2. Academic Validation
  3. Conceptual foundations of acetylcarnitine supplementation in neuropsychiatric long COVID syndrome: a narrative review

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

  • Eur Arch Psychiatry Clin Neurosci. 2024 Dec;274(8):1829-1845. doi: 10.1007/s00406-023-01734-3.
Dario Lucas Helbing # 1 2 3 4 5,  Eva-Maria Dommaschk # 1,  Lena Vera Danyeli 1 2 6,  Edgars Liepinsh 7 8,  Alexander Refisch 1 2,  Zümrüt Duygu Sen 1 2,  Liga Zvejniece 7,  Tonia Rocktäschel 1 2 3,  Leonie Karoline Stabenow 5 9,  Helgi B Schiöth 10,  Martin Walter 1 2 3 11 12 13 6,  Maija Dambrova 7 8,  Bianca Besteher 14 15 16
Affiliations

Affiliations

  • 1 Department of Psychiatry and Psychotherapy, Jena University Hospital, Friedrich Schiller University Jena, Philosophenweg 3, 07743, Jena, Germany.
  • 2 Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits, Underlying Mental Health (C-I-R-C), Jena, Magdeburg, Halle, Germany.
  • 3 German Center for Mental Health (DZPG), Site Halle, Jena, Magdeburg, Germany.
  • 4 Leibniz Institute on Aging, Fritz Lipmann Institute, Jena, Germany.
  • 5 Institute of Molecular Cell Biology, Jena University Hospital, Friedrich Schiller University Jena, 07745, Jena, Germany.
  • 6 Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany.
  • 7 Laboratory of Pharmaceutical Pharmacology, Latvian Institute of Organic Synthesis, Riga, Latvia.
  • 8 Faculty of Pharmacy, Riga Stradins University, Riga, Latvia.
  • 9 Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany.
  • 10 Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, 751 24, Uppsala, Sweden.
  • 11 Center for Behavioral Brain Sciences, Magdeburg, Germany.
  • 12 Department of Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany.
  • 13 Max Planck Institute for Biological Cybernetics, Tübingen, Germany.
  • 14 Department of Psychiatry and Psychotherapy, Jena University Hospital, Friedrich Schiller University Jena, Philosophenweg 3, 07743, Jena, Germany. [email protected].
  • 15 Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits, Underlying Mental Health (C-I-R-C), Jena, Magdeburg, Halle, Germany. [email protected].
  • 16 German Center for Mental Health (DZPG), Site Halle, Jena, Magdeburg, Germany. [email protected].
  • # Contributed equally.
PMID: 38172332 DOI: 10.1007/s00406-023-01734-3
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.

Keywords

Acetylcarnitine; Cognitive dysfunction; Depression; Fatigue; Long COVID.

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