Aminopeptides ameliorate long COVID symptoms in immunocompromised rheumatic patients through immune reconstitution

To evaluate the effects of aminopeptide nutritional support on immune reconstitution and antiviral capacity in immunocompromised patients with rheumatic diseases.

This single-center, retrospective cohort study included patients with rheumatic diseases and concomitant immunocompromised conditions who received treatments at the outpatient department of Peking Union Medical College Hospital between December 2021 and October 2024. Participants were divided into an experimental group (aminopeptide supplementation) and a control group according to whether they received aminopeptide treatment, with a treatment duration of 2-3 months. Data regarding SARS-CoV-2 virus infection, specific Long COVID symptoms, and outcomes were collected via questionnaire. TB lymphocyte subsets were recorded before and after treatment or at 3-6-month intervals.

A total of 171 patients with rheumatic diseases were enrolled, including 102 in the experimental group and 69 in the control group. Eighty-eight patients exhibited Long COVID symptoms, with fatigue being the most prevalent (67%). The experimental group showed a significantly higher rate of Long COVID symptom remission compared to the control group (64.2% vs. 22.9%), with a notable improvement in fatigue (68.3% vs. 27.8). Significant post-treatment increases were observed in peripheral blood CD3⁺ T cells and CD8⁺ T cells. Multivariate logistic regression analysis indicated that aminopeptide supplementation increased the rate of Long COVID symptom remission by 8.46-fold and the rate of fatigue improvement by 9.19-fold.

Supplementation with aminopeptides may improve nutritional status and enhance TB lymphocyte subsets levels in immunocompromised patients with rheumatic diseases, potentially contributing to better antiviral immunity and alleviation of Long COVID symptoms.