Glimmers of Hope: Post-COVID Syndrome Research

Sep 2, 2022 | Greg Vanichkachorn | @drvan | Comments (63)

Post COVID Syndrome (PCS) has been part of our language for more than 2 years. Despite that, research on this condition has been progressing slowly. Most of the research in the world has been focused on first figuring out what PCS really looks like and how it affects different populations. While this information is important, many patients are desperate for some news on treatments. Well, today is your day.

In July 2022, a research team from Ireland published their findings on a medication called naltrexone.  Naltrexone is a medication that is commonly used to reverse the effects of opioids. For example, naltrexone could be used when someone may have overdosed on a pain medication like morphine. When used for this purpose, the dosage is typically around 50mg. However, when naltrexone is used at very low doses, for example 1-4.5mg, it has shown to work mainly the immune system. With this effect, low dose naltrexone has been used for conditions such as Chron’s disease and chronic fatigue.

In this study, 38 patients with PCS were treated with low dose naltrexone. When symptoms before and after treatment were compared, a statistically significant improvement was found for fatigue, function, pain, concentration, and sleep.

Now, before everyone starts calling their favorite long haul COVID clinic, the study findings need to be interpreted cautiously. As we have discussed before, no research is perfect, and we must go beyond the title to really understand the limitations. First, this study looked at a very small population of patients. The smaller the number of participants, the less reliable the results are. In addition, the results of the group treated with naltrexone was not compared to a group of patients not treated with naltrexone. Without that comparison group, called a control group, we do not know if the reported improvements are due to naltrexone or just due to something completely separate, like the weather or green grass in Ireland. Also, the patients who were treated with naltrexone were aware they were being treated and examined. Just knowing that can sometimes change how someone feels.

Despite all those limitations, I am still excited about this study and others coming down the pike. It represents finally some first steps in treatment research, and it should be a sign of hope for patients with PCS around the world.

At this time, the Mayo Clinic specific post-COVID studies are only recruiting participants that are being seen at Mayo Clinic post-COVID clinics. If you are a patient being seen in Mayo Clinic's post-COVID clinics and would like to participate in research, please email postCovidRSCH@mayo.edu

Learn more about the most recent developments with post-COVID syndrome by following the Newsfeed and discuss your experience in the Post-COVID Recovery discussion group.

Interested in more newsfeed posts like this? Go to the Post-COVID Recovery blog.

@bebold

I have trouble understanding why people blame the vaccine when they've had covid. Not being very ill with covid doesn't mean you're not going to get long covid in fact your chances of getting long covid or even higher.

I had a very mild case, in fact all I had was a sore throat for the first month. Do not have much of a cough even. I did end up with severe shortness of breath in month four of getting sicker and sicker, all tests negative - only to find out I had a collapsed lung that wasn't being treated because in October of 2020, nobody was taking long covid seriously.

I just found out this week, two and a half years later
With an 02 in the 80s, low 90s, eben 78 the other day, that I'm now needing oxygen 24/7. I had covid before the vaccines came out and I've had vaccines since then. I've also had covid again which caused a spread off my autoimmune pain disorder. I fear deeply that people are blaming the vaccine because they don't know they have had covid because of mild symptoms or just plain denial as I've seen with friends. Or they test negative and never eber tested positive; there's so many false negatives they blame the vaccine and then we end up in the worst trouble.

I'm sorry he doesn't feel well and I hope he starts to improve soon but I'm not so sure about the whole thing about blaming the vaccine. I'm seeing it happen much too often. And then we end up with a lot of anti-vaxxers and now kids are dying of measles again and on and on as suddenly nobody seems to trust ANY vaccine. I hear people say "but measles isn't that bad it doesn't kill people." That's because we have had the vaccine gor a long time that most people trusted until all this anti-covid vaccine started. I'm afraid a lot of disinformation about the covid vaccine is causing people to stop taking vaccines for everything.

People are on such denial about what can happen after covid. People need to stop being in denial about it. I have friends who haven't been able to breathe since covid and they blame asthma instead of covid. Or the vaccine. And end up on more and more asthma medication and more and more testing, don't stay home when they probably do have covid, one even couldnt taste or smell but they test negative so they still went to work.

