Post-COVID Syndrome and Medications
Naturally there is significant interest in medications to treat Post COVID Syndrome. Data about the safety and benefit of medications and supplements is currently insufficient and more research is needed. Here, I will go through the common medications suggested for treatment, the evidence behind them, and our perspective here at Mayo Clinic.
- Ivermectin – There is no evidence that ivermectin is helpful in either acute COVID or post COVID syndrome. Additionally, the FDA has advised against its use in COVID. There is also significant toxicity which has led to serious side effects and hospital admission in many cases.
- Fluvoxamine – There have been some studies suggesting benefit of fluvoxamine in acute COVID for decreasing progression to severe COVID. The benefit in post COVID syndrome is unknown. Fluvoxamine is generally safe and may have beneficial effects on mood changes that are frequently present along with symptoms of post COVID syndrome.
- Prednisone – This has not been studied in post COVID syndrome. The studies on steroids (prednisone is a type of steroid) in acute COVID suggest benefit only once someone has low oxygen levels. If given in other settings, prednisone may cause harm and could lead to other infections as it suppresses the immune system, and can have detrimental effects on the gut, muscles, adrenal glands, and bones.
- Vitamin C – There is no evidence that Vitamin C has a role in the treatment of acute COVID or post COVID syndrome. There is some data that Vitamin C can help with fatigue and recovery from other viruses. Vitamin C is generally considered safe, but in high quantities can cause gastrointestinal symptoms or kidney stones.
- Omega-3 fatty acids – There is some evidence that omega-3 fatty acids do have anti-inflammatory effects. They are generally considered safe and do have significant health benefits. They may be beneficial in post COVID syndrome.
- Atorvastatin – There is no current evidence that this works for post COVID syndrome. Statins do have a potent anti-inflammatory effect, so may be of benefit. We recommend you discuss the risks and benefits with your primary care provider.
- Melatonin – generally considered safe, may help with sleep and recovery in post COVID syndrome.
- Vitamin D – There is no current evidence that this works for post COVID syndrome. Vitamin D is generally safe, but can cause toxicity with very high serum levels. We recommend keeping Vitamin D levels within goal range, so may be best to coordinate with your primary care physician and check serum levels of Vitamin D.
- Diagnosis and treatment of Mast Cell Activation Syndrome (MCAS) should be performed by an allergist/immunologist, as this syndrome is overdiagnosed due to broad diagnostic criteria and treatments for it can be costly and may have side effects that may be problematic.
Medications/Supplements which may have some benefit and are low toxicity:
- Vitamin C
- Omega-3 fatty acids
Medications/Supplements which are probably not beneficial but have low toxicity:
- Vitamin D
Components which are probably not beneficial and may be harmful: