Three years into the COVID-19 pandemic, with millions of people around the world suffering from long-term complications of the virus, there’s nonetheless no confirmed method to deal with or forestall Lengthy COVID—apart from not getting contaminated within the first place.
Not too long ago, nonetheless, there’s been motive for cautious optimism. Researchers have discovered promising (although preliminary) indicators that sure medicine might cut back the danger of growing Lengthy COVID, and probably even ease signs amongst people who find themselves already sick.
The most recent hopeful information pertains to metformin, an accessible and reasonably priced drug that’s been U.S. Meals and Drug Administration (FDA)-approved to deal with Sort 2 diabetes because the Nineteen Nineties. Metformin, which belongs to a category of medicine known as biguanides, is taken as a liquid or tablet and works by controlling the quantity of sugar within the blood. It additionally decreases inflammation in the body.
In a study that was posted on-line in March however has not but been peer-reviewed, researchers tracked a gaggle of 564 obese or overweight U.S. adults who began a two-week course of metformin once they had acute COVID-19. Individuals who took metformin had a 42% decrease probability of being identified with Lengthy COVID over the next 10 months, in comparison with those that took a placebo once they first acquired sick with COVID-19. (The research additionally tracked the consequences of medicine ivermectin and fluvoxamine, however neither confirmed a profit towards Lengthy COVID.)
Metformin gave the impression to be much more efficient when used early. Amongst individuals who took it inside 4 days of growing signs, the danger of Lengthy COVID dropped by greater than 60%. In whole, about 6% of people that took metformin went on to be identified with Lengthy COVID, in comparison with greater than 10% of the individuals who took a placebo.
Other studies have shown that metformin can cease the SARS-CoV-2 virus from replicating, which can assist forestall each extreme illness and long-term problems, explains research co-author Dr. Carolyn Bramante, an assistant professor on the College of Minnesota Medical Faculty. Metformin appears to work towards the virus by blocking a protein in human cells that the virus makes use of to repeat itself, and by disrupting the inflammatory response brought on by the virus, she says.
Bramante says she was pleasantly stunned by how properly metformin appeared to forestall Lengthy COVID, particularly when taken straight away, though extra analysis is required to substantiate the findings. “It’s in all probability in each pharmacy on the earth,” Bramante says. Somebody might doubtless “get metformin inside a day of realizing they’ve COVID.”
Sooner or later, Bramante says, researchers also needs to research whether or not metformin can deal with current Lengthy COVID signs. Some consultants consider Lengthy COVID is brought on by remnants of the virus lingering within the physique. If that’s true, Bramante says, metformin’s antiviral properties would possibly assist clear it from the physique.
Different current research have additionally urged that Paxlovid, an antiviral drug used to forestall extreme COVID-19 amongst high-risk sufferers, might assist forestall Lengthy COVID in an identical manner. One research, which was posted online in late 2022 however had not been peer-reviewed, discovered that individuals who took Paxlovid inside 5 days of testing constructive for COVID-19 had a 26% decrease danger of growing Lengthy COVID, in comparison with an untreated management group. (Ensitrelvir, one other antiviral drug that’s licensed in Japan however not the U.S., can also cut back the danger of growing Lengthy COVID when taken shortly after testing constructive, its manufacturer announced in February.)
Some researchers are additionally learning whether Paxlovid can treat Long COVID symptoms—an vital query, since there’s nonetheless no confirmed remedy for Lengthy COVID.
Learn Extra: People Are Far Less Likely to Get Long COVID After Omicron, Study Finds
Lengthy COVID is troublesome to deal with, not less than partly as a result of the illness takes many varieties. One particular person may need debilitating fatigue and mind fog whereas one other might have gastrointestinal points or nervous-system dysfunction. As a substitute of looking for a single drug that may deal with all of Lengthy COVID’s 200-plus potential symptoms, some analysis groups are zeroing in on particular signs, or teams of them, in hopes of discovering focused therapies.
Some instruments used to deal with folks with myalgic encephalomyelitis/power fatigue syndrome, a post-viral condition that shares key signs with Lengthy COVID (together with excessive fatigue and crashes after exertion), can also be efficient for folks with post-COVID problems, in keeping with an article printed in Nature Evaluations Microbiology in January. These instruments embody an energy-rationing strategy known as pacing, the anti-inflammatory drug low-dose naltrexone, and beta blockers to gradual coronary heart charge and decrease blood stress. Antihistamines have also been shown in small research to scale back some Lengthy COVID signs, together with fatigue, mind fog, and an lack of ability to train, as have blood-thinning drugs.
Dr. Eric Topol, founding father of the Scripps Analysis Translational Institute and co-author of the current evaluate, says he’s additionally inspired by preliminary data on stimulation of the vagus nerve, which helps management unconscious actions like respiration and coronary heart charge, to ease sure signs.
A number of analysis groups are additionally learning transcranial direct present stimulation (tDCS) as a possible remedy. Researchers have already studied whether or not tDCS units—which administer low-intensity electrical currents to the scalp to stimulate the mind—can enhance cognition, psychological well being, and power ache. Shoppers should purchase quite a lot of tDCS units to make use of at residence, although many haven’t been cleared by the FDA.
In a single small research that was posted online in September 2022 however had not been peer-reviewed, researchers discovered that, after eight tDCS classes, folks with Lengthy COVID reported reductions in bodily fatigue and melancholy, although psychological fatigue and total high quality of life scores didn’t enhance.
Medical neurologist and research co-author Dr. Jordi Matias-Guiu says he’s planning an extended follow-up research, with sufferers receiving therapies for 3 weeks, to see if that results in higher outcomes. “This needs to be confirmed in different medical trials, however the findings are encouraging,” he says. “This can be a approach that may very well be administered at residence, and this can be a non-invasive approach with minimal [side effects].”
The record of potential therapies is rising, however the area wants bigger, extra coordinated analysis tasks, Topol says; in the meanwhile, most findings are coming from small research that should be peer-reviewed, expanded, and duplicated. RECOVER, the U.S. Nationwide Institutes of Well being’s $1 billion Lengthy COVID analysis challenge, has begun designing trials of potential therapies, however they haven’t changed into therapies but.
The dearth of confirmed therapies is disappointing, Topol says, however he considers the current findings about metformin’s potential to forestall Lengthy COVID “superb information.”
Topol agrees that extra research on metformin are wanted—however he says he believes that the early findings are promising sufficient, and the drug is protected and low cost sufficient, that he would personally take it now if he acquired sick with COVID-19. “I don’t need to get Lengthy COVID,” Topol says.
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