[HN Gopher] L-arginine in severe Covid-19 decreases the length o...
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       L-arginine in severe Covid-19 decreases the length of
       hospitalization
        
       Author : drocer88
       Score  : 25 points
       Date   : 2021-09-10 21:11 UTC (1 hours ago)
        
 (HTM) web link (www.sciencedirect.com)
 (TXT) w3m dump (www.sciencedirect.com)
        
       | jleyank wrote:
       | Isn't it easier to get vaxxed and reduce your chance of cytokine
       | storm than to hope that there are existing compounds that can
       | help repair lung damage once it's already occurring? There are
       | already immunosuppressants that are cheap and widely available
       | that reduce damage, and the search is on for things that inhibit
       | viral replication. I think there is also research for universal
       | antibodies that attack regions that are rarely mutated.
       | 
       | Would be great if such last possibility treatments work as
       | patients are usually post COVID by the time the lungs are shot.
       | The course of other diseases would profit from lung repair,
       | possibly even smoking damage.
        
         | nradov wrote:
         | It's not either / or. Vaccines aren't 100% effective so we
         | still need treatments for breakthrough cases.
        
       | saool wrote:
       | 3.2g of arginine in a day doesn't sound like a lot. There's
       | around 2g in most meat/protein servings, and 1g on each egg
       | yolk[0]. I wonder how much of the study outcome is just the
       | result of changing dietary habits of the patients.
       | 
       | [0] http://www.dietandfitnesstoday.com/arginine.php
        
       | nomel wrote:
       | For those without access:
       | https://www.thelancet.com/pdfs/journals/eclinm/PIIS2589-5370...
        
       | criticaltinker wrote:
       | This is yet another piece of compelling evidence showing that
       | nutraceuticals can significantly reduce recovery time and improve
       | health outcomes.
       | 
       | Combined with _early_ treatment using widely available medicines,
       | it's clear we have a variety of tools at our disposal to mitigate
       | this pandemic.
       | 
       | Unfortunately many people are unaware of the evidence supporting
       | these types of treatments, partly because they receive such
       | little attention in mass media.
       | 
       | As usual I'm ready for the downvotes - for some reason people
       | here think this information is contentious or disagreeable.
        
         | Jimmc414 wrote:
         | Upvoted. Here is a good breakdown of other contentious early
         | Covid treatments.
         | 
         | COVID-19 early treatment: real-time analysis of 917 studies
         | https://c19early.com/
        
         | ltbarcly3 wrote:
         | I think your analysis is a little bit vague? There are an
         | almost unlimited number of chemicals that might be tried to
         | treat any given disease. You can't test all of them.
         | 
         | If you limit the chemicals to those available at a vitamin
         | store (which is how I'm interpreting 'nutraceutical') seems
         | like a terrible strategy for how to deploy research resources.
         | Almost no diseases are treatable in an effective way with these
         | chemicals, and when there are positive results in a study
         | involving these chemicals it is almost always not reproducible
         | or the effect of the chemical is insufficient to justify using
         | it. The vitamins and nutrients which we have evidence there is
         | a benefit to taking are already added to almost every food
         | product you can buy.
         | 
         | The only people who seem to be motivated to push this strategy
         | are the companies which profit from selling big plastic bottles
         | covered with the most misleading claims they can legally make,
         | and filled with what are basically placebo pills.
         | 
         | I'm going to go ahead and make a prediction: There is nothing
         | you can find in a vitamin shop, taken in any amount, that will
         | end up demonstrating sufficient benefit to the treatment of
         | COVID that it is worth using.
        
           | nradov wrote:
           | Have you reviewed the studies on Vitamin D? Several have
           | shown significant benefits and the costs are low.
           | 
           | https://vitamin-d-covid.shotwell.ca/
        
       | voldacar wrote:
       | Just wanted to say that this seems like really good data. Pre-
       | registered RCT with a large n and a very significant measured
       | effect.
       | 
       | I kind of wonder how necessary/effective this treatment would be
       | in people who are already enough protein, they didn't include
       | info on the diets of the patients involved.
        
         | criticaltinker wrote:
         | For others who are curious, N=101 in the OP paper, which is a
         | preliminary subset of the total subjects in the clinical trial
         | (N=290, according to the registration).
         | 
         | To your second point, arginine supplementation can still be
         | helpful for otherwise healthy individuals who are undergoing
         | physiological stress due to illness. FWIW there are some
         | supporting references on the Wikipedia page.
        
         | ltbarcly3 wrote:
         | I'm not sure, the data seems oddly and unnecessarily skewed in
         | terms of the group breakdown.
         | 
         | - The placebo group was almost 10 years older on average. You
         | might think that this would be fine, or even make the effect
         | demonstrated even larger than the study suggests, except 8
         | patients were removed from the placebo group due to being moved
         | to the ICU before the start of the study. This introduces a
         | massive amount of selection bias into the data when you only
         | had 48 in the placebo group to start with.
         | 
         | - The placebo group had about half as many women as a %
         | 
         | Of course there is an attempt to remove these confounding
         | factors in some of the data, but the big results appear to be
         | un-adjusted numbers (number of days in hospital being reduced,
         | reduction of the need for oxygen, etc).
         | 
         | There is also an odd coincidence that they selected 53 patients
         | for the Placebo group, and 48 for the L-Arginine group, and the
         | groups lost 8 and 3 patients to the ICU respectively, so the
         | final groups were both 45. Is this normal in these types of
         | studies? Why wouldn't they have made the intention to treat
         | population 50 for both cases?
        
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       (page generated 2021-09-10 23:02 UTC)