Researchers have gotten nearer to stopping and treating long-term COVID

TThree years on from the COVID-19 pandemic, which has left thousands and thousands of individuals all over the world affected by long-term problems of the virus, there’s nonetheless no confirmed technique to deal with or stop Lengthy COVID — except for not really curing it infect first.

Just lately, nonetheless, there was trigger for cautious optimism. Researchers have discovered promising (albeit tentative) proof that sure medication could scale back the chance of creating Lengthy COVID and probably even relieve signs in people who find themselves already sick.

The newest hopeful information pertains to metformin, an accessible and inexpensive drug that has been authorised by the US Meals and Drug Administration (FDA) to deal with kind 2 diabetes for the reason that 1990s. 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 irritation within the physique.

In a research posted on-line in March however not but peer-reviewed, researchers adopted a bunch of 564 obese or overweight US adults who started a two-week cycle of metformin after they have been affected by acute COVID-19. Folks taking metformin have been 42% much less prone to be recognized with lengthy COVID over the next 10 months in comparison with these taking a placebo after they first contracted COVID-19. (The research additionally tracked the results of the medication ivermectin and fluvoxamine, however neither confirmed any profit in opposition to Lengthy COVID.)

Metformin seemed to be much more efficient when used early. Individuals who took it inside 4 days of onset of signs lowered their threat of lengthy COVID by greater than 60%. Total, about 6% of individuals taking metformin have been recognized with Lengthy COVID, in comparison with greater than 10% of individuals taking placebo.

Different research have proven that metformin can cease the SARS-CoV-2 virus from replicating, which can assist stop each critical sickness and long-term problems, explains research chief Dr. Carolyn Bramante, assistant professor on the College of Minnesota Medical College. Metformin seems to work in opposition to the virus by blocking a protein in human cells that the virus makes use of to repeat itself and by interfering with the inflammatory response attributable to the virus, she says.

Bramante says she was pleasantly shocked by how effectively metformin appeared to forestall Lengthy COVID, particularly when taken right away, though extra analysis is required to substantiate the findings. “Most likely in each pharmacy on the planet,” says Bramante. Somebody may most likely “get metformin inside a day of figuring out they’ve COVID”.

Sooner or later, Bramante says researchers also needs to examine whether or not metformin can deal with present long-COVID signs. Some specialists imagine Lengthy COVID is attributable to remnants of the virus remaining within the physique. If that is true, Bramante says, metformin’s antiviral properties may assist clear it from the physique.

Different current research additionally recommend that Paxlovid, an antiviral drug used to forestall extreme COVID-19 in high-risk sufferers, could assist stop Lengthy COVID in the same manner. A research posted on-line in late 2022, however not peer-reviewed, discovered that individuals who took Paxlovid inside 5 days of testing optimistic for COVID-19 had a 26% lowered threat of creating Lengthy COVID , in comparison with an untreated management group. (Ensitrelvir, one other antiviral drug authorised in Japan however not within the US, may additionally scale back the chance of creating Lengthy COVID if taken shortly after a optimistic take a look at, the producer introduced in February.)

Some researchers are additionally learning whether or not Paxlovid can deal with Lengthy-COVID signs – an vital query as there may be nonetheless no confirmed remedy for Lengthy-COVID.

Proceed studying: Examine outcomes present that individuals are far much less prone to get lengthy COVID after Omicron

Lengthy COVID is troublesome to deal with, no less than partly as a result of the illness takes many varieties. One particular person might need debilitating fatigue and mind fog, whereas one other might need gastrointestinal points or nervous system dysfunction. Somewhat than looking for a single drug that may deal with all of Lengthy COVID’s 200+ potential signs, some analysis groups are specializing in particular signs or teams of them in hopes of discovering focused therapies.

Some brokers used to deal with folks with myalgic encephalomyelitis/continual fatigue syndrome, a postviral situation that shares key signs with Lengthy COVID (together with excessive fatigue and post-exercise collapses), could also be efficient, in response to an article printed in Nature Opinions Microbiology in January. These instruments embrace an vitality rationing technique generally known as pacing, the low-dose anti-inflammatory drug naltrexone, and beta-blockers to gradual coronary heart price and decrease blood stress. Antihistamines have additionally been proven in small research to cut back some long-term COVID signs, together with fatigue, mind fog and immobility, as have blood-thinning drugs.

dr Eric Topol, founding father of the Scripps Analysis Translational Institute and co-author of the current assessment, says he is additionally inspired by preliminary knowledge on stimulation of the vagus nerve, which helps management unconscious actions like respiration and coronary heart price to alleviate sure signs.

A number of analysis groups are additionally investigating transcranial direct present stimulation (tDCS) as a doable remedy. Researchers have beforehand examined whether or not tDCS units – which ship low-level electrical currents to the scalp to stimulate the mind – can enhance cognition, psychological well being and continual ache. Customers can buy a wide range of tDCS units to make use of at house, though many haven’t been FDA authorised.

In a small research that was posted on-line in September 2022 however was not peer-reviewed, researchers discovered that individuals with Lengthy COVID reported a discount in bodily fatigue and melancholy after eight periods of tDCS, though this was related to the psychological fatigue and general high quality of life scores didn’t enhance.

Scientific neurologist and research co-author Dr. Jordi Matias-Guiu says he is planning an extended follow-up research with sufferers handled for 3 weeks to see if that results in higher outcomes. “This needs to be confirmed in different scientific research, however the outcomes are encouraging,” he says. “It is a method that may very well be used at house and it is a non-invasive method with minimal effort [side effects].”

The checklist of doable therapies is rising, however the subject wants bigger, extra coordinated analysis tasks, says Topol; Presently, a lot of the outcomes come from small research that want peer assessment, amplification, and duplication. RECOVER, the US Nationwide Institutes of Well being’s $1 billion long-term COVID analysis undertaking, has begun creating research into potential therapies, however they haven’t but was therapies.

The dearth of confirmed therapies is disappointing, Topol says, however he thinks the current findings on metformin’s potential to forestall Lengthy COVID are “superb information.”

Topol agrees that extra research on metformin are wanted – however he believes the preliminary outcomes are promising sufficient and the drug is protected and low cost sufficient that if he does get COVID-19 he would take it personally now. “I do not wish to get Lengthy COVID,” says Topol.

write to Jamie Ducharme at jamie.ducharme@time.com.