Taurine supplementation as a therapeutic strategy for cellular senescence and chronic inflammation in long COVID: a systematic review and meta-analysis.

BACKGROUND: SARS-CoV-2 infection can induce cellular senescence(definition), resulting in chronic inflammation and senescence-associated secretory phenotype observed in post-acute sequalae of COVID-19 (PASC). Taurine, a conditionally essential amino acid with potent anti-inflammatory and antioxidant properties, is naturally upregulated during COVID-19 convalescence. Preclinical evidence suggests taurine protects against cellular senescence, telomerase deficiency, DNA damage, and mitochondrial dysfunction(definition), indicating its potential therapeutic role in PASC. METHODS: We systemically searched MEDLINE, Embase, Cochrane Library, and Scopus through 21st March 2025 for clinical trials investigating taurine supplementation in systemic perturbations associated with PASC. Outcomes of interest included markers of glycemic control, lipid metabolism, inflammation, oxidative stress, cardiopulmonary function, and neurocognition. In a parallel analysis, we systematically searched six databases (MEDLINE, Embase, Cochrane Library, CINAHL, Web of Science, and Scopus) for studies reporting plasma taurine levels during COVID-19 convalescence. Random-effects models were used to pool effect sizes, and meta-regression was employed to explore study heterogeneity. RESULTS: Analysis of 27 clinical trials (n = 1,030) demonstrated that taurine supplementation significantly improved markers of metabolic dysfunction (including hemoglobin A1c, fasting blood glucose, fasting insulin, HOMA-IR, total cholesterol, triglycerides, and low-density lipoprotein), inflammation (C-reactive protein, TNF-⍺, and IL-6), and oxidative stress (malondialdehyde). Supplementation also improved blood pressure and exercise capacity, though no significant effects on neurocognition were observed. Given the dose-response relationship identified between taurine and inflammatory markers TNF-⍺ and IL-6, a daily dose of 3,000 mg appears to offer an optimal balance between clinical efficacy and tolerability. Furthermore, a pooled analysis of six studies (n = 308) revealed significantly lower plasma taurine levels in individuals with PASC compared to recovered, symptom-free counterparts (SMD - 0.35, 95% CI: -0.63 to -0.08). CONCLUSIONS: Taurine supplementation effectively ameliorates key pathological features of PASC, including metabolic perturbation, endothelial dysfunction, and oxidative stress. The observed relative taurine deficiency in individuals with PASC further supports its potential as a therapeutic strategy to reduce senescence burden and chronic inflammation underlying this debilitating condition. TRIAL REGISTRATION: CRD420251011508 (Registration Date: 16 March 2025).