Carnitine and its Derivatives as a Potential Option for Cardiovascular, Neurologic and Metabolic Complications of COVID-19
Sara Nafisi
Faculty of Pharmacy, Istinye University, Istanbul, Turkey.
Bentelhoda Afsharirad
Department of Clinical Pharmacy, Pharmacy Faculty, Tabriz University of Medical Sciences, Tabriz, Iran.
Hossein Khalili
Department of Clinical Pharmacy, Pharmacy Faculty, Tehran University of Medical Sciences, Tehran, Iran.
Shima Hatamkhani *
Experimental and Applied Pharmaceutical Sciences Research Center, Urmia University of Medical Sciences, Urmia, Iran and Department of Clinical Pharmacy, School of Pharmacy, Urmia University of Medical Sciences, Urmia, Iran.
*Author to whom correspondence should be addressed.
Abstract
As a multisystem disease, COVID-19 and its treatment demonstrate a wide variety of complications. Carnitine is a non-essential amino acid derivative that plays an essential role in the metabolism of fatty acids and alleviates inflammation and oxidative stress. We investigated the possible role of carnitine and its derivatives in COVID-19-induced fatigue, cardiovascular, neurological, and reproductive system complications. A thorough literature search was performed using the keywords and their synonym words including COVID-19, SARS-CoV-2, SARS, MERS, Carnitine, and L-Carnitine. Non-English literature and conference abstracts were not included. Animal experiments were excluded unless supporting the basic evidence for carnitine efficacy. Oxidative stress and Inflammatory factors are vital in cellular injury pathways caused by COVID-19. Carnitine and SARS-Cov-2 followed common cytokine and stress oxidative-related cellular pathways. Carnitine may act as a protective antioxidant against SARS-Cov-2 infection by modulating proinflammatory cytokines. Considering the safety profile of carnitine, it may have promising clinical results in alleviating COVID-19 severity and its complications.
Keywords: COVID-19, SARS-CoV-2, COVID-19 drug treatment, carnitine, cytokine, oxidative stress