Key result
Adding exogenous L-arginine and phenibut to basic therapy in patients with CAD and Long COVID-19 significantly reduced anxiety scores by 36% and depression scores by 21%.
Why the study?
The dynamics of neurovegetative disorders in patients with CAD and Long COVID-19 syndrome under combined treatment including exogenous L-arginine and phenibut were not well assessed.
Does adding exogenous L-arginine and phenibut to basic therapy improve cognitive function, reduce anxiety/depression, and stabilize autonomic regulation in patients with CAD and Long COVID-19 syndrome?
RCT (n=31)
Open-label
elements of randomization
No
Does adding exogenous L-arginine and phenibut to basic therapy improve cognitive function, reduce anxiety/depression, and stabilize autonomic regulation in patients with CAD and Long COVID-19 syndrome?
Adding L-arginine and phenibut to standard medical therapy for CAD in patients with Long COVID-19 syndrome may improve neurocognitive function, reduce anxiety and depression, and improve autonomic cardiac regulation.
The aim of the study. To assess the dynamics of neurovegetative disorders in patients with coronary artery disease (CAD) with Long COVID-19 syndrome under the influence of combined treatment with the inclusion of exogenous L-arginine and phenibut in basic therapy. Materials and methods. A prospective study with parallel distribution and elements of randomization included 31 patients with CAD: stable angina of exertion of functional class II–III (age 69.0 (64.0; 76.0) years)), who had suffered from moderate or severe COVID-19 coronavirus disease with manifestations of Long COVID-19 syndrome. Patients were divided into two groups depending on the prescribed treatment: group I (n = 15) – basic therapy for CAD was used; in group II (n = 16) a combination of L-arginine and phenibut was additionally prescribed against the background of basic therapy. Heart rate variability (HRV) parameters were assessed using 24-hour Holter ECG monitoring, degree of cognitive impairment – MoCa scale, anxiety-depressive – HADS scale, as well as their dynamics under the influence of the treatment. Results. The use of combination therapy with the inclusion of exogenous L-arginine and phenibut in patients of group II contributed to an increase in the average integral indicator of cognitive status by 9.47 %, as well as a significant decrease in the level of anxiety-depressive symptoms: in the “Anxiety” subscale by 35.97 %, in the “Depression” subscale – by 20.81 % (p < 0.05). In the group receiving combination therapy with exogenous L-arginine and phenibut, a significant positive dynamics of most indicators of total HRV was determined: an increase in SDNNi by 1.22 times and 1.42 times, rMSSD, % by 1.56 times and 1.66 times, HRVT by 1.46 times and 1.40 in the daytime and nighttime periods, respectively. Analysis of HRV spectral indicators showed restoration of sympatho-parasympathetic balance and a significant decrease in the stress index by 1.89 and 2.03 times in the active and passive periods. Conclusions. Adding exogenous L-arginine and phenibut to the basic therapy in patients with CAD who have had COVID-19 contributes to a significant reduction in anxiety and depressive symptoms, improvement of cognitive function, and stabilization of autonomic regulation of cardiac activity, which indicates a positive neuromodulatory effect of the combination therapy.
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Mykhailovska et al. (2026) conducted an RCT in Coronary Artery Disease and Long COVID-19 syndrome (n=31). L-arginine and phenibut vs. Basic therapy for CAD was evaluated on HADS Anxiety score at 3 months (35.97% reduction, p=<0.05). Adding exogenous L-arginine and phenibut to basic therapy in patients with CAD and Long COVID-19 significantly reduced anxiety scores by 36% and depression scores by 21%.
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