Improved post-COVID-19 exercise tolerance and fatigue

COVID-19 is an infectious respiratory tract disease caused by SARS-CoV-2. This coronavirus can also attack other systems (e.g. the cardiovascular system) or induce an increased immunological response, leading to elevated proinflammatory cytokine levels (e.g. TNF-α, IL-6). In the course of COVID-19, the inflammation of the vascular endothelium has also been observed.

COVID-19 is not a short-lasting infection, with its far-reaching consequences including: chronic fatigue, exertional dyspnoea, myocarditis, brain fog, mental disorders, hair loss.


The latest studies carried out in a facility specialising in post-COVID-19 patient rehabilitation (Chudzik i wsp., 2021 – Literature  >> ) have demonstrated that 1-MNA at the daily dose of 58 mg improves exercise tolerance and fatigue in patients recovering from COVID-19.

This published work has shown that 1-MNA improves the distance achieved in the 6-minute walk test (6MWT). Patients who took 1-MNA (GrM1, 58 mg/day) doubled the average difference in the distance achieved compared to the control group (GrM0). The average distance change in the control group was 18.4 m, while in the group taking 1-MNA 38.86 m (Figure A).


Figure A. Average difference in the distance achieved in the 6-minute walk test (6MWT).

92% patients taking 1-MNA (GrM1) had a better 6MWT result (8% did not improve but reported lower fatigue on the fatigue severity scale [FSS]). The distance improvement in patients who did achieve it averaged 47 metres. In the control group (GrM0, without 1-MNA), the distance achieved after a month also increased, but the difference was not statistically significant (Figure B).


Figure B. Average distance obtained in the 6-minute walk test (6MWT) at the baseline and after a month. GrM0 – control group not taking 1-MNA (* no statistical significance; p = 0.068), GrM1 – patients taking 1-MNA (p = 0.000034).


After a month, there were also much less patients who reported high fatigue (FSS ≥ 4) among those who received 1-MNA as compared to patients without supplementation (Figure C).

Studies (Chudzik i wsp., 2021 – Literature  >> ) indicate that 58 mg/day of 1-MNA considerably improves physical efficiency in the 6-minute walk test and reduces the percentage of patients with high post-COVID-19 fatigue.

Figure C. The effects of using 1-MNA on the percentage of patients feeling high fatigue on the FSS scale (FSS ≥ 4). Phase 0 - at the beginning of the study; Phase 1 – after 1 month.