System Maintenance Notice

Please note that maintenance work is scheduled between 4 AM and 5 AM - CET. During this time, you may experience reduced performance. Thanks for your patience.

Publications

Journal Article Review Research Support, N.I.H., Extramural Epublish 60 citations

PubMed: 36969241 DOI: 10.3389/fimmu.2023.1129459

Therapeutic trials for long COVID-19: A call to action from the interventions taskforce of the RECOVER initiative.

Front Immunol 14:1129459

Authors: Hector Bonilla, Michael J Peluso, Kathleen Rodgers, Judith A Aberg, Thomas F Patterson, Robert Tamburro, Lawrence Baizer, Jason D Goldman, Nadine Rouphael, Amelia Deitchman, Jeffrey Fine, Paul Fontelo, Arthur Y Kim, Gwendolyn Shaw, Jeran Stratford, Patricia Ceger, Maged M Costantine, Liza Fisher, Lisa O'Brien, Christine Maughan, John G Quigley, Vilma Gabbay, Sindhu Mohandas, David Williams, Grace A McComsey

Affiliations

  • Department of Medicine and Infectious Diseases, Stanford University, Palo Alto, CA, United States.
  • Department of Medicine and Infectious Diseases, University of California, San Francisco, San Francisco, CA, United States.
  • Center for Innovations in Brain Science, University of Arizona, Tucson, AZ, United States.
  • Department of Medicine, Infectious Diseases, Icahn School of Medicine at Mount Sinai, Chief, Division of Infectious Disease, New York, NY, United States.
  • Department of Medicine, Infectious Diseases, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States.
  • Division of Intramural Research, National Institute of Health, Bethesda, MD, United States.
  • National Heart Lung and Blood Institute, Division of Lung Diseases, National Institutes of Health, Bethesda, MD, United States.
  • Department of Medicine, Organ Transplant and Liver Center, Swedish Medical Center, Seattle, WA, United States.
  • Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, United States.
  • Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, United States.
  • Department of Clinical Pharmacy, University of California, San Francisco, San Francisco, CA, United States.
  • Department of Rehabilitation Medicine at New York University (NYU) Grossman School of Medicine, Physical Medicine and Rehabilitation Service, New York University (NYU), New York University Medical Center, New York, NY, United States.
  • Applied Clinical Informatics Branch, National Library of Medicine, National Institutes of Health, Bethesda, MD, United States.
  • Department of Medicine at Harvard Medical School, Division of Infectious Disease, Boston, MA, United States.
  • Research Triangle Institute (RTI), International, Durham, NC, United States.
  • Department of Obstetrics and Gynecology, The Ohio State University, Columbus, OH, United States.
  • Long COVID Families, Houston, TX, United States.
  • Utah Covid-19 Long Haulers, Salt Lake City, UT, United States.
  • Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States.
  • Department of Medicine, Albert Einstein College of Medicine, New York, NY, United States.
  • Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
  • Department of Medicine, University of Michigan, Ann Arbor, MI, United States.
  • Department of Pediatrics and Medicine, Case Western Reserve University, Cleveland, OH, United States.

Abstract

Although most individuals recover from acute SARS-CoV-2 infection, a significant number continue to suffer from Post-Acute Sequelae of SARS-CoV-2 (PASC), including the unexplained symptoms that are frequently referred to as long COVID, which could last for weeks, months, or even years after the acute phase of illness. The National Institutes of Health is currently funding large multi-center research programs as part of its Researching COVID to Enhance Recover (RECOVER) initiative to understand why some individuals do not recover fully from COVID-19. Several ongoing pathobiology studies have provided clues to potential mechanisms contributing to this condition. These include persistence of SARS-CoV-2 antigen and/or genetic material, immune dysregulation, reactivation of other latent viral infections, microvascular dysfunction, and gut dysbiosis, among others. Although our understanding of the causes of long COVID remains incomplete, these early pathophysiologic studies suggest biological pathways that could be targeted in therapeutic trials that aim to ameliorate symptoms. Repurposed medicines and novel therapeutics deserve formal testing in clinical trial settings prior to adoption. While we endorse clinical trials, especially those that prioritize inclusion of the diverse populations most affected by COVID-19 and long COVID, we discourage off-label experimentation in uncontrolled and/or unsupervised settings. Here, we review ongoing, planned, and potential future therapeutic interventions for long COVID based on the current understanding of the pathobiological processes underlying this condition. We focus on clinical, pharmacological, and feasibility data, with the goal of informing future interventional research studies.

MeSH

Infections, Immune System Diseases, Therapeutics, Research, Sars-Cov-2, Post-Acute Covid-19 Syndrome

Cited by