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European Archives of Psychiatry and Clinical Neuroscience

Open Access 03-01-2024 | Long-COVID Syndrome | Invited Review

Conceptual foundations of acetylcarnitine supplementation in neuropsychiatric long COVID syndrome: a narrative review

Authors: Dario Lucas Helbing, Eva-Maria Dommaschk, Lena Vera Danyeli, Edgars Liepinsh, Alexander Refisch, Zümrüt Duygu Sen, Liga Zvejniece, Tonia Rocktäschel, Leonie Karoline Stabenow, Helgi B. Schiöth, Martin Walter, Maija Dambrova, Bianca Besteher

Published in: European Archives of Psychiatry and Clinical Neuroscience

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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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Metadata
Title
Conceptual foundations of acetylcarnitine supplementation in neuropsychiatric long COVID syndrome: a narrative review
Authors
Dario Lucas Helbing
Eva-Maria Dommaschk
Lena Vera Danyeli
Edgars Liepinsh
Alexander Refisch
Zümrüt Duygu Sen
Liga Zvejniece
Tonia Rocktäschel
Leonie Karoline Stabenow
Helgi B. Schiöth
Martin Walter
Maija Dambrova
Bianca Besteher
Publication date
03-01-2024
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Psychiatry and Clinical Neuroscience
Print ISSN: 0940-1334
Electronic ISSN: 1433-8491
DOI
https://doi.org/10.1007/s00406-023-01734-3