TY - JOUR
T1 - Therapeutic trials for long COVID-19
T2 - A call to action from the interventions taskforce of the RECOVER initiative
AU - the RECOVER Consortium
AU - Bonilla, Hector
AU - Peluso, Michael J.
AU - Rodgers, Kathleen
AU - Aberg, Judith A.
AU - Patterson, Thomas F.
AU - Tamburro, Robert
AU - Baizer, Lawrence
AU - Goldman, Jason D.
AU - Rouphael, Nadine
AU - Deitchman, Amelia
AU - Fine, Jeffrey
AU - Fontelo, Paul
AU - Kim, Arthur Y.
AU - Shaw, Gwendolyn
AU - Stratford, Jeran
AU - Ceger, Patricia
AU - Costantine, Maged M.
AU - Fisher, Liza
AU - O’Brien, Lisa
AU - Maughan, Christine
AU - Quigley, John G.
AU - Gabbay, Vilma
AU - Mohandas, Sindhu
AU - Williams, David
AU - McComsey, Grace A.
N1 - Publisher Copyright:
Copyright © 2023 Bonilla, Peluso, Rodgers, Aberg, Patterson, Tamburro, Baizer, Goldman, Rouphael, Deitchman, Fine, Fontelo, Kim, Shaw, Stratford, Ceger, Costantine, Fisher, O’Brien, Maughan, Quigley, Gabbay, Mohandas, Williams and McComsey.
PY - 2023
Y1 - 2023
N2 - 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.
AB - 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.
KW - SARS- CoV-2
KW - clinical trials
KW - long COVID
KW - long haulers
KW - post-acute sequela of SARS-CoV-2 (PASC)
KW - recover
KW - treatment
UR - http://www.scopus.com/inward/record.url?scp=85150686391&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85150686391&partnerID=8YFLogxK
U2 - 10.3389/fimmu.2023.1129459
DO - 10.3389/fimmu.2023.1129459
M3 - Review article
C2 - 36969241
AN - SCOPUS:85150686391
SN - 1664-3224
VL - 14
JO - Frontiers in immunology
JF - Frontiers in immunology
M1 - 1129459
ER -