Post-COVID Syndrome and Medications

Sep 3, 2021 | Ravindra Ganesh | @rganesh2603 | Comments (26)

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.

 

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. Melatonin – generally considered safe, may help with sleep and recovery in post COVID syndrome.
  8. 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.
  9. 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:

  • Fluvoxamine
  • Vitamin C
  • Omega-3 fatty acids
  • Melatonin
  • Atorvastatin

Medications/Supplements which are probably not beneficial but have low toxicity:

  • Vitamin D

Components which are probably not beneficial and may be harmful:

  • Ivermectin
  • Prednisone

To discuss the latest on Post-COVID Syndrome, head over to the Post-COVID Recovery discussion group.

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

@nananan

After I received my covid vaccines I developed vitiligo. Is this possibly connected to the vaccine? It has progressed from one hand to the other. I am a 75 year old female with no previous history of this.

Jump to this post

Vitiligo is an autoimmune disease. Our daughter developed pemphigus, also an autoimmune disease of the skin and mucus membranes, several weeks following her second Pfizer vaccination. Hard to believe this is coincidental..

REPLY

No definitive answer as yet. Should be the object of much study.

REPLY
@crmerwar

Vitiligo is an autoimmune disease. Our daughter developed pemphigus, also an autoimmune disease of the skin and mucus membranes, several weeks following her second Pfizer vaccination. Hard to believe this is coincidental..

Jump to this post

After receiving our second shots, my wife and I have both been sick for six months with fatigue, joint and muscle aches, elevated temperature and other symptoms of chronic fatigue syndrome. We'd had chronic fatigue syndrome for two decades, but had been feeling good and almost normal for the past ten years, until the shots. Does the Mayo Clinic have any help available?

REPLY

I had my initial covid infection in September 2020, My doctor states I have Long Covid and my only hospitalization is recent from september of 2021, where my iron got dangerously low. I was put on an Iron infusion 200ML every other day for 5 doses.

REPLY
@crmerwar

I am just learning to navigate your website, so I will reply to you.
I was in the hospital for 10 days in Jan 2020, 7 in the ICU following abdominal surgery for intestinal obstruction caused by adhesions. I was under general anesthesia for 3 1/2 hours because laparoscopic surgery was unsuccessful and belly opening was necessary. I had the full-blow ICU syndrome with confusion, agitation. and hallucinations. All disappeared as soon as I returned home.
Now, however, 20 months later I am still bothered by weakness, loss of stamina, breathlessness and impaired balance. My sleep cycle is confused, and I never awaken feeling refreshed despite 8-10 hours in bed. My memory is single track. At no time did I have any symptoms suggesting Covid infection. My symptoms are typical for PICUS. Other causes have been competingly investigated.
I am a retired Internist 91 years of age. I know that I have common age-related problems, but I cannot account for all of my lingering symptoms by that alone. I feel too bad.
In the recent past, I have tried regular PT and thought I was improving until I hit a wall and regressed. I keep my mind active, but my physical activity level is low because I am most comfortable when inactive.
When I came home post hospitalization 18 months ago, I resumed my role as primary care-giver for my wife who was under Hospice care. She died last Jan.
A few years ago this would have been unbelievable but now is not. All our 3 children and 2 grandchildren have illnesses that are clearly autoimmune in origin. My wife had pericarditis and myocarditis of undetermined origin in 2001 and died of cardiac cachexia. I had serum sickness as a kid albeit secondary to an injection of horse serum.
I anguish over what the virus and its treatment might do to our children. I'm discouraged for myself. Although all receive good medical care, no one seems interested in a link between autoimmune disease, side effects of vaccination( a daughter developed pemphigus several weeks after the second Pfizer dose), and the connection between long-haul Covid infection and PICUS.
If my history is helpful to others I will be pleased. Is it unrealistic at this point in time to expect more?
Thank you for taking the time to read this.
Charles

Jump to this post

Gracias por su historia a mi me han ayudado mucho escuchar cada historia. No pierda la esperanza

REPLY

i was wondering what your thoughts were about rheumatology meds and/or Hydroxychloriquine? to treat post covid symptoms

REPLY
@kvacanti

I had my initial covid infection in September 2020, My doctor states I have Long Covid and my only hospitalization is recent from september of 2021, where my iron got dangerously low. I was put on an Iron infusion 200ML every other day for 5 doses.

Jump to this post

@kvacanti, how are you doing now? Have the iron infusions helped?

REPLY

I've been dealing with post covid since march 2020. I am so weak. I've tried so many things and nothing seems to work on me. I am so sad and scared. Can someone share what they did to recover? Maybe there is something I am not seeing. TIA. 🙂

REPLY
@marcosivan1994

I've been dealing with post covid since march 2020. I am so weak. I've tried so many things and nothing seems to work on me. I am so sad and scared. Can someone share what they did to recover? Maybe there is something I am not seeing. TIA. 🙂

Jump to this post

There are many people with post-Covid symptoms discussing their illness and treatments here: https://connect.mayoclinic.org/group/post-covid-recovery-covid-19/
If you choose the discussion that most closely matches your symptoms and post your questions there, you will probably hear from others.
Sue

REPLY
@mendozj123

i was wondering what your thoughts were about rheumatology meds and/or Hydroxychloriquine? to treat post covid symptoms

Jump to this post

Many people ask about rheumatology medications for the treatment of post COVID symptoms. Here’s what Mayo Clinic experts have to say:

“We often get questions about rheumatology medications, as well as things like hydroxychloroquine. And this makes sense. We have often said that the long haul COVID state may be related to an autoimmune problem. While it is tempting to start throwing autoimmune medications at this condition, it is really not that simple. Some of these medications have serious side effects. And while we have all heard stories of improvements with such treatments, I have also heard stories of worsening, such as in patients who have been tried on hydroxychloroquine. What is really needed to try these treatments and others are well designed clinical trials. We are currently putting together such trials at Mayo Clinic and hopefully we will have opportunities for patients to participate in more experimental treatments within the next year.”

REPLY
Please sign in or register to post a reply.