All treatments (39)
ExperimentalAnticoagulation / antiplatelet therapyOne of the most debated long COVID treatments: thinning the blood to clear microclots">microclots">microclots.MoodAntidepressants / SSRIsDepression and anxiety are common in long COVID, and antidepressants can genuinely help with those symptoms.Viral reactivationAntivirals for EBV (valacyclovir / valganciclovir)If Epstein-Barr reactivation is part of your long COVID, reaching for antivirals seems obvious: there is a virus, so treat the virus.AutonomicBeta-blockers (propranolol, bisoprolol)When the heart races on standing, a low-dose beta-blocker can take the edge off.CardiopulmonaryBreathing retraining / physiotherapy (breathing pattern disorder)A great deal of post-COVID breathlessness comes not from damaged lungs but from a breathing pattern that has slipped into something fast, shallow, and upper-chest.MicrobiomeButyrate / SCFA supplementationIf long COVID depletes the bacteria that make butyrate, why not supply butyrate directly?SupportiveCBT / CBT-I (supportive)Cognitive behavioural therapy is genuinely useful for some things in long COVID and genuinely harmful when misapplied to others.AutonomicCompression garmentsA simple, drug-free way to keep blood from pooling in the legs.AutonomicCoordinated nonpharmacologic care (bundle)The least glamorous option for orthostatic symptoms is also the one with the best recent showing.MicrobiomeDietary fiber and prebioticsThe cheapest way to support a depleted gut is to feed the bacteria you want to grow.MicrobiomeFecal microbiota transplantationIf a few strains help, would resetting the whole microbiome help more?CognitionFibrin-targeting antibodyOne of the most striking long COVID findings is that a clotting protein, fibrin, may itself drive brain inflammation, and that an antibody aimed at fibrin protected the brain in…POTSFludrocortisoneFludrocortisone is a steroid that makes the body hold onto salt and water, expanding blood volume.Repurposed drugFluvoxamine / SSRIAn antidepressant with anti-inflammatory properties, tested as a way to prevent long COVID.ExertionGraded exercise therapy (GET)Graded exercise therapy asks you to steadily increase activity regardless of symptoms.CognitionGuanfacine + N-acetylcysteineThere is no treatment approved for long COVID cognitive symptoms, and anyone promising a cure is ahead of the evidence.ImmunologyH1/H2 antihistaminesCheap, familiar allergy drugs are among the most-tried long COVID treatments, on the theory that overactive mast cells are flooding the body with histamine.BreathingInspiratory muscle trainingFor long COVID breathlessness, one of the few options with real trial support is inspiratory muscle training: strengthening the muscles you breathe in with, using a small…AutonomicIvabradineA drug that calms a racing heart without lowering blood pressure, which makes it well suited to POTS.AutonomicIVIGSome long COVID looks like the immune system turning on the body's own control receptors, and IVIG is the treatment people reach for when they suspect that.Repurposed drugLow-dose naltrexone (LDN)A well-known drug, at a tiny fraction of its usual dose, that may quiet the inflammation behind long COVID fatigue.Repurposed drugLow-dose naltrexone (LDN)A well-known drug, at a tiny fraction of its usual dose, that may quiet the inflammation behind long COVID fatigue.ImmunologyMast cell stabilizersIf overactive mast cells are part of the problem, stabilizing them at the source is the next step beyond antihistamines.Repurposed drugMetforminOne of the few long COVID findings from a large randomized trial: a cheap diabetes drug, taken early in infection, lowered the chance of developing long COVID by about 40 percent.CognitionMicroglial modulators (CSF1R inhibitors, anti-CCL11, NSAIDs, tetracyclines)Some of the most interesting ideas for COVID brain fog target the brain's own immune cells, the microglia.AutonomicMidodrineWhere a racing heart is not the whole story, the problem is often vessels that will not tighten on standing.AntiviralMonoclonal antibodies vs reservoirIf long COVID is partly driven by virus that never fully cleared, then attacking that reservoir, with antivirals or lab-made antibodies, could help.SupplementOxaloacetateA metabolic supplement aimed squarely at long COVID fatigue.ExertionPacing / energy-envelope managementPacing is the practice of keeping activity inside an energy budget so you avoid the delayed crash that follows overexertion.AutonomicPyridostigmineA drug that strengthens the body's own brake on heart rate.Mast cellQuercetin / luteolin / montelukast / low-histamine dietWhen mast cells seem to be flaring, most people start with diet changes and over-the-counter compounds long before any prescription.CardiopulmonaryRecumbent / supine-biased rehabilitation (PEM-bounded)Upright exercise can be the exact thing that floors you, yet gentle movement done lying down may be tolerable.Viral persistenceReservoir-targeting antiviralsIf the virus never fully left, then clearing that hidden reservoir could treat long COVID at its root rather than chasing its symptoms.AutonomicSalt and fluid loadingThe first and cheapest step for a racing, dizzy circulation: give it more volume to work with.MicrobiomeSIM01 synbioticThe first randomized trial to show that fixing the gut can ease long COVID.ExperimentalTherapeutic apheresis (H.E.L.P.)An invasive blood-filtering procedure marketed by some private clinics for long COVID, often at great expense.MoodTreat the biological substrate (anti-inflammatory, sleep, POTS, pacing)Sometimes the most effective way to lift mood in long COVID is not to target mood directly, but to treat the biological drivers underneath it: inflammation, broken sleep,…CognitiveTreat the substrate (pacing, POTS, sleep) + vaccinationBrain fog rarely has a single cause you can aim a drug at, which is why the honest approach is indirect: stop fixing the fog directly and start removing the things that make it…CardiopulmonaryTreat the substrate (POTS, dysautonomia) + cardiac surveillanceChest pain and palpitations after COVID are frightening, and they most often trace back to an autonomic problem rather than the heart itself.