I'm not saying that the vaccine doesn't affect people at all, what I know from experience is if the vaccine causes you misery then covid could really be bad for you to get, inflammation-wise.

I hope you find an answer that's treatable because long covid is not treatable and people just don't understand. My uncle is doing the same thing. Had a mild case of covid and now he's got parkinsonian symptoms but blaming the vaccine instead of blaming covid. The symptoms started after covid and are well-known symptoms of that can occur with long covid.

I do know that they are finding some of the vaccines are causing trouble, but it's very specific related to the company and the shot but I wonder if they also are blaming the vaccines when it's really a problem with people who have had covid and are saying they never did. They have said don't get the shot close to the time you have covid. People are getting the flu shot and the covid shot at the same time which means neither one of them are effective. According to my cardiologist who treats a minmum of 10 young people a day now with heart disease from covid.

Yep there's a lot we don't know but mostly I think we don't know how much long covid there is and how serious it is. People don't know that people like me exist. My life is basically over because of covid I'm on oxygen 24/7. I'm in pain, on crutches and this is long covid it's not the vaccine. There was no vaccine.

I know this is really going to make anti-vaxxers upset but I think it's worth not blaming everything on the vaccine. I'm just saying... When the vaccine for covid is being blamed for all of long covid issues, then people go in the opposite direction and stop all vaccines. And that's undoing a hundred years of Medical research. Shall we stop all antibiotics?

I just wanted to add that I'm not saying it's not from the vaccine I'm not saying it is from the vaccine I'm just saying don't rule out long covid. More people end up with long covid for a mild case than they do from a moderate case.

Especially if like me you have had it twice, never tested positive in my life, but my IGG blood test shows I definitely had it.

Best of luck. Betty

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i agree about this vaccine thing, being at really crowded airports and in packed planes one week before Christmas in Dec of 2019 was when i got covid...there where no vaccines then for it. i was really sick, so much for my trip, it wasn't fun! sooo i ended up with post or long covid, what ever you want to call it..since then..long before any vaccine my symptoms started..the cough along with a lot of phlegm ..that never leaves my throat, messed up sinuses, sore throat and hoarse voice, some headaches, dizziness, brain fog, taste and smell changes, plugged ears, vision changes, memory changes, moody and anxiety come and go, i'm now always itchy..sometimes with a rash that burns at times on different parts of me, bowel and bladder changes, out of breath at times, leg cramps..that are not charlie horses, tight chest at times, nauseous, digestion system messed up..when i eat or drink anything..i really get a lot of phlegm, always really tired, now i have high blood pressure, numb toes and the internal tingling all over when it decides it want to be there, muscle and joint pain....and a lot more. i never had any of these symptoms before covid, i also gained 35lbs for no reason at all. when i was sick my oxygen level was low, phlegm was so bad i almost did end up in the hospital because i couldn't breath..and now i found out on my last dr. appt that my bone density has thinned..i was shocked to hear that because it was always amazing, my bones where great! that has been one thing i always made sure of...maybe that's one of the reasons my back has been really bothering me..i wonder..is it another crap thing from covid, curious??? well, that is all, hang in there everyone, we have to beat this demon virus......prayers to you all!!

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@msdoss

Karen. I am looking for a group of people that did not have COVID, but are experiencing increased autoimmune issues. I did have the 1st & 2nd COVID Pfizer vaccine shots.
I did have an autoimmune condition prior to vaccine, but have developed issues after taking the vaccine.

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My husband is in that situation. He had headaches, then daily migraines, and now also POTS, dizziness, vestibular migraine, and nausea. This is almost every day, has been going on for 9 months, and it started the morning after receiving his second booster. (Moderna after 3 Pfizers) He cannot work, read, drive, walk, etc. and is bedridden for much of the day. It feels to us like an autoimmune reaction, but doctors seem to only want to treat the migraine symptom. Very frustrating.

