Covid-19, L-Arginine reduces hospitalizations and respiratory support

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Covid-19, a study carried out at the Federico II University of Naples confirms that L-Arginine as supportive therapy reduces hospitalization and respiratory support

L-Arginine can help in post Covid therapy by reducing hospitalization and the need for respiratory support in patients affected by the Coronavirus. The discovery comes from a clinical study carried out by an all-Italian research team supervised by the scientific coordinator Bruno Trimarco, Professor Emeritus of Cardiology at the Federico II University of Naples. The study, which saw the collaboration of the Neapolitan University, the Cotugno Hospital in Naples and the Albert Einstein University in New York City, randomized, double-blind, placebo-controlled, demonstrates how the addition of L-arginine for high-dose oral route (two vials of 1.66g per day) to standard therapy in patients admitted to sub-intensive unit for Covid-19 allows for an earlier reduction in respiratory assistance (on the tenth day of treatment, in the group treated with L-arginine there is an improvement in a number of patients greater than 60% compared to the control group), and a marked reduction in hospitalization days compared to patients treated with standard therapy alone (p> 0.0001).

The work, which in its interim analysis resulted in the enrollment of 100 patients, was published in The Lancet’s free-access newspaper (EclinicalMedicine), which aims to help frontline healthcare professionals solve challenges. of health, and has been registered on the international ClinicaTrials.gov platform.

L-Arginine post Covid: excellent results from therapy in support of the classic one

It is interesting to observe that while Prof. Gaetano Santulli, professor of Cardiology and researcher at Albert Einsten University in New York, indicated in March 2020 that SARS-CoV-2, the Coronavirus that causes Covid-19, mainly attacks the endothelium , Prof. Giuseppe Fiorentino of the Cotugno Hospital in Naples found, in patients hospitalized for Covid-19, that the addition of L-arginine to standard therapy could determine a more favorable course of the disease.

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There is concrete evidence that endothelial dysfunction is one of the main mechanisms underlying the development of severe Covid-19 disease; for example, a recent work by Prof. Santulli published in Critical Care has shown how the evaluation of endothelial function at the time of admission can predict the occurrence of cerebrovascular events in patients hospitalized for Covid-19. However, no clinical study had so far shown that an intervention aimed at improving endothelial function could actually be useful in improving the course of patients suffering from this disease, so much so that it was necessary to provide an interim analysis after the completion of the first 100 patients enrolled to evaluate the accuracy of the calculation of the number of patients to be recruited. Given their importance in terms of public health, the study authors decided to publish the results of this interim analysis, which indicates for the first time that the addition of oral L-arginine to standard therapy in patients with Severe Covid-19 dramatically anticipates the reduction in respiratory support and nearly halves the length of hospitalization.

The demonstration, albeit preliminary given that the study is still ongoing, that two vials per day of L-arginine (1.66g x 2) orally in addition to standard therapy in patients hospitalized for Covid-19 can significantly improve the course of Covid-19 disease is of particular importance given the scarcity of treatments available in this type of patients and represents a new frontier for better management of Covid-19 patients based on a solid pathophysiological rationale.

L-Arginine post Covid: other trials in Italy

There are several hospitals that in the last year have resorted to supplementation of L-arginine in the therapy of covid patients, obtaining positive results.

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In addition to the Cotugno in Naples, the use of L-arginine in patients with post-Covid syndrome was also positively evaluated at the IRCCS-San Raffaele in Rome and the hospital in Codogno di Lodi. Since April last year, a ‘Day Hospital Post Covid’ has been activated at the Columbus hospital of the Gemelli Polyclinic Foundation in Rome. Also in this facility there was positive evidence in the supplementation of L-arginine in patients with post-covid syndrome, through an adequate personalized rehabilitation program (respiratory and motor).

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