Effects of l-Arginine Plus Vitamin C Supplementation on l-Arginine Metabolism in Adults with Long COVID: Secondary Analysis of a Randomized Clinical Trial.

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.

• Authors: Riccardo Calvani, Jacopo Gervasoni, Anna Picca, Francesca Ciciarello, Vincenzo Galluzzo, Hélio José Coelho-Júnior, Clara Di Mario, Elisa Gremese, Sara Lomuscio, Anna Maria Paglionico, Lavinia Santucci, Barbara Tolusso, Andrea Urbani, Federico Marini, Emanuele Marzetti, Francesco Landi, Matteo Tosato, Gemelli against COVID-19 Post-Acute Care Team
• Journal: International journal of molecular sciences (Int J Mol Sci) Vol. 24 Issue 6 (Mar 07 2023) ISSN: 1422-0067 [Electronic] Switzerland
• PMID: 36982151 (Publication Type: Randomized Controlled Trial, Journal Article)

Chemical References

• Ascorbic Acid
• Citrulline
• Arginine
• Nitric Oxide
• Ornithine

Topics

• Humans
• Adult
• Post-Acute COVID-19 Syndrome
• Ascorbic Acid (therapeutic use)
• Citrulline (metabolism)
• COVID-19
• SARS-CoV-2 (metabolism)
• Arginine (metabolism)
• Nitric Oxide (metabolism)
• Ornithine
• Dietary Supplements