Assessing kidney function, electrolyte homeostasis, and quality of life post-COVID-19: Efficacy of L-carnitine intervention

Abstract

Patients with coronavirus disease often experience kidney impairment, leading to disruptions in electrolyte balance, reduced quality of life, and implications for disease prognosis. This necessitates continuous exploration of new treatment strategies. Our study aimed to assess kidney function, electrolyte homeostasis, and quality of life in COVID-19-related kidney damage, exploring the effectiveness of L-carnitine in the post-COVID-19 period.

Methods. This single-center prospective study involved 50 patients with impaired kidney function (GFR <90 ≥45 ml/min/1.73m²) three to six months after COVID-19. The average patient age was 60.4 (42.0; 68.0) years, with a gender distribution of 50% women and 50% men. Patients were categorized based on oxygen therapy requirements during the acute COVID-19 phase. Additionally, a blind division into subgroups with and without L-carnitine assessed its clinical effectiveness.

Results. The study revealed a higher occurrence of hyponatremia (p<0.001) and hypokalemia (p<0.001) in the group with severe COVID-19 and oxygen therapy. A direct correlation was established between sodium and potassium levels and blood saturation indicators during COVID-19 (r=0.57, p<0.05 and r=0.47, p<0.05, respectively). The addition of L-carnitine resulted in significantly reduced serum urea and creatinine levels and increased glomerular filtration rate (GFR). Patients with impaired kidney function post-COVID-19 exhibited reduced quality of life in both observation groups according to SF-36 indicators. However, those receiving L-carnitine experienced a notable improvement in quality of life by the study's end.

Conclusions. The severity of the acute COVID-19 phase with oxygen therapy correlated directly with post-COVID hyponatremia and hypokalemia, accompanied by lower quality of life. L-carnitine administration (2g per day) post-COVID in patients with kidney damage led to enhanced kidney function (increased GFR and improved nitrogen metabolism) and improved quality of life indicators.