WASHINGTON (AP) — The National Institutes of Health (NIH) is launching several studies to investigate potential treatments for long COVID, a condition that has been causing significant distress to millions of people. The move is highly anticipated and represents a crucial step in the United States’ efforts to combat this mysterious ailment.
The announcement was made as patients suffering from long COVID have endured months, or even years, of debilitating health issues without any proven remedies and only a few well-designed studies to explore potential treatment options.
Dr. Ziyad Al-Aly from Washington University in St. Louis, whose own research shed light on the impact of long COVID, remarked that the NIH’s $1.15 billion RECOVER project is a positive step in the right direction. While he is not directly involved in the NIH’s project, he emphasized the urgency of finding answers as numerous unproven therapies are taking advantage of vulnerable patients. Despite some feelings that the initiative may have been delayed and not as extensive as hoped, it remains an essential effort in addressing the challenges posed by long COVID.
Scientists have yet to pinpoint the exact cause of long COVID, a term encompassing approximately 200 diverse symptoms. It is estimated that between 10% and 30% of individuals have encountered some form of long COVID after recovering from a coronavirus infection, although this risk has decreased somewhat since the early days of the pandemic.
U.S. Health and Human Services Secretary, Xavier Becerra, emphasized the complexity of long COVID, stating that if he were to ask ten people about what it truly entails, he would receive ten different answers. This highlights the lack of a singular, comprehensive understanding of the condition within the medical community.
Indeed, the RECOVER initiative has taken a proactive approach in understanding long COVID by closely monitoring 24,000 patients through observational studies. These studies aim to identify the most prevalent and challenging symptoms associated with the condition. The gathered insights are now shaping comprehensive treatment trials.
The first two treatment trials will explore the potential benefits of Pfizer’s antiviral drug, Paxlovid, in alleviating long COVID. The theory behind this investigation is that some live coronavirus or its remnants may persist in the body, triggering the disorder. Typically, Paxlovid is prescribed for a duration of five days when individuals initially contract COVID-19. However, the trials will explore whether extending the treatment to up to 25 days could offer relief for long COVID patients. This represents a promising avenue to investigate possible treatments for this complex and often debilitating condition.
The RECOVER initiative is taking a comprehensive approach to address the cognitive problems associated with long COVID, commonly referred to as “brain fog.” Several treatments are being investigated, including the BrainHQ cognitive training program developed by Posit Science Corp, the PASC-Cognitive Recovery program from New York City’s Mount Sinai Health System, and a brain circuit stimulating device created by Soterix Medical.
In addition to cognitive issues, two upcoming studies will focus on treating sleep problems and problems with the autonomic nervous system. The latter controls involuntary functions such as breathing and heartbeat, and it will target the disorder known as POTS (Postural Orthostatic Tachycardia Syndrome).
Another planned study aims to explore exercise intolerance and fatigue in long COVID patients. However, there are concerns among some patient groups about the potential harm that exercise may cause to certain individuals with long COVID. The NIH is taking these concerns into consideration and seeking input to ensure safety.
The trials are currently enrolling between 300 to 900 adult participants, with the possibility of expanding in the future. These trials differ from traditional experiments as they employ more flexible “platform studies.” This approach allows the NIH to continuously add new potential therapies as they become available, and failing treatments can be removed without disrupting the entire trial. Dr. Amy Patterson of the NIH highlighted the agility of this method, enabling rapid adjustments to include promising treatments that emerge during the course of the study.
The flexibility of the NIH’s platform studies has been recognized as a key advantage by Dr. Anthony Komaroff, a Harvard researcher who has extensively studied chronic fatigue syndrome or ME/CFS, a similar mysterious disorder. Dr. Komaroff, while not directly involved in the NIH program, appreciates the approach taken in the Paxlovid study. He points out that if the initial 25-day dose shows only promising hints of effectiveness, researchers can explore extending the test to a longer course of treatment rather than starting from scratch with a completely new approach.
Regarding the wait for these treatment trials, Dr. Komaroff understands people’s frustration. However, he believes that the NIH’s decision to wait until some clues emerged about the underlying biology was appropriate. Identifying specific targets based on these clues is crucial for conducting meaningful and effective treatment trials. This strategic approach can lead to more informed and successful interventions for long COVID.
