Indian Randomized Trial Finds That Oral Beta-Hydroxybutyrate Alleviates COVID-19 Related Acute Respiratory Distress Syndrome
Nikhil Prasad Fact checked by:Thailand Medical News Team May 04, 2024 6 months, 2 weeks, 4 days, 23 hours, 16 minutes ago
COVID-19 News: Acute respiratory distress syndrome (ARDS) is a critical complication observed in COVID-19 patients, often necessitating intensive care and mechanical ventilation. The recent emergence of the novel coronavirus, SARS-CoV-2, has highlighted the urgent need for effective therapies to manage ARDS and improve patient outcomes. In this context, a randomized trial conducted by researchers from Guru Nanak Dev University, Punjab, India, Government Medical College, Amritsar, Punjab, India, and Government Polytechnic College, Amritsar, Punjab, India, has shed light on the potential benefits of oral beta-hydroxybutyrate (BHB) in alleviating COVID-19-related ARDS. This
COVID-19 News report delves into the study's methodology, results, and implications.
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Oral Beta-Hydroxybutyrate Alleviates COVID-19 Related Acute Respiratory Distress Syndrome
Understanding Acute Respiratory Distress Syndrome (ARDS) in COVID-19
ARDS is a severe respiratory condition characterized by fluid accumulation in the lungs, leading to low blood oxygen levels, breathing difficulties, and a high mortality rate. COVID-19, caused by SARS-CoV-2, can induce ARDS either by direct infection of lung cells or through an exaggerated immune response triggering inflammation and tissue damage. The severity of ARDS is often categorized based on oxygen levels, ranging from mild to severe as per the Berlin criteria (Mild (200 mm Hg – 300 mmHg PaO2/FIO2), Moderate (100 mmHg – 200 mmHg PaO2/FIO2), Severe (below 100 mmHg PaO2/FIO2).
The Role of Beta-Hydroxybutyrate (BHB) in Metabolism and Immune Modulation
BHB, a ketone body produced during fasting or ketogenic states, has garnered attention for its diverse physiological roles. It serves as an alternative energy source and regulates cellular processes, including inflammation and immune function. Studies have shown that BHB can modulate immune responses, reduce inflammation, and improve cellular resilience, making it a potential therapeutic agent for conditions like ARDS.
The Study Design and Participants
The randomized trial included 75 patients with mild to moderate ARDS symptoms, as per the Berlin criteria, at the time of enrollment. Patients were randomly assigned to receive oral BHB (25 g twice daily) or a placebo for five days. Key outcomes measured included changes in pro-inflammatory cytokines (Interleukin-1β, Interleukin-6, Interleukin-18, Tumor Necrosis Factor-alpha) and anti-inflammatory cytokine (Interleukin-10) levels, BHB levels, hospitalization duration, and adverse events.
Results and Insights
The findings of the study revealed significant improvements in patients receiving oral BHB compared to the placebo group. There was a notable decrease in pro-inflammatory cytokines such as Interleukin-1β, Interleukin-6, Interleukin-18, and Tumor Necrosis Factor-alpha, coupled with an increase in the anti-inflammatory cytokine Interleukin-10. Moreover, BHB supplementation led to
higher BHB levels in patients, correlating with reduced hospitalization duration and no reported serious adverse events.
Discussion on Clinical Implications
The trial's rigorous methodology, including randomization, blinding, and strict data collection, lends credibility to the observed outcomes. The modulation of immunological markers, particularly the significant reduction in pro-inflammatory cytokines and elevation of anti-inflammatory cytokines, underscores the potential of oral BHB as an adjunct therapy for COVID-19-related ARDS. Importantly, the safety profile of BHB supplementation was upheld, with no adverse effects noted during the study period.
Conclusion and Future Directions
In conclusion, the study provides promising evidence supporting the use of oral BHB as a therapeutic strategy for managing COVID-19-related ARDS. By targeting inflammatory pathways and enhancing immune regulation, BHB supplementation could contribute to improved clinical outcomes and reduced disease severity. Further research with larger sample sizes and longer follow-up periods is warranted to validate these findings and explore the full potential of BHB therapy in combating respiratory complications associated with COVID-19.
Clinical Trial Registration
The clinical trial discussed in this article was registered with the Indian Clinical Trial Registry ensuring transparency and adherence to ethical standards in research.
https://ctri.nic.in/CTRI/2021/03/031790
Final Thoughts
As we continue to navigate the complexities of COVID-19 and its associated complications, innovative approaches like BHB supplementation offer hope in enhancing treatment efficacy and patient recovery. Collaborative efforts between researchers, healthcare providers, and policymakers are crucial in translating scientific discoveries into tangible benefits for individuals affected by respiratory distress syndromes.
The study findings were published in the peer reviewed journal: Research in Social and Administrative Pharmacy
https://www.sciencedirect.com/science/article/abs/pii/S1551741124001517
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