Long COVID: New Insights Could Provide Treatment Options

Although some may be hopeful that the end of the COVID-19 pandemic is near, millions still are facing their own lifelong version of the pandemic. These individuals are diagnosed with Long COVID, a post-COVID condition. 

The Centers for Disease Control and Prevention defines Long COVID as a wide range of new, returning, or ongoing health problems that people experience four or more weeks after first being infected with the SARS-CoV-2 virus. The symptoms that an individual can experience during Long COVID include difficulty breathing, fatigue, brain fog, various types of bodily pain and mood changes.  

It is currently estimated that more than half of the 236 million people globally diagnosed with COVID-19 will experience symptoms of Long COVID. According to experts interviewed by the American Medical Association, no organ system is spared in the effects of Long COVID and although researchers have proposed clinical guidelines for the treatment of Long COVID, the CDC currently only provides interim guidance for providers treating the condition.  

Some of the progress in Long COVID research has been stymied by the lack of understanding about who is most likely to contract the condition and how the condition can produce such a broad range of symptoms. New research from the University of Florence and Careggi University Hospital in Italy may have found clues to this problem. 

In research slated to be presented at this year’s European Congress of Clinical Microbiology & Infectious Diseases, researchers have discovered that the symptoms caused by Long COVID could be connected to the variant that they contract. In their analysis, they compared patients who had been infected with the original SARS-CoV-2 virus to those who had been infected when the Alpha variant of the virus was dominant. They found that in those who had been infected during the dominance of the Alpha variant, patients were more likely to present with muscle aches and pains, insomnia, brain fog and anxiety or depression and were less likely to experience loss of smell, difficulty swallowing and hearing impairment.  

Although the study is observational and does not denote cause and effect, this discovery could provide important insights into understanding what patients may experience if they are later diagnosed with Long COVID. The observational study of 428 patients also pointed again toward the large and growing problem of Long COVID: 76% of patients reported at least one persistent symptom after recovering from COVID-19. 

 To that end, researchers and drug developers have undertaken the task of determining what treatments could help those with Long COVID. Some lines of research have focused on if treatment received during COVID-19 infection has an impact on the outcome of Long COVID, but many patients who have Long COVID have had asymptomatic or near asymptomatic infections.  

Other lines of research include investigating existing therapeutics to see if they have an impact on symptoms of Long COVID. The HEAL-COVID trial, sponsored by Cambridge University Hospitals, is aimed at evaluating the drugs apixaban, an anti-coagulant, and atorvastatin, a statin with anti-inflammatory properties, and their ability to prevent or reduce long term symptoms in COVID-19 patients who have been admitted to the hospital. The University of Chicago is also investigating sirolimus, an immunosuppressive drug, to see if it is effective at reducing the likelihood of developing pulmonary fibrosis in patients who are hospitalized with COVID-19 pneumonia. 

Other advancements in Long COVID treatment are being led by small biotechs including Axcella Therapeutics, NLS Pharmaceutics, First Wave BioPharma and others. Axcella is expected to provide Phase IIa results in mid-2022 for its trial of AXZ1125 for the treatment of fatigue in those with Long COVID. NLS’s candidate also is targeted at chronic fatigue in those with Long COVID, with preclinical data in animal models showcasing initial beneficial results. First Wave BioPharma’s candidate FW-COV is aimed at gastrointestinal issues caused by Long COVID with early data showing positive effects. 

Although patients with Long COVID may be waiting a while before effective treatments are released, they are eligible to apply for Social Security Disability Insurance (SSDI) if their ability to work has been severely disrupted. It can be difficult to apply and receive approval but steps like applying as early as possible, documenting symptoms in detail and being aware of qualifications could make the process easier.