2023-07-31 18:40:15
The U.S. National Institutes of Health has begun a series of studies aimed at testing possible treatments for long-lasting COVID, an eagerly awaited step in U.S. efforts to combat this mysterious illness that affects millions of people.
Monday’s announcement from the NIH’s US$1.15 billion RECOVER project echoes the frustration of patients who have struggled for months, if not years, with health issues sometimes disabling, with no proven treatment and with only a few rigorous studies to test potential treatments.
“It’s a year or two late and more limited in scope than we could have hoped for, but it’s nevertheless a step in the right direction,” said Dr Ziyad Al-Aly, of the University Washington in St. Louis, which is not involved in the NIH project, but whose own research has highlighted the long-term effects of COVID-19.
Getting answers is critical, he added, because “there are a lot of people who exploit the vulnerability of patients” with unproven therapies.
Scientists don’t yet know what causes long COVID, an umbrella term that refers to around 200 widely varying symptoms. It is estimated that between 10 and 30% of people who have recovered from coronavirus infection have suffered from some form of long-lasting COVID, a risk that has diminished somewhat since the start of the pandemic.
“If I ask ten people, I’ll get ten answers to the question of what long COVID actually is,” said Xavier Becerra, US Secretary of Health and Human Services.
That’s why, so far, the RECOVER initiative has followed 24,000 patients in observational studies to identify the most common and distressing symptoms ― results that serve as the basis today. treatment trials on several fronts. The first two essays will cover the following points:
If taking Pfizer’s antiviral drug Paxlovid for 25 days could provide relief from long-lasting COVID, due to a theory that a live coronavirus, or its remnants, could be hiding in the body and causing illness. Normally, Paxlovid is used at the start of the infection and only for five days. Treatments for “brain fog” and other cognitive problems. They include Posit Science’s BrainHQ cognitive training program, one called PASC-Cognitive Recovery from New York’s Mount Sinai Health System, and a device from Soterix Medical that electrically stimulates brain circuits.
Two other studies will be launched in the coming months. One of them will test treatments for sleep disorders. The other will focus on problems with the autonomic nervous system ― which controls unconscious functions such as breathing and heart rate ― including the disorder called POTS.
A more controversial study on exercise intolerance and fatigue is also planned, with the NIH seeking input from certain patient groups who fear that exercise may do more harm than good to some sufferers since long from COVID-19.
For now, the trials are involving 300 to 900 adult participants, but they are likely to expand. Unlike conventional experiments that test one treatment at a time, these more flexible “platform studies” will allow the NIH to add additional potential therapies as they go.
“We can quickly pivot,” explained NIH Dr. Amy Patterson. A failing treatment can be abandoned without ending the whole trial and “if something promising is on the horizon, we can integrate it”.
Anthony Komaroff is a Harvard researcher who is not part of the NIH program, but has long studied an equally mysterious disease, chronic fatigue syndrome or ME/CFS. According to him, the Paxlovid study “makes perfect sense”, and if a 25-day dose shows signs of efficacy, researchers could extend the trial to a longer treatment instead of starting from scratch.
Mr. Komaroff also said that he understands people’s frustration with waiting for these therapeutic trials, but that he thinks the NIH was right to wait “until we have clues about the underlying biology,” adding, “You need to have targets for testing.”
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