tang
- Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Emergency, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Yuntao Liu
- Department of Emergency, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Zhongde Zhang
- Department of Emergency, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
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Mattioli LB, Frosini M, Corazza I, Fiorino S, Zippi M, Micucci M, Budriesi R. Long COVID-19 gastrointestinal related disorders and traditional Chinese medicine: A network target-based approach. Phytother Res 2024; 38:2323-2346. [PMID: 38421118 DOI: 10.1002/ptr.8163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 01/30/2024] [Accepted: 02/03/2024] [Indexed: 03/02/2024]
Abstract
The significant number of individuals impacted by the pandemic makes prolonged symptoms after COVID-19 a matter of considerable concern. These are numerous and affect multiple organ systems. According to the World Health Organization (WHO), prolonged gastrointestinal issues are a crucial part of post-COVID-19 syndrome. The resulting disruption of homeostasis underscores the need for a therapeutic approach based on compounds that can simultaneously affect more than one target/node. The present review aimed to check for nutraceuticals possessing multiple molecular mechanisms helpful in relieving Long COVID-19-specific gastrointestinal symptoms. Specific plants used in Keywords Chinese Medicine (TCM) expected to be included in the WHO Global Medical Compendium were selected based on the following criteria: (1) they are widely used in the Western world as natural remedies and complementary medicine adjuvants; (2) their import and trade are regulated by specific laws that ensure quality and safety (3) have the potential to be beneficial in alleviating intestinal issues associated with Long COVID-19. Searches were performed in PubMed, Elsevier, Google Scholar, Scopus, Science Direct, and ResearchGate up to 2023. Cinnamomum cassia, Glycyrrhiza uralensis, Magnolia officinalis, Poria cocos, Salvia miltiorrhiza, Scutellaria baicalensis, and Zingiber officinalis were identified as the most promising for their potential impact on inflammation and oxidative stress. Based on the molecular mechanisms of the phytocomplexes and isolated compounds of the considered plants, their clinical use may lead to benefits in gastrointestinal diseases associated with Long COVID-19, thanks to a multiorgan and multitarget approach.
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Affiliation(s)
- Laura Beatrice Mattioli
- Department of Pharmacy and Biotechnology, Food Chemistry and Nutraceutical Lab, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Maria Frosini
- Department of Life Sciences, University of Siena, Siena, Italy
| | - Ivan Corazza
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Sirio Fiorino
- Internal Medicine Unit, Azienda USL, Budrio Hospital, Bologna, Italy
| | - Maddalena Zippi
- Unit of Gastroenterology & Digestive Endoscopy, Sandro Pertini Hospital, Rome, Italy
| | - Matteo Micucci
- Department of Biomolecular Sciences, Università degli Studi di Urbino "Carlo Bo", Urbino, Italy
| | - Roberta Budriesi
- Department of Pharmacy and Biotechnology, Food Chemistry and Nutraceutical Lab, Alma Mater Studiorum-University of Bologna, Bologna, Italy
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Tanaka Y, Ikeda K, Kaneko Y, Ishiguro N, Takeuchi T. Why does malaise/fatigue occur? Underlying mechanisms and potential relevance to treatments in rheumatoid arthritis. Expert Rev Clin Immunol 2024; 20:485-499. [PMID: 38224064 DOI: 10.1080/1744666x.2024.2306220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 01/12/2024] [Indexed: 01/16/2024]
Abstract
INTRODUCTION Fatigue and malaise are commonly associated with a wide range of medical conditions, including rheumatoid arthritis (RA). Evidence suggests that fatigue and malaise can be overwhelming for patients, yet these symptoms remain inadequately-managed, largely due to an incomplete elucidation of the underlying causes. AREAS COVERED In this assessment of the published literature relating to the pathogenesis of fatigue or malaise in chronic conditions, four key mechanistic themes were identified. Each theme (inflammation, hypothalamic-pituitary-adrenal axis, dysautonomia, and monoamines) is discussed, as well as the complex network of interconnections between themes which suggests a key role for inflammatory cytokines in the development and persistence of fatigue. EXPERT OPINION Fatigue is multifaceted, poorly defined, and imperfectly comprehended. Moreover, the cause and severity of fatigue may change over time, as a consequence of the natural disease course or pharmacologic treatment. This detailed synthesis of available evidence permits us to identify avenues for current treatment optimization and future research, to improve the management of fatigue and malaise in RA. Within the development pipeline, several new anti-inflammatory therapies are currently under investigation, and we anticipate that the next five years will herald much-needed progress to reduce the debilitating nature of fatigue in patients with RA.
