Mental Intervention and Nicotinamide Riboside Supplementation in Long Covid

NCT ID: NCT05703074

Last Updated: 2025-02-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE2

Total Enrollment

310 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-01-30

Study Completion Date

2025-07-31

Brief Summary

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Long COVID, also referred to as post-acute sequela of COVID-19 (PASC), is present in a substantial number of individuals, and treatment for this is warranted. Two different hypothetical models of Long COVID suggest attenuated mitochondrial energy production and functional brain alterations associated with psychosocial load, respectively, to be key mechanisms in the underlying pathophysiology. Given the potential importance of metabolic disturbances, dietary supplement by Nicotinamide Riboside (NR, sales name Niagen®) may be beneficial. Given the potential importance of functional brain alterations, a tailored and personalized Mind-Body Reprocessing Therapy (MBRT) may be beneficial. The MBRT consists of 4 to 6 face-to-face therapist encounters in combination with digital resources.

The primary objective is to determine whether NR 1000 mg twice daily and/or MBRT increase health-related quality of life in individuals with Long COVID compared with care as usual and/or placebo. The Medical Outcome Study 36-item short form (SF-36), general health subscore is the primary endpoint. Secondary endpoints are: Markers of inflammation (hsCRP) and cognitive function (trail making test), cost-effectiveness, and the patient-reported symptoms fatigue, dyspnoea, and global impression of change in symptoms, function and quality of life. Explorative objectives encompass intervention effects on additional cognitive function markers, biological markers (indices of inflammation and autonomic nervous activity), disability markers (work attendance) and patient symptoms, as well as the exploration of long-term effects, differential subgroup effects, intervention effect mediators and intervention effect predictors.

The study is a randomized controlled trial featuring a 2 x 2 factorial design where MBRT is compared with usual care and NR is compared with placebo. The latter comparison is double blinded. Eligible participants are individuals (18-70 years) with confirmed Long COVID interferring negatively with daily activities. A total of 310 participants will be enrolled. After baseline assessment (T1), the participants will be randomized 1:1 for both treatment comparisons, resulting in four treatment groups: a) MBRT and NR; b) usual care and NR; c) MBRT and placebo; d) usual care and placebo. All treatment periods last for three months, followed by primary endpoint assessment (T2). Total follow-up time is 12 months (T3). A comprehensive investigational program at all time points includes clinical examination, functional testing (spirometry, autonomic cardiovascular control, neurocognitive functions), sampling of biological specimens (blood) and questionnaire charting (background/demographics, clinical symptoms, psychosocial factors, study events).

Detailed Description

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Conditions

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Long COVID

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

A 2 x 2 factorial randomized controlled trial, where Mind-Body Reprocessing Therapy (MBRT) is compared with care as usual and Nicotinamide Riboside (NR) is compared with placebo.
Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
For the NR vs placebo comparison, participants, care providers, investigators and outcome assessors are blinded. For the MBRT vs. usual care comparison, due to the nature of the intervention, only outcome assessors are blinded

Study Groups

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MBRT and NR

Psychological therapy and dietary supplement

Group Type OTHER

Nicotinamide Riboside (NR)

Intervention Type DIETARY_SUPPLEMENT

4 capsules (a total of 1000 mg) 2 times daily for 84 days

Mind-body reprocessing therapy (MBRT)

Intervention Type BEHAVIORAL

4-6 face-to-face meetings over 3-4 weeks, unlimited access to designated online resources.

MBRT and placebo

Psychological therapy and placebo dietary supplement

Group Type OTHER

Mind-body reprocessing therapy (MBRT)

Intervention Type BEHAVIORAL

4-6 face-to-face meetings over 3-4 weeks, unlimited access to designated online resources.

Placebo

Intervention Type DIETARY_SUPPLEMENT

4 capsules (empty) 2 times daily for 84 days.

Care as usual and NR

No psychological therapy (information only) and dietary supplement

Group Type OTHER

Nicotinamide Riboside (NR)

Intervention Type DIETARY_SUPPLEMENT

4 capsules (a total of 1000 mg) 2 times daily for 84 days

Care as usual

Intervention Type BEHAVIORAL

A brief self-help leaflet on long COVID is distributed, otherwise care as usual by the general practitioner

Care as usual and placebo

No psychological therapy (information only) and placebo dietary supplement

Group Type OTHER

Care as usual

Intervention Type BEHAVIORAL

A brief self-help leaflet on long COVID is distributed, otherwise care as usual by the general practitioner

Placebo

Intervention Type DIETARY_SUPPLEMENT

4 capsules (empty) 2 times daily for 84 days.

Interventions

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Nicotinamide Riboside (NR)

4 capsules (a total of 1000 mg) 2 times daily for 84 days

Intervention Type DIETARY_SUPPLEMENT

Mind-body reprocessing therapy (MBRT)

4-6 face-to-face meetings over 3-4 weeks, unlimited access to designated online resources.

Intervention Type BEHAVIORAL

Care as usual

A brief self-help leaflet on long COVID is distributed, otherwise care as usual by the general practitioner

Intervention Type BEHAVIORAL

Placebo

4 capsules (empty) 2 times daily for 84 days.

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Undergone acute COVID-19, confirmed EITHER by a positive PCR-test OR a positive self-test combined with confirmatory antibody-pattern in blood.
* Persistent symptoms at least 6 months following acute COVID-19 without symptom-free interval.
* Functional disability to an extent that impacts negatively on normal activities (such as work attendance, physical exercise, social activities, etc.)
* Informed consent

Exclusion Criteria

* Other chronic illnesses, demanding life situations or concomitant drug use/substance abuse that is considered a plausible cause of persistent symptoms and associated disability
* Sustained organ damage (lung, heart, brain) following acute, serious Covid-19
* Pregnancy.
* Bedridden
* Insufficient command of Norwegian
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Akershus

OTHER

Sponsor Role lead

Responsible Party

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Vegard Wyller

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Torbjørn Omland, PhD

Role: STUDY_CHAIR

Akershus University Hospital/University of Oslo

Locations

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Akershus University Hospital

Lørenskog, , Norway

Site Status

Countries

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Norway

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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983971636

Identifier Type: -

Identifier Source: org_study_id

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