People living with Long COVID are understandably frustrated by the continuing lack of a cure or at least a comprehensive treatment that would work for everyone across the board to relieve their suffering. It’s true that, despite substantial investments in Long COVID research in North America, Europe, and Asia, there is still no standardized, evidence-based treatment. Many questions remain regarding the best approach to managing and reversing Long COVID, yet treatments are available for individual symptoms. Learn more about the therapies, advancements, and research areas for Long COVID symptom management.*

Rehabilitation and Behavioral Therapies

Given the complex and multisystemic nature of Long COVID, non-pharmacological approaches have proven beneficial and continue to be actively investigated. Some of the most promising interventions include:

• Physical exercise and rehabilitation. Among the 312 registered Long COVID trials, 38 focus on physical rehabilitation. These include structured exercise programs aimed at:
  • Restoring pulmonary function, 
  • Reducing  fatigue, and 
  • Improving overall well-being.
• Behavioral therapy and cognitive rehabilitation. With 13 trials investigating behavioral therapy, cognitive interventions have gained attention for addressing memory and concentration issues often associated with Long COVID.
• Multidisciplinary care models. Some countries, like Spain, have established Long COVID units that integrate multiple specialties, including pulmonology, neurology, and psychiatry, to offer personalized and comprehensive treatment.

Most interventions remain in experimental phases, and their effectiveness varies among individuals. Further studies are required to determine the optimal intensity and duration of rehabilitation strategies.

Addressing the Underlying Pathophysiology

One of the greatest challenges in treating Long COVID is the lack of understanding regarding its underlying biological mechanisms. Research suggests three primary drivers:

• Persistent viral presence. Lingering viral fragments may continue to trigger immune responses, prolonging symptoms.
• Autoimmune reactions. Some studies indicate that Long COVID may be linked to post-infectious autoimmune dysfunction, requiring targeted immunotherapies.
• Tissue damage and dysregulation. Organ damage sustained during acute infection, particularly in the lungs and nervous system, may lead to prolonged health issues.

Future trials must focus on therapies that directly address these mechanisms rather than merely alleviating symptoms. Long COVID studies have also disproportionately focused on White, female, Delta-variant-infected patients while failing to explore broader population variations. A more inclusive research approach is crucial for understanding the full spectrum of Long COVID and ensuring equitable treatment access.

Pharmacological Treatments: Ongoing Research

Pharmacological interventions are among the most widely explored treatments for Long COVID. Clinical trials have tested a range of medications, including:

• Antiviral therapies. Paxlovid, originally developed for acute COVID-19 treatment, has been investigated for its potential to alleviate lingering symptoms, but results remain inconclusive.
• Anti-inflammatory drugs. Fluvoxamine, an SSRI with anti-inflammatory properties, has been tested in multiple trials, but its efficacy against Long COVID symptoms requires further validation.
• Herbal and alternative medicine. Some trials have explored herbal formulations, particularly in Asia, where traditional medicine plays a significant role in healthcare. However, these studies have yet to produce definitive evidence.

Of the 312 clinical trials focused on Long COVID therapies, only 11 have published results, and none have conclusively identified an effective pharmacological treatment. This highlights the urgent need for continued research and larger-scale studies to determine the safety and efficacy of these potential treatments.

*Ramonfaur, D., Ayad, N., Hong Zhi Liu, P., Zhou, J., et al. (2024, September). The global clinical studies of Long COVID. International Journal of Infectious Diseases. https://www.ijidonline.com/article/S1201-9712(24)00176-0/fulltext 

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