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Affiliation(s)
- Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kei Ikeda
- Department of Rheumatology, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Yuko Kaneko
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
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Zifko U, Guendling K, Seet R, Kasper S. Management of cognitive impairment associated with post-COVID-19 syndrome: recommendations for primary care. Front Pharmacol 2024; 15:1338235. [PMID: 38711990 PMCID: PMC11072190 DOI: 10.3389/fphar.2024.1338235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/22/2024] [Indexed: 05/08/2024] Open
Abstract
Introduction: Although post-COVID-19 syndrome (PCS) with cognitive impairment is increasingly encountered in primary care, evidence-based recommendations for its appropriate management are lacking. Methods: A systematic literature search evaluating the diagnosis and treatment of cognitive impairment associated with PCS was conducted. Practical recommendations for the management of PCS-associated cognitive impairment in primary care are summarized, based on an evaluation of pharmacological plausibility and clinical applications. Results: Currently, the pathology of cognitive impairment associated with PCS remains unclear with no high-quality data to support targeted interventions. Existing treatment approaches are directed towards symptom relief where counseling on the chronicity of the disease and regular reassessments at 4- to 8-week intervals is considered reasonable. Patients should be informed and encouraged to adopt a healthy lifestyle that centers around balanced nutrition and appropriate physical activities. They may also benefit from the intake of vitamins, micronutrients, and probiotics. The administration of Ginkgo biloba extract could offer a safe and potentially beneficial treatment option. Other non-pharmacological measures include physiotherapy, digitally supported cognitive training, and, if indicated, ergotherapy or speech therapy. In most patients, symptoms improve within 8 weeks. If serious, ambiguous, or when new symptoms occur, specialized diagnostic measures such as comprehensive neurocognitive testing or neuroimaging should be initiated. Very few patients would require inpatient rehabilitation. Conclusion: PCS with cognitive impairment is a debilitating condition that could affect daily functioning and reduce work productivity. Management in primary care should adopt a multidisciplinary approach, centering around physical, cognitive, and pharmacological therapies.
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Affiliation(s)
- Udo Zifko
- Rudolfinerhaus private clinic GmbH, Rudolfinerhaus, Vienna, Austria
| | | | - Raymond Seet
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Siegfried Kasper
- Center for Brain Research, Department of Molecular Neuroscience, Medical University of Vienna, Vienna, Austria
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Deodato M, Qualizza C, Martini M, Mazzari L, Furlanis G, Buoite Stella A, Manganotti P. Efficacy of dual-task augmented reality rehabilitation in non-hospitalized adults with self-reported long COVID fatigue and cognitive impairment: a pilot study. Neurol Sci 2024; 45:1325-1333. [PMID: 38191766 DOI: 10.1007/s10072-023-07268-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/12/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND Cognitive impairment and chronic fatigue represent common characteristics of the long COVID syndrome. Different non-pharmacological treatments have been proposed, and physiotherapy has been proposed to improve the symptoms. This study aimed to evaluate the effects of a dual-task augmented reality rehabilitation protocol in people with long COVID fatigue and cognitive impairment. METHODS AND MATERIALS Ten non-hospitalized adults with reported fatigue and "brain fog" symptoms after COVID (7/10 females, 50 years, range 41-58) who participated in 20 sessions of a 1-h "dual-task" training, were compared to 10 long COVID individuals with similar demographics and symptoms (9/10 females, 56 years, range 43-65), who did not participate to any rehabilitation protocol. Cognitive performance was assessed with the Trail Making Test (TMT-A and -B) and Frontal Assessment Battery (FAB), and cardiovascular and muscular fatigue were assessed with the fatigue severity scale (FSS), six-minute walking test and handgrip endurance. Finally, transcranial magnetic stimulation (TMS) investigated cortical excitability. RESULTS The mixed-factors analysis of variance found a significant interaction effect only in cognitive performance evaluation, suggesting TMT-B execution time decreased (- 15.9 s, 95% CI 7.6-24.1, P = 0.001) and FAB score improved (1.88, 95% CI 2.93-0.82, P = 0.002) only in the physiotherapy group. For the remaining outcomes, no interaction effect was found, and most parameters similarly improved in the two groups. CONCLUSION The preliminary results from this study suggest that dual-task rehabilitation could be a feasible protocol to support cognitive symptoms recovery after COVID-19 and could be helpful in those individuals suffering from persisting and invalidating symptoms.
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Affiliation(s)
- Manuela Deodato
- School of Physiotherapy, Department of Medicine, Surgery and Health Sciences, University of Trieste, Via Pascoli 31, 34100, Trieste, Italy
| | - Caterina Qualizza
- School of Physiotherapy, Department of Medicine, Surgery and Health Sciences, University of Trieste, Via Pascoli 31, 34100, Trieste, Italy
| | - Miriam Martini
- School of Physiotherapy, Department of Medicine, Surgery and Health Sciences, University of Trieste, Via Pascoli 31, 34100, Trieste, Italy
- PhD Program in Personalized Medicine and Innovative Therapies, Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada Di Fiume 447, 34149, Trieste, Italy
| | - Laura Mazzari
- School of Physiotherapy, Department of Medicine, Surgery and Health Sciences, University of Trieste, Via Pascoli 31, 34100, Trieste, Italy
| | - Giovanni Furlanis
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada Di Fiume 447, 34149, Trieste, Italy
| | - Alex Buoite Stella
- School of Physiotherapy, Department of Medicine, Surgery and Health Sciences, University of Trieste, Via Pascoli 31, 34100, Trieste, Italy.
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada Di Fiume 447, 34149, Trieste, Italy.
