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Experts Develop Multimodal Approach for Treating Long COVID, Other Post-Acute Infectious Syndromes
Pharmacy Times, September 13, 2024
By Luke Halpern, Assistant Editor
An international team of researchers has proposed a multimodal approach involving a mixture of physical and pharmacological interventions to treat post-acute infectious syndromes (PAIS), including the condition known as long COVID that affects survivors of SARS-CoV-2 infection, the virus that causes COVID-19.
The team sought to examine the optimal treatment strategy for PAIS, which affects not only survivors of COVID-19 but those of influenza and acute infections such as Ebola and polio. Symptoms across these conditions, regardless of the precipitating condition, are consistent and overlap, “indicating the potential contribution of a shared etiopathogenesis,” the team wrote.
Through a systemic review of registered trials for treatment of PAIS, the team sorted through a variety of therapies, including pharmacotherapies, rehabilitative approaches and other methods like psychotherapy. Though they cautioned that not one treatment can be used for all patients, they discussed multiple forms of treatments that had a positive effect on patients with long COVID.
Metformin, a first-line drug in the treatment of type 2 diabetes mellitus, was found to be a pharmaceutic treatment that had a positive effect on long COVID. A safe and affordable treatment, metformin is a powerful suppressor of chronic inflammatory responses in macrophages. By reducing levels of inflammatory markers seen in acute and chronic inflammation, the drug was hypothesized to be helpful in the treatment of long COVID.
Specific studies were cited by way of a targeted machine analysis to back up its effectiveness. A double-blind trial in which adults with overweight or obesity and SARS-CoV-2 infection took metformin for 2 weeks found that they were less likely than those who took a placebo to report a diagnosis of long COVID.
Low-dose naltrexone (LDN), an oral μ-opioid receptor antagonist, is another treatment that showed promise in the systemic review. LDN is FDA approved to treat opioid and alcohol dependence; through the formation of endogenous opioids, the immune system is modulated, and the proliferation of B and T cells is inhibited.
LDN’s anti-inflammatory effects have led to its use in treating diseases like multiple sclerosis and fibromyalgia. In one recent test assessing LDN as a treatment for long COVID, it demonstrated a positive effect on clinical symptoms and patient-reported measures of fatigue, according to the investigators. The drug’s immune modulating and pain reducing effects make it an ideal candidate to pair with metformin.
Read full article here: https://www.pharmacytimes.com/view/experts-develop-multimodal-approach-for-treating-long-covid-other-post-acute-infectious-syndromes