Abstract
In order to evaluate the efficacy of oral supplementation with 3 g of arginine per day associated with creatine, L-carnitine, aspartic acid, magnesium, selenium and vitamins C and E (Argivit© Aesculapius Farmaceutici) in the prevention and treatment of sarcopenia in patients with COVID-19-related pneumonia, we conducted a parallel randomized study comparing it with standard therapy alone. Forty patients on standard therapy plus supplementation were compared with a control group of 40 patients, all hospitalized at the sub-intensive care unit of the Del Mare Hospital in Naples, with a clinical diagnosis of SARS-CoV-2 infection and COVID-19 pneumonia. Muscle strength was assessed with the handgrip test and muscle ultrasound. Arginine-supplemented patients had an average grip strength of 23.5 at the end of hospitalization compared with 22.5 in the untreated group with less reduction, showing statistical significance (p < 0.001). In the same way, the thickness of the vastus lateralis quadriceps femoris muscle measured at the end of hospitalization showed less reduction on ultrasound, with a higher average value in the group receiving treatment than in the group of patients without supplementation (p < 0.001). Upon discharge there was a 58.40% reduction in ventilation days in patients with arginine supplementation compared with the control group.
Highlights
L-Arginine is an amino acid classified as essential because it plays a key role at certain times of life
In the context of a complex and multifactorial disease, such as respiratory failure in hospitalized and defaulter patients, preventing sarcopenia and counteracting the general catabolic state is fundamental as it affects quality of life, complications and prognosis, because at the same time it is essential to act on respiratory dynamics
We compared the two groups, the one treated with arginine associated with creatine, L-carnitine, aspartic acid, magnesium, selenium and vitamins C and E (Argivit© Aesculapius Farmaceutici, Brescia, Italy) versus the untreated one, in terms of the maintenance of grip strength from the moment of admission (T0) and to the day of discharge (T1)
Summary
L-Arginine is an amino acid classified as essential because it plays a key role at certain times of life (such as adolescence, puberty, extensive trauma, burns). Supplementation with L-arginine stimulates nitric oxide production, improves collagen synthesis in tenocytes, improves tendon function and accelerates healing of damaged tendons. In our COVID Operative Unit, the use of arginine, in association with other important active principles from the metabolic, energetic and immunological points of view, among others, such as creatine, L-carnitine, aspartic acid, magnesium, selenium and vitamins C and E (Argivit© Aesculapius Pharmaceutics, Brescia, Italy), has made it possible to count on several different and synergic actions, and in particular the anabolic and pro-energetic effect on striated muscles, useful in improving respiratory dynamics and supporting the endothelium in the production of nitric oxide, starting with its only precursor, arginine. NO production in skeletal muscle contributes to improved metabolic control by altering blood flow, glucose uptake, oxidative phosphorylation, contractility and excitation–contraction coupling. In addition to enhancing thermoregulation, improves post-concussion rehabilitation and/or neuroprotection of the spinal cord [1,2]
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