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada Di Fiume 447, 34149, Trieste, Italy.
| | - Paolo Manganotti
- School of Physiotherapy, Department of Medicine, Surgery and Health Sciences, University of Trieste, Via Pascoli 31, 34100, Trieste, Italy
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada Di Fiume 447, 34149, Trieste, Italy
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada Di Fiume 447, 34149, Trieste, Italy
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Guerra G, Lucariello A, Komici K. Editorial: Long COVID: nutrition and lifestyle changes. Front Nutr 2024; 11:1375449. [PMID: 38450231 PMCID: PMC10915234 DOI: 10.3389/fnut.2024.1375449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 02/06/2024] [Indexed: 03/08/2024] Open
Affiliation(s)
- Germano Guerra
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - Angela Lucariello
- Department of Sport Sciences and Wellness, University of Naples “Parthenope”, Naples, Italy
| | - Klara Komici
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
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Zaman R, Ravichandran V, Tan CK. Role of dietary supplements in the continuous battle against COVID-19. Phytother Res 2024; 38:1071-1088. [PMID: 38168043 DOI: 10.1002/ptr.8096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 11/13/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024]
Abstract
A sudden outbreak of the COVID-19 pandemic was a big blow to the world community on every level. Created by a novel coronavirus, SARS-CoV-2, which was previously unknown to the human immune system. The expert opinion almost immediately united on the fact that the most effective way of fighting the pandemic would be by building immunity artificially via a mass immunization program. However, it took about a year for the approval of the first vaccine against COVID-19. In the meantime, a big part of the general population started adapting nutritious diet plans and dietary supplements to boost natural immunity as a potential prophylactic strategy against SARS-CoV-2 infection. Whether they originate from mainstream medicine, such as synthetic supplements, or traditional herbal remedies in the form of single or poly-herbs, these supplements may comprise various components that exhibit immunomodulatory, anti-inflammatory, antioxidant, and antimicrobial characteristics. There is a substantial body of predictions and expert opinions suggesting that enhancing one's diet with dietary supplements containing additional nutrients and bioactive compounds like vitamins, minerals, amino acids, fatty acids, phytochemicals, and probiotics can enhance the immune system's ability to develop resistance against COVID-19, although none of them have any conclusive evidence nor officially recommended by World Health Organization (WHO). The current review critically acclaims the gap between public perception-based preference and real evidence-based study to weigh the actual benefit of dietary supplements in relation to COVID-19 prevention and management.
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Affiliation(s)
- Rahela Zaman
- School of Healthy Aging, Aesthetics and Regenerative Medicine, Faculty of Medicine and Health Sciences, UCSI University, Kuala Lumpur, Malaysia
| | - Vignesh Ravichandran
- School of Healthy Aging, Aesthetics and Regenerative Medicine, Faculty of Medicine and Health Sciences, UCSI University, Kuala Lumpur, Malaysia
| | - Chung Keat Tan
- School of Healthy Aging, Aesthetics and Regenerative Medicine, Faculty of Medicine and Health Sciences, UCSI University, Kuala Lumpur, Malaysia
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Helbing DL, Dommaschk EM, Danyeli LV, Liepinsh E, Refisch A, Sen ZD, Zvejniece L, Rocktäschel T, Stabenow LK, Schiöth HB, Walter M, Dambrova M, Besteher B. Conceptual foundations of acetylcarnitine supplementation in neuropsychiatric long COVID syndrome: a narrative review. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-023-01734-3. [PMID: 38172332 DOI: 10.1007/s00406-023-01734-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 11/21/2023] [Indexed: 01/05/2024]
Abstract
Post-acute sequelae of COVID-19 can present as multi-organ pathology, with neuropsychiatric symptoms being the most common symptom complex, characterizing long COVID as a syndrome with a significant disease burden for affected individuals. Several typical symptoms of long COVID, such as fatigue, depressive symptoms and cognitive impairment, are also key features of other psychiatric disorders such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and major depressive disorder (MDD). However, clinically successful treatment strategies are still lacking and are often inspired by treatment options for diseases with similar clinical presentations, such as ME/CFS. Acetylcarnitine, the shortest metabolite of a class of fatty acid metabolites called acylcarnitines and one of the most abundant blood metabolites in humans can be used as a dietary/nutritional supplement with proven clinical efficacy in the treatment of MDD, ME/CFS and other neuropsychiatric disorders. Basic research in recent decades has established acylcarnitines in general, and acetylcarnitine in particular, as important regulators and indicators of mitochondrial function and other physiological processes such as neuroinflammation and energy production pathways. In this review, we will compare the clinical basis of neuropsychiatric long COVID with other fatigue-associated diseases. We will also review common molecular disease mechanisms associated with altered acetylcarnitine metabolism and the potential of acetylcarnitine to interfere with these as a therapeutic agent. Finally, we will review the current evidence for acetylcarnitine as a supplement in the treatment of fatigue-associated diseases and propose future research strategies to investigate the potential of acetylcarnitine as a treatment option for long COVID.
