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| Item Type: | Article |
|---|---|
| Title: | Nicotinamide modulates gut microbial metabolic potential and accelerates recovery in mild-to-moderate COVID-19 |
| Creators Name: | Schreiber, S., Waetzig, G.H., López-Agudelo, V.A., Geisler, C., Schlicht, K., Franzenburg, S., di Giuseppe, R., Pape, D., Bahmer, T., Krawczak, M., Kokott, E., Penninger, J.M., Harzer, O., Kramer, J., von Schrenck, T., Sommer, F., Zacharias, H.U., Millet Pascual-Leone, B., Forslund, S.K., Heyckendorf, J., Aden, K., Hollweck, R., Laudes, M. and Rosenstiel, P. |
| Abstract: | Cellular NAD(+) depletion, altered tryptophan metabolism and gut microbiome dysbiosis are associated with disease progression and unfavourable clinical outcomes in COVID-19. Here, we show that supplementing tryptophan metabolism with nicotinamide alleviates COVID-19 symptoms. We evaluate a 4-week intervention with a novel nicotinamide formulation (1,000 mg) in a prospective, double-blind, randomized, placebo-controlled trial in 900 symptomatic outpatients with PCR-proven COVID-19. In the primary analysis population of participants at risk for severe COVID-19, 57.6% of those receiving nicotinamide and 42.6% receiving placebo recover from their performance drop at week 2 (P = 0.004). Nicotinamide is also beneficial for returning to normal activities (P = 0.009). Effects on gut metagenomic signatures parallel clinical efficacy, suggesting that nicotinamide influences COVID-19-associated faecal microbiome changes. After 6 months, responders to nicotinamide in acute COVID-19 show fewer post-COVID symptoms than placebo responders (P = 0.010). No relevant safety signals are observed. Overall, our results show that nicotinamide leads to faster recovery of physical performance and modulates COVID-19-associated faecal microbiome changes. |
| Source: | Nature Metabolism |
| ISSN: | 2522-5812 |
| Publisher: | Nature Publishing Group |
| Date: | 12 May 2025 |
| Official Publication: | https://doi.org/10.1038/s42255-025-01290-1 |
| PubMed: | View item in PubMed |
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