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Post-COVID Syndrome and Medications

Sep 3, 2021 | Ravindra Ganesh | @rganesh2603 | Comments (27)

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.

4 Reactions

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jrg200911 | @jrg200911 | Nov 24, 2021

Thank you. Good for confirmation of good information.

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americapena76 | @americapena76 | Jun 18, 2022

Es posible que después de 1 mes siga teniendo un terrible dolor de huesos , mareos y fatiga ??

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Amanda Burnett | @amandaa | Jun 20, 2022

Hola @americapena76 y bienvenido a Mayo Clinic Connect. Todos aquí en Connect son pacientes como usted, por lo que no pueden sugerir un tratamiento médico, pero podemos ayudarlo a conectarse con miembros que han pasado por problemas similares como @jrg200911 and @jrg200911

Se ha reunido con un médico acerca de sus síntomas?

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jrg200911 | @jrg200911 | Jun 20, 2022

@americapena76

Ahora con más de 21 meses de COVID prolongado...

Todos los diversos síntomas: Mis 'Bag-o-Symptoms'
"Cada día es un nuevo día. Es como sacar la lotería de mi Bag-o-Symptoms para ver cuál me enfermará y en qué medida. Todos ellos simplemente aumentan y disminuyen a lo largo de mis días”. (Algo así como la caja de bombones de Forest Gump)

-Inicio inicial de los síntomas el 11/09/2020 (después de una infección asintomática aguda por COVID - hasta el 11/09/2020, me describiría como saludable y activo. Durante toda la primavera y el verano de 2020 caminé de 3 a 7 millas por día): Los síntomas aparecieron literalmente de la noche a la mañana desde el 10/09/2020 hasta el 11/09/2020. Golpéame como un camión Mack.

-Presión en el Pecho: Elefante en mi pecho

-Corazón acelerado/Palpitaciones: Jack LaLanne está dentro de mi pecho haciendo calistenia

-Problemas cognitivos: Perderse en - tratando de navegar a través del Bosque de Niebla Cerebral (Alrededor de un mes - principios de 10/2020 - antes de que supiera que "Niebla Cerebral" era una cosa, la entrada de mi diario describía... "El cerebro está en una niebla - muy difícil de concentrar.”
[Entrada a finales de 10/2020:
Realmente estoy pensando que la "niebla mental" es algo real. Mi terapeuta dijo que la semana pasada no quería asustarme, pero notó que me faltaban palabras cuando hablaba con ella. Ella sabía que los pensamientos estaban allí, pero cuando traté de ponerlos en oraciones, no pude pronunciar algunas palabras.]

- Fatiga "aplastante": debe sentarse o acostarse para una "siesta de desmayo"

-SOB: Se siente como si mis pulmones estuvieran envueltos en tela de queso.

-Dolor en el pecho: dolor intenso que irradia

-Náuseas, seguidas de rubor en todo el cuerpo y picos de frecuencia cardíaca (hasta más de 200) sin un desencadenante aparente (a menudo mientras está sentado y/o con poco o ningún esfuerzo)... los llamo "episodios"

-Si me exijo demasiado en un día (como ducharme Y salir de casa para hacer un mandado o comer), me arriesgo a “pagarlo más tarde” con un “ataque” de síntomas graves que a veces dura días. (No siempre, eso sí... lotería/Bag-o-Symptoms)

-En los primeros días, después de que todos los diagnósticos regulares regresaron con resultados en el rango "Normal", mi diario dice: "Solo desearía poder comprar una pista sobre el diagnóstico".

ACTUALIZACIÓN: Me aceptaron en el Programa de recuperación posterior al COVID de Mayo Clinic - Rochester, MN. Consulta inicial (virtual) en abril con una semana de seguimiento de diagnóstico y planificación del tratamiento en persona. Con la esperanza de "comprar esa pista".

Después de las primeras semanas de WTH ???, visitas a la sala de emergencias, visitas al médico sin pruebas COVID POSITIVAS y todos los diagnósticos regresando dentro del rango NORMAL, mis temores desaparecieron y, en cambio, corrí a mi refugio de confianza en tiempos de problemas.

Mi Señor me lleva y todo está bien en mi alma. Todavía estoy comprometido a buscar el tratamiento disponible y encontrar el camino de la recuperación. Desde que recibí una prueba de células T COVID-POSITIVA en agosto de 2021, es mucho más fácil ahora que me escuchan y me aceptan dentro de la comunidad médica de Long Hauler. Antes de eso, bueno, no tanto...

Sí, cada día es un nuevo día con cualquier variedad y severidad de los síntomas, pero no experimento absolutamente ningún miedo mientras descanso en los brazos del amor perfecto de Dios que promete echar fuera todo miedo. ¡Hasta ahora, muy bien en esa nota! Dios es fiel.

Actualizaré a medida que aprenda consejos y trucos y/o compre la pista para el diagnóstico y tratamiento/terapia ganadora.
Gracias

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rayjay535353 | @rayjay535353 | Oct 2, 2022
In reply to @pauljay "After receiving our second shots, my wife and I have both been sick for six months..." + (show)
@pauljay

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?

Jump to this post

Very sorry about what you're going through. It's too bad we can't ask the million or so that have passed away without the vaccine.

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bunzman | @bunzman | Oct 3, 2022

Not sure not understand your reply to pauljay? How would examining anyone who did not take the vaccine provide any information on adverse reactions to taking it. I have been left scratching my head as some very unusual and chronic issues since having my 2nd shot, but others also have responded adversely too as clearly albeit in much smaller numbers than long covid. But it would be naive to expect it to be entirely risk free given it is intended to trigger (an immune) response and that a few systems will not respond as intended. That is why getting the vaccine or any other treatment should always involve a risk/benefit assessment based on the individual.

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katey122 | @katey122 | Oct 20 11:26am

I have a Doctor who has noticed the same thing. I was completely up to date on my Covid Vaccinations, got covid, ended in ICU 3weeks on ventilator. Now have long covid.

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