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Affiliation(s)
- Dario Lucas Helbing
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Friedrich Schiller University Jena, Philosophenweg 3, 07743, Jena, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits, Underlying Mental Health (C-I-R-C), Jena, Magdeburg, Halle, Germany
- German Center for Mental Health (DZPG), Site Halle, Jena, Magdeburg, Germany
- Leibniz Institute on Aging, Fritz Lipmann Institute, Jena, Germany
- Institute of Molecular Cell Biology, Jena University Hospital, Friedrich Schiller University Jena, 07745, Jena, Germany
| | - Eva-Maria Dommaschk
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Friedrich Schiller University Jena, Philosophenweg 3, 07743, Jena, Germany
| | - Lena Vera Danyeli
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Friedrich Schiller University Jena, Philosophenweg 3, 07743, Jena, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits, Underlying Mental Health (C-I-R-C), Jena, Magdeburg, Halle, Germany
- Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany
| | - Edgars Liepinsh
- Laboratory of Pharmaceutical Pharmacology, Latvian Institute of Organic Synthesis, Riga, Latvia
- Faculty of Pharmacy, Riga Stradins University, Riga, Latvia
| | - Alexander Refisch
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Friedrich Schiller University Jena, Philosophenweg 3, 07743, Jena, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits, Underlying Mental Health (C-I-R-C), Jena, Magdeburg, Halle, Germany
| | - Zümrüt Duygu Sen
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Friedrich Schiller University Jena, Philosophenweg 3, 07743, Jena, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits, Underlying Mental Health (C-I-R-C), Jena, Magdeburg, Halle, Germany
| | - Liga Zvejniece
- Laboratory of Pharmaceutical Pharmacology, Latvian Institute of Organic Synthesis, Riga, Latvia
| | - Tonia Rocktäschel
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Friedrich Schiller University Jena, Philosophenweg 3, 07743, Jena, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits, Underlying Mental Health (C-I-R-C), Jena, Magdeburg, Halle, Germany
- German Center for Mental Health (DZPG), Site Halle, Jena, Magdeburg, Germany
| | - Leonie Karoline Stabenow
- Institute of Molecular Cell Biology, Jena University Hospital, Friedrich Schiller University Jena, 07745, Jena, Germany
- Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany
| | - Helgi B Schiöth
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, 751 24, Uppsala, Sweden
| | - Martin Walter
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Friedrich Schiller University Jena, Philosophenweg 3, 07743, Jena, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits, Underlying Mental Health (C-I-R-C), Jena, Magdeburg, Halle, Germany
- German Center for Mental Health (DZPG), Site Halle, Jena, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
- Department of Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany
| | - Maija Dambrova
- Laboratory of Pharmaceutical Pharmacology, Latvian Institute of Organic Synthesis, Riga, Latvia
- Faculty of Pharmacy, Riga Stradins University, Riga, Latvia
| | - Bianca Besteher
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Friedrich Schiller University Jena, Philosophenweg 3, 07743, Jena, Germany.
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits, Underlying Mental Health (C-I-R-C), Jena, Magdeburg, Halle, Germany.
- German Center for Mental Health (DZPG), Site Halle, Jena, Magdeburg, Germany.
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Jie XL, Luo ZR, Yu J, Tong ZR, Li QQ, Wu JH, Tao Y, Feng PS, Lan JP, Wang P. Pi-Pa-Run-Fei-Tang alleviates lung injury by modulating IL-6/JAK2/STAT3/IL-17 and PI3K/AKT/NF-κB signaling pathway and balancing Th17 and Treg in murine model of OVA-induced asthma. JOURNAL OF ETHNOPHARMACOLOGY 2023; 317:116719. [PMID: 37268260 DOI: 10.1016/j.jep.2023.116719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/23/2023] [Accepted: 05/30/2023] [Indexed: 06/04/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Pi-Pa-Run-Fei-Tang (PPRFT) is an empirical TCM prescription for treating asthma. However, the underlying mechanisms of PPRFT in asthma treatment have yet to be elucidated. Recent advances have revealed that some natural components could ameliorate asthma injury by affecting host metabolism. Untargeted metabolomics can be used to better understand the biological mechanisms underlying asthma development and identify early biomarkers that can help advance treatment. AIM OF THE STUDY The aim of this study was to verification the efficacy of PPRFT in the treatment of asthma and to preliminarily explore its mechanism. MATERIALS AND METHODS A mouse asthma model was built by OVA induction. Inflammatory cell in BALF was counted. The level of IL-6, IL-1β, and TNF-α in BALF were measured. The levels of IgE in the serum and EPO, NO, SOD, GSH-Px, and MDA in the lung tissue were measured. Furthermore, pathological damage to the lung tissues was detected to evaluate the protective effects of PPRFT. The serum metabolomic profiles of PPRFT in asthmatic mice were determined by GC-MS. The regulatory effects on mechanism pathways of PPRFT in asthmatic mice were explored via immunohistochemical staining and western blotting analysis. RESULTS PPRFT displayed lung-protective effects through decreasing oxidative stress, airway inflammation, and lung tissue damage in OVA-induced mice, which was demonstrated by decreasing inflammatory cell levels, IL-6, IL-1β, and TNF-α levels in BALF, and IgE levels in serum, decreasing EPO, NO, and MDA levels in lung tissue, elevating SOD and GSH-Px levels in lung tissue and lung histopathological changes. In addition, PPRFT could regulate the imbalance in Th17/Treg cell ratios, suppress RORγt, and increase the expression of IL-10 and Foxp3 in the lung. Moreover, PPRFT treatment led to decreased expression of IL-6, p-JAK2/Jak2, p-STAT3/STAT3, IL-17, NF-κB, p-AKT/AKT, and p-PI3K/PI3K. Serum metabolomics analysis revealed that 35 metabolites were significantly different among different groups. Pathway enrichment analysis indicated that 31 pathways were involved. Moreover, correlation analysis and metabolic pathway analysis identified three key metabolic pathways: galactose metabolism; tricarboxylic acid cycle; and glycine, serine, and threonine metabolism. CONCLUSION This research indicated that PPRFT treatment not only attenuates the clinical symptoms of asthma but is also involved in regulating serum metabolism. The anti-asthmatic activity of PPRFT may be associated with the regulatory effects of IL-6/JAK2/STAT3/IL-17 and PI3K/AKT/NF-κB mechanistic pathways.
