Long-COVID treatments: why the world is still waiting

Bhasha Mewar has had it with doctors. Over the past two years, Mewar has spent nearly all of her life savings seeing heart and respiratory specialists, haematologists, urologists, dermatologists and more, in a desperate bid to tame her long-COVID symptoms. She has taken a slew of drugs: beta blockers to calm her racing heart, steroid inhalers to ease her laboured breathing and an antimalarial drug prescribed to her for reasons she never fully understood.

And when Mewar — a curator at an art museum in Ahmedabad, India, who has been sick since what was probably a bout of COVID-19 in March 2020 — would visit her lung doctor twice a month, he always told her the same thing: you need to exercise. “I can’t even walk to the bathroom,” she would reply.

It’s an unwelcome odyssey undertaken by millions of people living with long COVID, a complex and sometimes debilitating syndrome that can linger for months or years after an acute SARS-CoV-2 infection. There is no proven treatment, leaving physicians and people with the condition to play whack-a-mole with its many symptoms. And sometimes, people with the syndrome turn to untested, self-prescribed therapies. Although at least 26 randomized clinical trials of long-COVID therapies are under way (see ‘Trials take off’), many are too small or lack the necessary control groups to give clear results. “If you look at long COVID at this moment in time, I’d paint a slightly ‘Wild West’ and desperate picture really,” says immunologist Danny Altmann at Imperial College London.

Even so, researchers are narrowing in on the pathology that underlies long COVID. In the next year, key trials could yield results for drugs that target the immune system, blood clots or lurking fragments of the coronavirus itself. “I’m still optimistic,” Altmann says. “The right stuff is going on, and there’s a fair amount of funding out there. Something is going to give.”

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