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@drvan are you still posting on this blog? Please continue to post, specifically if you have insights on the cognitive effects for PASC. How long are you seeing this impact patients once they start cognitive rehab therapy?

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Very well written. Thanks for sharing. I am taking liw dose naltrexone, 4.5 mg daily. Just started a few days ago but already noticing I am less fatigued, more alert, mood improved and stamina is better. Finally something that actually helps!

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@beebee000

i agree about this vaccine thing, being at really crowded airports and in packed planes one week before Christmas in Dec of 2019 was when i got covid...there where no vaccines then for it. i was really sick, so much for my trip, it wasn't fun! sooo i ended up with post or long covid, what ever you want to call it..since then..long before any vaccine my symptoms started..the cough along with a lot of phlegm ..that never leaves my throat, messed up sinuses, sore throat and hoarse voice, some headaches, dizziness, brain fog, taste and smell changes, plugged ears, vision changes, memory changes, moody and anxiety come and go, i'm now always itchy..sometimes with a rash that burns at times on different parts of me, bowel and bladder changes, out of breath at times, leg cramps..that are not charlie horses, tight chest at times, nauseous, digestion system messed up..when i eat or drink anything..i really get a lot of phlegm, always really tired, now i have high blood pressure, numb toes and the internal tingling all over when it decides it want to be there, muscle and joint pain....and a lot more. i never had any of these symptoms before covid, i also gained 35lbs for no reason at all. when i was sick my oxygen level was low, phlegm was so bad i almost did end up in the hospital because i couldn't breath..and now i found out on my last dr. appt that my bone density has thinned..i was shocked to hear that because it was always amazing, my bones where great! that has been one thing i always made sure of...maybe that's one of the reasons my back has been really bothering me..i wonder..is it another crap thing from covid, curious??? well, that is all, hang in there everyone, we have to beat this demon virus......prayers to you all!!

Jump to this post

I could have written this. I,too, had Covid before it was well known. Later took the vaccine and had additional flare up. Now I’ve had post Covid for over two years. Currently the thing that is driving me crazy is the phlegm. It never ever goes away. I clear my throat almost constantly. I get so fatigued I can hardly sit up at times. It’s so bad after I eat that I dread eating but still gain weight. I won’t go on and on, although I could! My oxygen level becomes so low at times I have to rush to the oxygen. My doctor put me on home oxygen now.
There has to be an answer for this.

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@tccyj66

你好!LDN是什么?能详细说明吗?

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tccy, LDN means Low Dose Naltrexone. You can read more about it on Mayo Clinic here:
https://www.mayoclinic.org/drugs-supplements/naltrexone-oral-route/side-effects/drg-20068408

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@bebold

I have trouble understanding why people blame the vaccine when they've had covid. Not being very ill with covid doesn't mean you're not going to get long covid in fact your chances of getting long covid or even higher.

I had a very mild case, in fact all I had was a sore throat for the first month. Do not have much of a cough even. I did end up with severe shortness of breath in month four of getting sicker and sicker, all tests negative - only to find out I had a collapsed lung that wasn't being treated because in October of 2020, nobody was taking long covid seriously.

I just found out this week, two and a half years later
With an 02 in the 80s, low 90s, eben 78 the other day, that I'm now needing oxygen 24/7. I had covid before the vaccines came out and I've had vaccines since then. I've also had covid again which caused a spread off my autoimmune pain disorder. I fear deeply that people are blaming the vaccine because they don't know they have had covid because of mild symptoms or just plain denial as I've seen with friends. Or they test negative and never eber tested positive; there's so many false negatives they blame the vaccine and then we end up in the worst trouble.

I'm sorry he doesn't feel well and I hope he starts to improve soon but I'm not so sure about the whole thing about blaming the vaccine. I'm seeing it happen much too often. And then we end up with a lot of anti-vaxxers and now kids are dying of measles again and on and on as suddenly nobody seems to trust ANY vaccine. I hear people say "but measles isn't that bad it doesn't kill people." That's because we have had the vaccine gor a long time that most people trusted until all this anti-covid vaccine started. I'm afraid a lot of disinformation about the covid vaccine is causing people to stop taking vaccines for everything.