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Affiliation(s)
- Xiao-Lu Jie
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, 310014, China
| | - Zi-Rui Luo
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, 310014, China
| | - Jin Yu
- Hangzhou Zhongmei Huadong Pharmaceutical Co., Ltd., Hangzhou, 310014, China
| | - Zhe-Ren Tong
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, 310014, China
| | - Qiao-Qiao Li
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, 310014, China
| | - Jia-Hui Wu
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, 310014, China
| | - Yi Tao
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, 310014, China
| | - Pei-Shi Feng
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, 310014, China
| | - Ji-Ping Lan
- Experiment Center for Teaching & Learning Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
| | - Ping Wang
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, 310014, China.
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10
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Tosato M, Calvani R, Ciciarello F, Galluzzo V, Martone AM, Zazzara MB, Pais C, Savera G, Robles MC, Ramirez M, Landi F. Malnutrition in COVID-19 survivors: prevalence and risk factors. Aging Clin Exp Res 2023; 35:2257-2265. [PMID: 37665556 PMCID: PMC10520154 DOI: 10.1007/s40520-023-02526-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 07/31/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Nutritional status is a critical factor throughout COVID-19 disease course. Malnutrition is associated with poor outcomes in hospitalized COVID-19 patients. AIM To assess the prevalence of malnutrition and identify its associated factors in COVID-19 survivors. METHODS Study cohort included 1230 COVID-19 survivors aged 18-86 attending a post-COVID-19 outpatient service. Data on clinical parameters, anthropometry, acute COVID-19 symptoms, lifestyle habits were collected through a comprehensive medical assessment. Malnutrition was assessed according to Global Leadership Initiative on Malnutrition (GLIM) criteria. RESULTS Prevalence of malnutrition was 22% at 4-5 months after acute disease. Participants who were not hospitalized during acute COVID-19 showed a higher frequency of malnutrition compared to those who needed hospitalization (26% versus 19%, p < 0.01). Malnutrition was found in 25% COVID-19 survivors over 65 years of age compared to 21% younger participants (p < 0.01). After multivariable adjustment, the likelihood of being malnourished increased progressively and independently with advancing age (Odds ratio [OR] 1.02; 95% CI 1.01-1.03) and in male participants (OR 5.56; 95% CI 3.53-8.74). Malnutrition was associated with loss of appetite (OR 2.50; 95% CI 1.73-3.62), and dysgeusia (OR 4.05; 95% CI 2.30-7.21) during acute COVID-19. DISCUSSION In the present investigation we showed that malnutrition was highly prevalent in a large cohort of COVID-19 survivors at 4-5 months from acute illness. CONCLUSIONS Our findings highlight the need to implement comprehensive nutritional assessment and therapy as an integral part of care for COVID-19 patients.
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Affiliation(s)
- Matteo Tosato
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Riccardo Calvani
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy.
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, 00168, Rome, Italy.
| | - Francesca Ciciarello
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Vincenzo Galluzzo
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Anna Maria Martone
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Maria Beatrice Zazzara
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Cristina Pais
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Giulia Savera
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Maria Camprubi Robles
- Abbott Nutrition, Research and Development, Camino de Purchil 68, 18004, Granada, Spain
| | - Maria Ramirez
- Abbott Nutrition, Research and Development, Camino de Purchil 68, 18004, Granada, Spain
| | - Francesco Landi
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
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11
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Chen D, Li J, Gao Q, Kang Z, Chen H, Fu P. Structural characterization of polysaccharide fractions in areca (Areca catechu L.) inflorescence and study of its immunological enhancement activity in vitro and in vivo. Food Res Int 2023; 171:113006. [PMID: 37330846 DOI: 10.1016/j.foodres.2023.113006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 06/19/2023]
Abstract
To obtain the structure-function relationship of the polysaccharides derived from areca (Areca catechu L.) inflorescences in the aspect of its immunomodulatory ability, the plant-based polysaccharide was isolated and purified on column chromatography. The purity, primary structure and immune activity of four polysaccharide fractions (AFP, AFP1, AFP2 and AFP2a) were characterized comprehensively. The main chain of AFP2a was confirmed to be composed of → 3,6)-β-D-Galp-(1→, with branch chains linked to the O-3 position on the main chain. The immunomodulatory activity of the polysaccharides was evaluated using the RAW264.7 cells and immunosuppression mice model. It was observed that AFP2a enabled greater NO release (49.72 μmol/L) than other fractions, significantly promoted the phagocytic activity of macrophages, and improved splenocyte proliferation and T lymphocyte phenotype in mice. The present results may shine a light on a new research direction in immunoenhancers and provide a theoretical foundation for the development and application of areca inflorescence.
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Affiliation(s)
- Di Chen
- Hainan University-HSF/LWL Collaborative Innovation Laboratory, School of Food Science and Engineering, Hainan University, Haikou, China; State Key Laboratory of Marine Resource Utilization in South China Sea, Hainan University, Haikou 570228, China
| | - Jin Li
- Hainan University-HSF/LWL Collaborative Innovation Laboratory, School of Food Science and Engineering, Hainan University, Haikou, China
| | - Qian Gao
- Huachuang Institute of Areca Research-Hainan, Haikou 570228, China
| | - Zonghua Kang
- Hunan Kouweiwang Group Co., Ltd, Yiyang 413499, China
| | - Haiming Chen
- Hainan University-HSF/LWL Collaborative Innovation Laboratory, School of Food Science and Engineering, Hainan University, Haikou, China; Huachuang Institute of Areca Research-Hainan, Haikou 570228, China.
| | - Pengcheng Fu
- Hainan University-HSF/LWL Collaborative Innovation Laboratory, School of Food Science and Engineering, Hainan University, Haikou, China; State Key Laboratory of Marine Resource Utilization in South China Sea, Hainan University, Haikou 570228, China.
