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Individuals living with Long COVID often experiencing a degree of undue fatigue after physical or cognitive exertion secondary to the condition, timed post-exertional malaise 9PEM). This trial aims to explore the efficacy of creatine monohydrate in managing PEM
cognitive dysfunction, and post-exertional malaise are common complaints of those living with Post-COVID Condition (PCC), a sequelae of symptoms that persist beyond acute infection. Similar to other types of post-viral fatigue, the diagnosis and treatment of PCC are challenging due to the lack of a valid biomarker for the condition. Though the etiology of PCC is not well understood, recent research has found reduced skeletal muscle creatine concentration in those with PCC, which may contribute to fatigue. The objective of this study is to determine if eight weeks of creatine monohydrate supplementation (8g/day) improves symptoms of fatigue, cognition, exercise capacity, and PEM in individuals living with PCC.
Participants will complete two cardiopulmonary exercise tests 24-hours apart on a cycle ergometer before and after an eight-week intervention period. Venous blood samples will be collected before and after exercise on both days to assess changes in mitochondrial function. During the intervention, participants will be randomly assigned to supplement with 8g/day of either creatine monohydrate or a control (maltodextrin). Cognition will be indirectly assessed via self-report of cognitive symptom frequency and severity at baseline, mid-intervention (i.e., 4 weeks) and post-intervention.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Creatine monohydrate | Experimental | 8 g/day creatine monohydrate |
|
| Maltodextrin | Placebo Comparator | 8 g/day maltodextrin |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Creatine monohydrate | Dietary Supplement | 8 g/day creatine monohydrate powder |
|
| Measure | Description | Time Frame |
|---|---|---|
| Oxygen consumption at ventilatory threshold | point of respiratory compensation point (i.e., ventilatory threshold 2) as a percent of maximal oxygen consumption | From enrollment to the end of intervention at 8 weeks |
| Heart rate at ventilatory threshold | heart rate (in bpm) at point of ventilatory threshold | From enrollment to the end of intervention at 8 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Fatigue | severity assessed using visual analog scale with zero being not present and 100 being the worst imaginable | From baseline to mid intervention (4 weeks) to the end of the intervention (8 weeks) |
| Brain fog |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Keely A Shaw, PhD | Contact | 3064587102 | keely.shaw@ucalgary.ca |
| Name | Affiliation | Role |
|---|---|---|
| Keely A Shaw, PhD | University of Calgary | Principal Investigator |
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IPD will be provided upon reasonable request to the PI
IPD will be available beginning ~ December 2026 for 5 years
IPD will be accessible by reasonable request (email) to the PI
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| ID | Term |
|---|---|
| D009043 | Motor Activity |
| ID | Term |
|---|---|
| D001519 | Behavior |
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| ID | Term |
|---|---|
| D003401 | Creatine |
| ID | Term |
|---|---|
| D006146 | Guanidines |
| D000578 | Amidines |
| D009930 | Organic Chemicals |
| D000596 | Amino Acids |
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Participants will be randomized 1:1 to the treatment or control group
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severity assessed using visual analog scale with zero being not present and 100 being the worst imaginable
| From baseline to mid intervention (4 weeks) to post intervention (8 weeks) |
| D000602 |
| Amino Acids, Peptides, and Proteins |