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Total creatine concentration in the skeletal muscle and brain of long COVID patients were significantly lower when compared to the reference value. Will supplementing with creatine help restore these levels, thus reducing long Covid 19?
We found that long COVID population is characterized by reduced creatine levels in energy-demanding organs, with lower creatine levels in the skeletal muscle linked with severe muscle pain. Creatine depletion could thus be a newly discovered metabolic footprint of long COVID, perhaps as an end result of supraphysiological energy utilization in this perplexing condition. Still, creatine levels reflect the status of skeletal muscle mass which could be affected by age, physical exercise, chronic inflammation, and medication[6]; these factors were not evaluated in this trial which partly limits the interpretation of our findings. Another possible limitation is a relatively small sample size which is partly due to a high cost of proton MRS per patient, time consuming requirements of the procedure, and complex safety protocols, although it provides a gold standard noninvasive technique for analyzing tissue creatine levels. Replenishing creatine in long COVID by exogenous administration could be considered as a possible strategy to correct the deficit and help relieve patients from myalgia in this clinical population. However, a separate randomized controlled trial will have to be conducted in the future to verify this postulation.
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"Endorsing creatine might be thus of great importance in tackling highly prevalent post-viral fatigue syndrome after COVID-19 pandemics; additional studies are warranted to confirm our findings in various post-COVID-19 cohorts."
We found that long COVID population is characterized by reduced creatine levels in energy-demanding organs, with lower creatine levels in the skeletal muscle linked with severe muscle pain. Creatine depletion could thus be a newly discovered metabolic footprint of long COVID, perhaps as an end result of supraphysiological energy utilization in this perplexing condition. Still, creatine levels reflect the status of skeletal muscle mass which could be affected by age, physical exercise, chronic inflammation, and medication[6]; these factors were not evaluated in this trial which partly limits the interpretation of our findings. Another possible limitation is a relatively small sample size which is partly due to a high cost of proton MRS per patient, time consuming requirements of the procedure, and complex safety protocols, although it provides a gold standard noninvasive technique for analyzing tissue creatine levels. Replenishing creatine in long COVID by exogenous administration could be considered as a possible strategy to correct the deficit and help relieve patients from myalgia in this clinical population. However, a separate randomized controlled trial will have to be conducted in the future to verify this postulation.
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Effects of six-month creatine supplementation on patient- and clinician-reported outcomes, and tissue creatine levels in patients with post-COVID-19 fatigue syndrome
CONCLUSION
Taking creatine for 6 months appears to improve tissue bioenergetics and attenuate clinical features of post-COVID-19 fatigue syndrome, possibly due to its energy-replenishing and neuroprotective activity. Endorsing creatine might be thus of great importance in tackling highly prevalent PVFS after COVID-19 pandemics; additional studies are warranted to confirm our findings in various post-COVID-19 cohorts."Endorsing creatine might be thus of great importance in tackling highly prevalent post-viral fatigue syndrome after COVID-19 pandemics; additional studies are warranted to confirm our findings in various post-COVID-19 cohorts."