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12
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Magnavita N, Arnesano G, Di Prinzio RR, Gasbarri M, Meraglia I, Merella M, Vacca ME. Post-COVID Symptoms in Occupational Cohorts: Effects on Health and Work Ability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095638. [PMID: 37174158 PMCID: PMC10178744 DOI: 10.3390/ijerph20095638] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/15/2023] [Accepted: 04/23/2023] [Indexed: 05/15/2023]
Abstract
Post-acute COVID-19 syndrome is frequently observed in workers and has a substantial impact on work ability. We conducted a health promotion program to identify cases of post-COVID syndrome, analyze the distribution of symptoms and their association with work ability. Of the 1422 workers who underwent routine medical examination in 2021, 1378 agreed to participate. Among the latter, 164 had contracted SARS-CoV-2 and 115 (70% of those who were infected) had persistent symptoms. A cluster analysis showed that most of the post-COVID syndrome cases were characterized by sensory disturbances (anosmia and dysgeusia) and fatigue (weakness, fatigability, tiredness). In one-fifth of these cases, additional symptoms included dyspnea, tachycardia, headache, sleep disturbances, anxiety, and muscle aches. Workers with post-COVID were found to have poorer quality sleep, increased fatigue, anxiety, depression, and decreased work ability compared with workers whose symptoms had rapidly disappeared. It is important for the occupational physician to diagnose post-COVID syndrome in the workplace since this condition may require a temporary reduction in work tasks and supportive treatment.
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Affiliation(s)
- Nicola Magnavita
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Occupational Health Service, Local Health Unit Roma 4, 00053 Civitavecchia, Italy
| | - Gabriele Arnesano
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Reparata Rosa Di Prinzio
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Health Systems and Service Research, Post-Graduate School of Health Economics and Management, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Martina Gasbarri
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Occupational Health Service, Local Health Unit Roma 4, 00053 Civitavecchia, Italy
| | - Igor Meraglia
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Marco Merella
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Maria Eugenia Vacca
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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13
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Calvani R, Gervasoni J, Picca A, Ciciarello F, Galluzzo V, Coelho-Júnior HJ, Di Mario C, Gremese E, Lomuscio S, Paglionico AM, Santucci L, Tolusso B, Urbani A, Marini F, Marzetti E, Landi F, Tosato M. Effects of l-Arginine Plus Vitamin C Supplementation on l-Arginine Metabolism in Adults with Long COVID: Secondary Analysis of a Randomized Clinical Trial. Int J Mol Sci 2023; 24:ijms24065078. [PMID: 36982151 PMCID: PMC10049539 DOI: 10.3390/ijms24065078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 03/09/2023] Open
Abstract
Altered l-arginine metabolism has been described in patients with COVID-19 and has been associated with immune and vascular dysfunction. In the present investigation, we determined the serum concentrations of l-arginine, citrulline, ornithine, monomethyl-l-arginine (MMA), and symmetric and asymmetric dimethylarginine (SDMA, ADMA) in adults with long COVID at baseline and after 28-days of l-arginine plus vitamin C or placebo supplementation enrolled in a randomized clinical trial, compared with a group of adults without previous history of SARS-CoV-2-infection. l-arginine-derived markers of nitric oxide (NO) bioavailability (i.e., l-arginine/ADMA, l-arginine/citrulline+ornithine, and l-arginine/ornithine) were also assayed. Partial least squares discriminant analysis (PLS–DA) models were built to characterize systemic l-arginine metabolism and assess the effects of the supplementation. PLS–DA allowed discrimination of participants with long COVID from healthy controls with 80.2 ± 3.0% accuracy. Lower markers of NO bioavailability were found in participants with long COVID. After 28 days of l-arginine plus vitamin C supplementation, serum l-arginine concentrations and l-arginine/ADMA increased significantly compared with placebo. This supplement may therefore be proposed as a remedy to increase NO bioavailability in people with long COVID.
