The corona pandemic has left deep marks, both socially and individually. What started as an unknown virus has led to global health problems that are still being felt. People who became moderately ill from COVID-19 made up the majority of the cases. On the other hand, about 20% of the patients developed severe symptoms, requiring medical assistance and in many cases hospitalization.
It doesn't stop at this acute phase of the disease. Many people continue to experience symptoms months after their infection, which we now know as long COVID. About 10% of Dutch people who have contracted COVID-19 deal with this prolonged illness. Symptoms such as fatigue, breathing problems, and cognitive impairments can persist and significantly reduce quality of life.
Fortunately, research shows that NMN (nicotinamide mononucleotide) may offer an approach in the treatment of long COVID. NMN, known for its role in promoting cellular health and energy production, is now being investigated for its potential to support the recovery processes in long COVID patients. In this blog, we will delve deeper into this.
What is long COVID?
Long COVID, also known as post-COVID syndrome or post-acute sequelae of SARS-CoV-2 infection (PASC), refers to a collection of symptoms that persist after the acute phase of COVID-19 has passed. While most people recover from COVID-19 within a few weeks, some continue to experience a range of symptoms that can last for weeks, months, or even longer.
The complaints associated with long COVID can be varied and multifaceted. Common symptoms include:
- Extreme fatigue: An overwhelming feeling of exhaustion that does not go away even after sufficient rest.
- Shortness of breath: Difficulty breathing or feeling like you are not getting enough air.
- Cognitive disorders: Often referred to as 'brain fog', this includes problems with concentration, memory, and clear thinking.
- Chest pain: Discomfort or pain in the chest area, sometimes accompanied by an increased heart rate.
- Muscle and joint pain: Persistent pain in muscles and joints without a clear cause.
- Headache and dizziness: Persistent headache and dizziness, often worsened by exertion or rapid movement.
- Sleep problems: Difficulty falling asleep or staying asleep, which can lead to increased fatigue.
- Digestive problems: Stomach complaints such as nausea, diarrhea, or abdominal pain.
The exact cause of long COVID is not yet fully understood, but it is suspected to be related to a combination of inflammation, immune dysfunction, and possible organ damage caused by the virus. Therefore, the search for effective treatments, such as NMN, is of great importance to alleviate symptoms and accelerate recovery.
How does NMN improve the immune system?
The immune system is crucial for protecting the body against infections and diseases, and its effectiveness is closely linked to the availability of nicotinamide adenine dinucleotides (NAD). NAD is essential for cellular energy production and helps the immune system respond to stress, inflammation, and infections. A lack of sufficient NAD can weaken the immune response and increase susceptibility to infections.
Animal studies show that disrupted NAD metabolism leads to reduced immune function and an increased inflammatory response. Moreover, researchers have discovered that the use of NAD precursors, such as NMN, can enhance immune function and reduce the expression of inflammatory markers. This means that NMN can help optimize the immune system and regulate the inflammatory response, which is essential for patients with long COVID.
NMN supplements offer a promising approach to restore NAD levels and thus support the immune system.Â
T-cells and the immune system
T cells play a major role in our immune defense. They are important in initiating the body's response to infections and target cells that are infected by viruses or other pathogens. Additionally, T cells release crucial cytokines, which act as signaling molecules and coordinate the activity of other immune cells. As a result, they are involved in directing and organizing the immune response.
During their development, T-cells differentiate into various subtypes. Each subtype has specific functions, such as recognizing and attacking pathogens or regulating the immune response. This differentiation process is crucial because it allows T-cells to specialize in combating different pathogens. Thanks to this specialization, they can provide an effective immune response against various infections, including viruses.
For this differentiation process, certain proteins are needed, including sirtuins, which play a key role in cellular processes. Sirtuin 2 (Sirt-2), in particular, is essential for the development and function of T-cells and is activated by NAD+. A good supply of NAD+ is therefore important for activating Sirt-2 and supporting efficient differentiation of T-cells. This again highlights the potential benefits of NMN supplements for the immune system, as NMN helps increase NAD+ levels and thereby can help strengthen the immune system.
The role of macrophages
Macrophages are an essential part of our immune system. These specialized white blood cells act as the 'cleaners' of our body. They have a dual purpose: they remove pathogens, such as bacteria and viruses, and also clear away dead or damaged cells. Additionally, macrophages function as a communication bridge between the innate and adaptive immune systems. They present antigens to T-cells, which helps in initiating a targeted immune response.
The activation and effectiveness of macrophages are influenced by the availability of NAD+. NAD+ is involved in the energy production of cells and helps regulate the metabolic processes that are crucial for the immune response of macrophages.
A study that used rats showed that increasing NAD+ levels through supplements could protect them against lethal doses of bacterial toxins. This highlights the importance of NAD+ in activating and enhancing the effectiveness of macrophages in fighting infections.
NMN long covid research
The use of NMN as a potential treatment for long COVID has garnered much attention from researchers. Various studies have focused on NMN in supporting patients with long COVID, with an emphasis on restoring cellular energy and strengthening the immune system.
Study 1: Mice and COVID-19
From a study, published in Nature, it turned out that administering NMN saved 30% of the older mice infected with a deadly variant of SARS-CoV-2 from death. The research results show that NAD+ or NMN supplements can partially restore the disrupted gene expression and metabolism caused by the SARS-CoV-2 infection. This mouse study therefore supports further research into treating COVID-19 patients via the NAD+ pathway.Â
Long COVID clinics
Surgeon Nebil Behar suggests in a letter to The BMJ that NAD boosters, such as NMN (nicotinamide mononucleotide), can help in the treatment of long COVID. He notes that COVID-19 depletes the NAD supply, especially in older and sick patients. Behar believes that prescribing NMN in long COVID clinics can help alleviate symptoms such as fatigue and organ damage. He emphasizes that studies on the safety of NAD boosters have been completed and advocates for their use to help patients recover faster.
Study 3: NMN cocktail treatment in older COVID-19 patients
A study published on SSRN examined the effectiveness of an NMN cocktail in older COVID-19 patients. The results showed that this combination of supplements could contribute to a faster recovery and improved immune function. This suggests that NMN in combination with other supplements could be a potential therapeutic approach.
Conclusion
COVID-19 has left deep marks on many people, and long COVID has led to prolonged health problems. Research suggests that restoring NAD+ levels using NMN supplements can help improve the immune system, reduce inflammation, and restore cellular energy, all of which are essential for treating long COVID.
From T-cells to macrophages, every aspect of our immune system depends on NAD+ for optimal functioning, and the presence of NMN can help achieve this. Studies suggest that the use of NMN may be a promising approach, especially for older patients with complicated COVID-19 infections.
Although further research is needed to fully understand the effectiveness of NMN in long COVID, existing data points to a strong molecular basis for its success. Therefore, NMN could be an innovative approach for the treatment of long COVID and the restoration of patients' health.