People are on such denial about what can happen after covid. People need to stop being in denial about it. I have friends who haven't been able to breathe since covid and they blame asthma instead of covid. Or the vaccine. And end up on more and more asthma medication and more and more testing, don't stay home when they probably do have covid, one even couldnt taste or smell but they test negative so they still went to work.

I'm not saying that the vaccine doesn't affect people at all, what I know from experience is if the vaccine causes you misery then covid could really be bad for you to get, inflammation-wise.

I hope you find an answer that's treatable because long covid is not treatable and people just don't understand. My uncle is doing the same thing. Had a mild case of covid and now he's got parkinsonian symptoms but blaming the vaccine instead of blaming covid. The symptoms started after covid and are well-known symptoms of that can occur with long covid.

I do know that they are finding some of the vaccines are causing trouble, but it's very specific related to the company and the shot but I wonder if they also are blaming the vaccines when it's really a problem with people who have had covid and are saying they never did. They have said don't get the shot close to the time you have covid. People are getting the flu shot and the covid shot at the same time which means neither one of them are effective. According to my cardiologist who treats a minmum of 10 young people a day now with heart disease from covid.

Yep there's a lot we don't know but mostly I think we don't know how much long covid there is and how serious it is. People don't know that people like me exist. My life is basically over because of covid I'm on oxygen 24/7. I'm in pain, on crutches and this is long covid it's not the vaccine. There was no vaccine.

I know this is really going to make anti-vaxxers upset but I think it's worth not blaming everything on the vaccine. I'm just saying... When the vaccine for covid is being blamed for all of long covid issues, then people go in the opposite direction and stop all vaccines. And that's undoing a hundred years of Medical research. Shall we stop all antibiotics?

I just wanted to add that I'm not saying it's not from the vaccine I'm not saying it is from the vaccine I'm just saying don't rule out long covid. More people end up with long covid for a mild case than they do from a moderate case.

Especially if like me you have had it twice, never tested positive in my life, but my IGG blood test shows I definitely had it.

Best of luck. Betty

Jump to this post

Betty, it breaks my heart to hear about the struggles you are dealing with. Like you, I had Covid. I then got pneumonia, then started having spells of very low oxygen and had to be rushed to the ER several times before being put on home oxygen. I only use it occasionally now- a year later. I am wondering, did your low oxygen start out severe and then stay there warranting your 24/7 stay on oxygen? Or did it gradually increase in severity? When you remove your oxygen now, does it immediately drop to low levels or does it take several hours? Thank you for the info. I don’t know what is in my future and doctors seem to know less than patients.

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@poppy67

I could have written this. I,too, had Covid before it was well known. Later took the vaccine and had additional flare up. Now I’ve had post Covid for over two years. Currently the thing that is driving me crazy is the phlegm. It never ever goes away. I clear my throat almost constantly. I get so fatigued I can hardly sit up at times. It’s so bad after I eat that I dread eating but still gain weight. I won’t go on and on, although I could! My oxygen level becomes so low at times I have to rush to the oxygen. My doctor put me on home oxygen now.
There has to be an answer for this.

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yes me too as i've said..if i could have just one symptom gone..it would be the phlegm....

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@poppy67

I could have written this. I,too, had Covid before it was well known. Later took the vaccine and had additional flare up. Now I’ve had post Covid for over two years. Currently the thing that is driving me crazy is the phlegm. It never ever goes away. I clear my throat almost constantly. I get so fatigued I can hardly sit up at times. It’s so bad after I eat that I dread eating but still gain weight. I won’t go on and on, although I could! My oxygen level becomes so low at times I have to rush to the oxygen. My doctor put me on home oxygen now.
There has to be an answer for this.

Jump to this post

Odd question- does you phlegm cause you to hiccup? I’m on the fourth day of bouts of hiccups. It feels like there’s a lot of thick phlegm going down my throat and it makes it uncomfortable to eat or drink. I’ve been taking mucinex to see if it’s a sinus issue and increasing water intake. It could also be a side effect from my combo of meds. Thanks

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