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Affiliation(s)
- Riccardo Calvani
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Correspondence: ; Tel.: +39-(06)-3015-5559
| | - Jacopo Gervasoni
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Anna Picca
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Department of Medicine and Surgery, LUM University, 70010 Casamassima, Italy
| | | | - Vincenzo Galluzzo
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Hélio José Coelho-Júnior
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Clara Di Mario
- Immunology Core Facility, Gemelli Science Technological Park (GSTeP), Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Elisa Gremese
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Immunology Core Facility, Gemelli Science Technological Park (GSTeP), Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Sara Lomuscio
- Metabolomics Research Core Facility, Gemelli Science and Technology Park (GSTeP), Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | | | - Lavinia Santucci
- Metabolomics Research Core Facility, Gemelli Science and Technology Park (GSTeP), Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Barbara Tolusso
- Immunology Core Facility, Gemelli Science Technological Park (GSTeP), Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Andrea Urbani
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Federico Marini
- Department of Chemistry, Sapienza University of Rome, 00185 Rome, Italy
| | - Emanuele Marzetti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Francesco Landi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Matteo Tosato
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
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14
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Wilson AD, Forse LB. Potential for Early Noninvasive COVID-19 Detection Using Electronic-Nose Technologies and Disease-Specific VOC Metabolic Biomarkers. SENSORS (BASEL, SWITZERLAND) 2023; 23:2887. [PMID: 36991597 PMCID: PMC10054641 DOI: 10.3390/s23062887] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/19/2023] [Accepted: 03/03/2023] [Indexed: 06/12/2023]
Abstract
The established efficacy of electronic volatile organic compound (VOC) detection technologies as diagnostic tools for noninvasive early detection of COVID-19 and related coronaviruses has been demonstrated from multiple studies using a variety of experimental and commercial electronic devices capable of detecting precise mixtures of VOC emissions in human breath. The activities of numerous global research teams, developing novel electronic-nose (e-nose) devices and diagnostic methods, have generated empirical laboratory and clinical trial test results based on the detection of different types of host VOC-biomarker metabolites from specific chemical classes. COVID-19-specific volatile biomarkers are derived from disease-induced changes in host metabolic pathways by SARS-CoV-2 viral pathogenesis. The unique mechanisms proposed from recent researchers to explain how COVID-19 causes damage to multiple organ systems throughout the body are associated with unique symptom combinations, cytokine storms and physiological cascades that disrupt normal biochemical processes through gene dysregulation to generate disease-specific VOC metabolites targeted for e-nose detection. This paper reviewed recent methods and applications of e-nose and related VOC-detection devices for early, noninvasive diagnosis of SARS-CoV-2 infections. In addition, metabolomic (quantitative) COVID-19 disease-specific chemical biomarkers, consisting of host-derived VOCs identified from exhaled breath of patients, were summarized as possible sources of volatile metabolic biomarkers useful for confirming and supporting e-nose diagnoses.
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Affiliation(s)
- Alphus Dan Wilson
- Pathology Department, Center for Forest Health & Disturbance, Forest Genetics and Ecosystems Biology, Southern Research Station, USDA Forest Service, Stoneville, MS 38776, USA
| | - Lisa Beth Forse
- Southern Hardwoods Laboratory, Southern Research Station, USDA Forest Service, Stoneville, MS 38776, USA
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15
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Mattioli AV, Selleri V, Zanini G, Nasi M, Pinti M, Stefanelli C, Fedele F, Gallina S. Physical Activity and Diet in Older Women: A Narrative Review. J Clin Med 2022; 12:jcm12010081. [PMID: 36614882 PMCID: PMC9821197 DOI: 10.3390/jcm12010081] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/12/2022] [Accepted: 12/17/2022] [Indexed: 12/24/2022] Open
Abstract
Physical activity and diet are essential for maintaining good health and preventing the development of non-communicable diseases, especially in the older adults. One aspect that is often over-looked is the different response between men and women to exercise and nutrients. The body's response to exercise and to different nutrients as well as the choice of foods is different in the two sexes and is strongly influenced by the different hormonal ages in women. The present narrative review analyzes the effects of gender on nutrition and physical activity in older women. Understanding which components of diet and physical activity affect the health status of older women would help target non-pharmacological but lifestyle-related therapeutic interventions. It is interesting to note that this analysis shows a lack of studies dedicated to older women and a lack of studies dedicated to the interactions between diet and physical activity in women. Gender medicine is a current need that still finds little evidence.
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Affiliation(s)
- Anna Vittoria Mattioli
- Istituto Nazionale per le Ricerche Cardiovascolari, 40126 Bologna, Italy
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, 41124 Modena, Italy
- Correspondence:
| | - Valentina Selleri
- Istituto Nazionale per le Ricerche Cardiovascolari, 40126 Bologna, Italy
- Department of Life Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Giada Zanini
- Department of Life Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Milena Nasi
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Marcello Pinti
- Department of Life Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Claudio Stefanelli
- Istituto Nazionale per le Ricerche Cardiovascolari, 40126 Bologna, Italy
- Department of Quality of Life, Alma Mater Studiorum, 40126 Bologna, Italy
| | - Francesco Fedele
- Istituto Nazionale per le Ricerche Cardiovascolari, 40126 Bologna, Italy
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Sabina Gallina
- Istituto Nazionale per le Ricerche Cardiovascolari, 40126 Bologna, Italy
- Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy
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16
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Tosato M, Calvani R, Picca A, Ciciarello F, Galluzzo V, Coelho-Júnior HJ, Di Giorgio A, Di Mario C, Gervasoni J, Gremese E, Leone PM, Nesci A, Paglionico AM, Santoliquido A, Santoro L, Santucci L, Tolusso B, Urbani A, Marini F, Marzetti E, Landi F. Effects of l-Arginine Plus Vitamin C Supplementation on Physical Performance, Endothelial Function, and Persistent Fatigue in Adults with Long COVID: A Single-Blind Randomized Controlled Trial. Nutrients 2022; 14:nu14234984. [PMID: 36501014 PMCID: PMC9738241 DOI: 10.3390/nu14234984] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/19/2022] [Accepted: 11/20/2022] [Indexed: 11/25/2022] Open
Abstract
Long COVID, a condition characterized by symptom and/or sign persistence following an acute COVID-19 episode, is associated with reduced physical performance and endothelial dysfunction. Supplementation of l-arginine may improve endothelial and muscle function by stimulating nitric oxide synthesis. A single-blind randomized, placebo-controlled trial was conducted in adults aged between 20 and 60 years with persistent fatigue attending a post-acute COVID-19 outpatient clinic. Participants were randomized 1:1 to receive twice-daily orally either a combination of 1.66 g l-arginine plus 500 mg liposomal vitamin C or a placebo for 28 days. The primary outcome was the distance walked on the 6 min walk test. Secondary outcomes were handgrip strength, flow-mediated dilation, and fatigue persistence. Fifty participants were randomized to receive either l-arginine plus vitamin C or a placebo. Forty-six participants (median (interquartile range) age 51 (14), 30 [65%] women), 23 per group, received the intervention to which they were allocated and completed the study. At 28 days, l-arginine plus vitamin C increased the 6 min walk distance (+30 (40.5) m; placebo: +0 (75) m, p = 0.001) and induced a greater improvement in handgrip strength (+3.4 (7.5) kg) compared with the placebo (+1 (6.6) kg, p = 0.03). The flow-mediated dilation was greater in the active group than in the placebo (14.3% (7.3) vs. 9.4% (5.8), p = 0.03). At 28 days, fatigue was reported by two participants in the active group (8.7%) and 21 in the placebo group (80.1%; p < 0.0001). l-arginine plus vitamin C supplementation improved walking performance, muscle strength, endothelial function, and fatigue in adults with long COVID. This supplement may, therefore, be considered to restore physical performance and relieve persistent symptoms in this patient population.
