What Drugs Are Used for COVID Long Haulers?

The COVID-19 pandemic has left a significant impact on global health, with a new concern emerging: Long COVID, also known as Post-Acute Sequelae of SARS-CoV-2 infection (PASC) or simply, long haulers. This condition refers to a group of symptoms that persist for weeks, months, or even years after the acute phase of the infection has resolved. But what treatments and drugs are available for these COVID long haulers? Let’s delve into the current therapeutic approaches being used and studied for Long COVID.

Guanfacine and N-acetylcysteine (NAC) for Brain Fog 

A promising development comes from Yale researchers who have found initial evidence that a combination of two existing medications, guanfacine and N-acetylcysteine (NAC), can mitigate or even eliminate brain fog in long COVID patients.

Guanfacine, developed in the lab of Amy Arnsten, and NAC, an antioxidant also used for the treatment of traumatic brain injury (TBI), were combined by Dr. Arman Fesharaki-Zadeh, who has been treating Long COVID patients with this regimen. The combined therapy was successful in relieving brain fog for a small cohort of patients.

While larger, placebo-controlled clinical trials are needed to establish these drugs as a definitive treatment for post-COVID-19 neurocognitive deficits, the researchers suggest that patients can obtain these drugs now, as they are FDA-approved, affordable, and widely available.

Antivirals: A Potential Game-Changer?

One of the most promising treatments for Long COVID is antiviral medication. Pfizer’s PAXLOVID, initially developed to treat active COVID-19 cases, was being studied for its potential benefits for long haulers through Stanford, though the study was stopped early and we await more information. The drug works by preventing the virus from replicating inside the body, and researchers are hopeful that it could help alleviate persistent symptoms like fatigue, weakness, and brain fog.

On July 31, 2023, the National Institutes of Health announced the launch of a phase 2 clinical trial through the RECOVER Initiative called RECOVER-VITAL that focuses on PAXLOVID for the treatment of Long COVID. They report that the first trial sites are activated and they are currently enrolling participants.

Anti-Inflammatory Drugs: Tackling the Inflammation In COVID Long Haulers

Inflammation is a key player in Long COVID, with many patients experiencing a persistent inflammatory response. Drugs like colchicine, an anti-inflammatory medication traditionally used for gout, are being explored for their potential to reduce inflammation and alleviate symptoms in Long COVID patients.

Antihistamines: An Unexpected Ally 

Interestingly, some antihistamines, such as famotidine (Pepcid) and diphenhydramine (Benadryl), have shown promise in treating Long COVID. While these drugs are typically used for allergies and heartburn, they may also help reduce inflammation and other symptoms associated with Long COVID.

Vagus Nerve Stimulation: A Novel Approach

Another intriguing approach is the stimulation of the vagus nerve, a key component of the body’s parasympathetic nervous system. Devices that stimulate this nerve have been granted Emergency Use Authorization by the FDA for use in COVID-19 patients, and there’s hope that this approach could help manage the cytokine storm often seen in Long COVID.

RTHM Continues to Follow The Science

While the fight against Long COVID continues, these treatments offer a glimmer of hope for those grappling with persistent symptoms. It’s important to remember that what works for one patient may not work for another, and treatment often involves a degree of trial and error. As research progresses, RTHM clinicians can hope for more effective and targeted therapies for Long COVID in the near future.

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