For patients in critical care in intensive care units and elsewhere in the hospital, adjuvant Coenzyme Q10 treatment needs to be considered. Plasma CoQ10 levels are significantly lower in patients receiving critical care. This is true for both patients with septic shock and patients without septic shock [Coppadoro 2013; Hasanloei 2021; Vassiliou 2021].

Critical care patient recovering in hospital

Adjuvant CoQ10 treatment of critical care patients can contribute to shorter stays in the Intensive Care Unit and to shorter stays in the hospital.

Researchers report abnormally low circulating CoQ10 concentrations in patients with sepsis and in patients at risk of sepsis. CoQ10 supplementation can boost mitochondrial function and improve ATP energy generation. CoQ10 supplementation can mitigate cellular damage caused by oxidative stress and inflammation. CoQ10 adjuvant treatment can perhaps help prevent and treat sepsis-associated multi-organ failure [Dupic 2011].

Effectiveness of CoQ10 Supplementation in Intensive Care

In a 2021 randomized controlled trial, Hasanloei et al showed beneficial effects of CoQ10 supplementation on patients in an intensive care unit. The patients received sublingual CoQ10 (400 mg/day) or placebo for seven days.

In the beginning of the study, there were no significant differences between the active treatment group and the control group. At the end of the study, the CoQ10 supplementation was associated with the following beneficial outcomes [Hasanloei 2021]:

  • reduction in malondialdehyde levels – a biomarker for oxidative stress
  • reduction in interleukin 6 levels – a biomarker for inflammation
  • reduction in Glasgow Coma Score – a marker for the level of consciousness
  • reduction in ICU length of stay and hospital length of stay
  • reduction in duration of mechanical ventilation

The researchers reported that the CoQ10 administration had beneficial effects on patients with traumatic injury and had no side effects [Hasanloei 2021].

Deficiency of CoQ10 in Sepsis Patients in the ICU

In a 2021 study at the Evangelismos Hospital in Athens, Greece, Vassiliou et al investigated circulating CoQ10 levels in initially non-septic patients who were admitted to the ICU. The study findings showed the following serum CoQ10 levels in the ICU patients on average [Vassiliou 2021]:

  • On admission, patients who later developed sepsis had CoQ10 levels of 0.89 mg/L.
  • On admission, patients who did not develop sepsis had CoQ10 levels of 0.81 mg/L.
  • The difference between the two above CoQ10 levels was not statistically significant.
  • Both sets of CoQ10 concentrations – 0.89 and 0.81 mg/L – were significantly lower than the CoQ10 concentrations in healthy controls: 1.04 mg/L.

Accordingly, CoQ10 levels in critically ill patients were already quite low on ICU admission. Then, CoQ10 levels decreased significantly in the patients who developed sepsis and septic shock.

  • At the earliest development of sepsis, the patients’ CoQ10 levels fell to 0.63 mg/L.
  • At septic shock, the patients’ CoQ10 levels fell even farther to 0.42 mg/L.

Vassiliou et al concluded that that sepsis severity leads to CoQ10 depletion.

Deficiency of CoQ10 in ICU Patients Without Septic Shock

At Massachusetts General Hospital in Boston, USA, Coppadoro et al investigated plasma CoQ10 levels in critically ill patients with and without septic shock.

  • Compared to health controls (0.79 mg/L), critically ill patients with septic shock (0.37 mg/L) and without septic shock (0.56 mg/L) had CoQ10 concentrations significantly lower.
  • The difference between the CoQ10 concentrations in the two groups of critically ill patients was not statistically significant.

The researchers noted that CoQ10 levels correlated inversely with age.

Coppadoro et al concluded that the much lower plasma CoQ10 concentrations are not specific to patients with septic shock but are typical for patients with a broad range of critical illness. CoQ10 insufficiency is associated with numerous conditions.

Deficiency of CoQ10 and Inflammation in Septic Shock

In an analysis of blood samples from patients with septic shock at Beth Israel Deaconess Medical Center in Boston, USA, Donnino et al observed the following significant factors:

  • CoQ10 levels were abnormally low in patients with septic shock compared to controls.
  • CoQ10 levels were negatively associated with vascular endothelial markers and inflammatory molecules.

Donnino et al urged that the clinical significance of the abnormally low CoQ10 levels in patients with septic shock be investigated.

Conclusions: CoQ10 Deficiency and Critically Ill Patients

CoQ10 supplementation can improve biomarkers of oxidative stress and inflammation in ICU patients.

Adjuvant CoQ10 treatment (100-400 mg/day) of ICU patients may shorten the duration of ICU and hospital stays.

CoQ10 supplementation of ICU patients may reduce ventilation time.

CoQ10 supplementation of ICU patients may help to lower mortality risk.

Sources

Coppadoro A et al. Plasma levels of Coenzyme Q10 are reduced in critically ill patients as compared to healthy volunteers and correlate with age. Crit Care. 2012;16(Suppl 1):154.

Donnino MW et al. Coenzyme Q10 levels are low and may be associated with the inflammatory cascade in septic shock. Crit Care. 2011;15:R189.

Dupic L et al. Coenzyme Q10 deficiency in septic shock patients. Crit Care. 2011;15(5):194.

Hasanloei MAV et al. Effect of Coenzyme Q10 supplementation on oxidative stress and clinical outcomes in patients with low levels of Coenzyme Q10 admitted to the intensive care unit. J Nutr Sci. 2021 Jul 12;10:e48.

Vassiliou AG et al. Serum Coenzyme Q10 levels are decreased in critically-ill septic patients: results from a preliminary study. Biol Res Nurs. 2021 Apr;23(2):198-207.

The information presented in this review article is not intended as medical advice. It should not be used as such.