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Affiliation(s)
- Matteo Tosato
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Riccardo Calvani
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Correspondence: ; Tel.: +39-(06)-3015-5559
| | - Anna Picca
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Department of Medicine and Surgery, LUM University, 70010 Casamassima, Italy
| | | | - Vincenzo Galluzzo
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Hélio José Coelho-Júnior
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Angela Di Giorgio
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Clara Di Mario
- Immunology Core Facility, Gemelli Science Technological Park (GSTeP), Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Jacopo Gervasoni
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Elisa Gremese
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Immunology Core Facility, Gemelli Science Technological Park (GSTeP), Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Paolo Maria Leone
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Antonio Nesci
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | | | - Angelo Santoliquido
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Department of Cardiovascular Sciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Luca Santoro
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Lavinia Santucci
- Metabolomics Research Core Facility, Gemelli Science and Technology Park (GSTeP), Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Barbara Tolusso
- Immunology Core Facility, Gemelli Science Technological Park (GSTeP), Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Andrea Urbani
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Department of Biochemistry and Clinical Biochemistry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Federico Marini
- Department of Chemistry, Sapienza University of Rome, 00185 Rome, Italy
| | - Emanuele Marzetti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Francesco Landi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Gaylis NB, Kreychman I, Sagliani J, Mograbi J, Gabet Y. The results of a unique dietary supplement (nutraceutical formulation) used to treat the symptoms of long-haul COVID. Front Nutr 2022; 9:1034169. [DOI: 10.3389/fnut.2022.1034169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 10/03/2022] [Indexed: 11/13/2022] Open
Abstract
Long-COVID is a syndrome characterized by debilitating symptoms that persist over 3 months after infection with the SARS-CoV-2 virus. It affects 15 to 33% of COVID-19 recovered patients and has no dedicated treatment. First, we found that β-caryophyllene and pregnenolone have a significant synergistic effect in the resolution of LPS-induced sepsis and inflammation in mice. Then we combined these two compounds with seven others and designed a unique dietary supplement formulation to alleviate long COVID inflammatory and neurological disorders. We performed a one-arm open-labeled study at a single site with 51 eligible patients from 18 states. Each participant recorded the severity level of 12 symptoms (including fatigue, weakness, cardiac and neurological symptoms, shortness of breath, gastrointestinal disorders, ageusia or anosmia, anxiety, joint pain, rash, cough, and insomnia) at baseline, 2- and 4-week time points. On average, all the symptoms were significantly milder after 2 weeks, with further improvement after 4 weeks. Importantly, each symptom was significantly attenuated in 72 to 84% of the participants. There were no significant adverse effects. Our data indicate that the use of this nutraceutical product is a safe and significantly efficient option to reduce multiple symptoms of long COVID.
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18
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Are Nutraceuticals Effective in COVID-19 and Post-COVID Prevention and Treatment? Foods 2022; 11:foods11182884. [PMID: 36141012 PMCID: PMC9498392 DOI: 10.3390/foods11182884] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/09/2022] [Accepted: 09/15/2022] [Indexed: 11/17/2022] Open
Abstract
The beginning of the end or the end of the beginning? After two years mastered by coronavirus disease 19 (COVID-19) pandemic, we are now witnessing a turnaround. The reduction of severe cases and deaths from COVID-19 led to increasing importance of a new disease called post-COVID syndrome. The term post-COVID is used to indicate permanency of symptoms in patients who have recovered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Immune, antiviral, antimicrobial therapies, as well as ozone therapy have been used to treat COVID-19 disease. Vaccines have then become available and administered worldwide to prevent the insurgence of the disease. However, the pandemic is not over yet at all given the emergence of new omicron variants. New therapeutic strategies are urgently needed. In this view, great interest was found in nutraceutical products, including vitamins (C, D, and E), minerals (zinc), melatonin, probiotics, flavonoids (quercetin), and curcumin. This review summarizes the role of nutraceuticals in the prevention and/or treatment of COVID-19 disease and post-COVID syndrome.
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