Dramatic Clinical Improvement in Nine Consecutive Acutely Ill Elderly COVID-19 Patients Treated with a Nicotinamide Mononucleotide Cocktail: A Case Series
Posted: 14 Sep 2020
Cedars Sinai Medical Center
Date Written: August 17, 2020
Background: Nicotinamide adenine dinucleotide (NAD+) – a coenzyme found in every cell in the human body – is involved in hundreds of critical metabolic processes. However, as humans age, intracellular NAD+ levels decrease – this depletion appears to be exacerbated during complicated SARS-COV-2 infections. NAD+ depletion impairs our antiviral defense systems and our ability to optimally control inflammation.
Methods: Ten consecutive acutely-ill presumed SARS-CoV-2 infected patients older than 50 years were treated with over-the-counter nicotinamide mononucleotide (NMN), betaine, sodium chloride and zinc sulfate (NMN cocktail). Eight patients had positive nasopharyngeal SARS-CoV-2 NAA test results, one patient was clinically diagnosed with COVID-19 based on classic symptoms and one patient was excluded as COVID-19 was ruled out. The COVID-19 patients were monitored with clinical evaluations, body temperatures and room air (RA) oxygen saturation (O2 sat) levels. Serial inflammatory cytokine measurements and chest X-rays (CXRs) were done in 7/9 of the COVID-19 patients.
Results: Cases #1, 4, 7 and 10 were critically-ill with worsening O2 sats, pulmonary infiltrates and inflammation prior to administration of the NMN cocktail. Post-treatment, prompt clinical improvement was seen including fever resolution in 2-3 days (4/4), rapid CXR improvement (4/4), dramatic drops in CRP (4/4) and IL-6 (3/4) within 72 hours and hospital discharge in ≤ 5 days (3/3 cases). No patient required ICU care or intubation post treatment. Cases 5 and 8 (bilateral pneumonias but no prior CXRs) and cases 2 and 3 (symptomatic outpatients with failed trials of hydroxychloroquine (HCQ), azithromycin (AZ) and zinc (Zn) with no CXRs performed) had a strong temporal relationship between NMN cocktail use and rapid clinical improvement. Patient #6 improved with prompt fever and symptom resolution but after premature NMN cocktail discontinuation he relapsed.
Summary: The NMN cocktail resulted in rapid and dramatic clinical and laboratory improvement in older persons with complicated SARS-CoV-2 infections. NMN with and without boosters deserves further study in elderly patients with complicated COVID-19 as this treatment has a strong molecular rationale for success, can be safely administered orally at home and in critically ill hospitalized patients.
Note: Ethical Approval: Consecutive patients were enrolled in this study after signing written informed consent for study participation and for identified data being reported in a published case series on an over the counter food supplement. Thus this research is exempt under 45 CFR 46.101(b) (4) from all 45 CFR part 46 requirements and therefore does not require IRB approval. (website: https://www.hhs.gov/ohrp/regulations-and-policy/decision-charts-pre-2018-text-version/index.html#p0205)
Funding: None to declare
Declaration of Interest: None to declare
Keywords: NMN cocktail, NMN, NAD+ precursors, COVID-19, pneumonia, ARDS, hypoxia, cytokine storm
Huizenga, Robert, Dramatic Clinical Improvement in Nine Consecutive Acutely Ill Elderly COVID-19 Patients Treated with a Nicotinamide Mononucleotide Cocktail: A Case Series (August 17, 2020). Available at SSRN: https://ssrn.com/abstract=3677428