Up to 30% of people who are infected with COVID-19, even asymptomatic and mild cases, will go on to develop long-COVID complications, according to expert estimates. Scientists have been working to understand and treat the causes of lingering symptoms, such as anxiety, brain fog, joint and muscle pain, fatigue, heart palpitations, and shortness of breath, as well as new, debilitating conditions that go beyond those common complaints. That research is paying off with the discovery of new uses for existing medications. 

New Understanding of Long-COVID Causes

According to Bruce Patterson, MD, virologist, long-COVID researcher, and CEO of medical diagnostics company IncellDx, long-hauler syndrome occurs due to an abnormal immune system response. Even after the virus has cleared the body, a long-hauler’s immune system continues to produce proteins called cytokines. These help fight active infections but can cause widespread inflammation and damage if their production isn’t controlled. “These mobile cells go all over the body,” Patterson says. “That’s why the symptoms are so diverse.”

The devastating impact of long COVID on the lives of many of its sufferers drives Patterson’s research. “It is gut-wrenching when I hear these stories of very vibrant, productive people who are on the spectrum from can’t-get-off-the-sofa to bedridden,” Patterson says. “The fatigue is overwhelming for the majority of them. Their exercise intolerance affects their mental health status. They can’t do what they normally do. It’s like having the flu for 12 to 15 months, but without a fever.”

One Long-Hauler’s Struggle

One of these unfortunate cases is Miranda Erlanson. Erlanson, 28, was a healthy middle school teacher, volleyball coach, and stepmom to three before contracting COVID in March of 2020. At the time, she didn’t qualify for a COVID test because she hadn’t been out of the country. An ER physician treated her for bronchitis, but the treatments didn’t work. 

“I became sicker and sicker,” Erlanson said. “I began mixing up some of my words, and I was getting hot flashes. Then I started getting soreness in my ligaments, which at first I thought was from an old volleyball injury. After that, I started getting nauseous.” Other complications included collapsed lungs, difficulty standing, low-grade fevers, and vomiting multiple times a day. She became wheelchair-bound when she could no longer feel her legs. Though she hasn’t needed a ventilator, she does use supplemental oxygen and has been hospitalized three times. 

“My illness has been a grief process because we are grieving the loss of the person I used to be,” she said. “We used to be active members of the community. I ran a half marathon a few days before I got sick.”

Hope from New Research Findings

At the start of 2021, Erlanson had still not recovered, but in February, she participated in a webinar with Patterson and his research collaborators, Purvi Parikh, MD and Ram Yogendra, MD, MPH, the founders of the Chronic COVID Treatment Center. The physicians, in partnership with patients, developed two algorithms that assess changes to the immune system after a COVID infection and predict the severity of individual cases of long COVID. 

Their study led the team to an encouraging realization. “We’ve identified this immune signature that we’ve discovered can direct treatment with drugs that are currently available on the market,” said Patterson. “We direct therapy to the cause.”

Which Drugs Are Helping?

According to Patterson, the three types of drugs he and his partners have found to be beneficial in treating long-COVID symptoms are:

• Glucocorticoid steroids. Glucocorticoids, such as prednisone, halt the inflammation process. 
• Statins. A class of cholesterol-lowering drugs that have recently been shown to prevent inflammation in blood vessel linings. 
• CCR5 inhibitors. Scientists believe that CCR5 inhibitors, originally designed to treat HIV, may block the inflammatory response seen in long-COVID cases.

An experimental CCR5 inhibitor called leronlimab, specifically designed to treat long COVID, is currently in development. Erlanson received the drug during a clinical trial and noticed a significant improvement in her symptoms approximately three days after receiving her first dose on March 16. 

During her participation in the trial, Erlanson said, “I was able to eliminate more than 24 symptoms. I could think without it causing a headache. My lower body was not numb. This treatment got me out of my wheelchair, fixed the partial myoclonic jerks that I was having, and it fixed my nausea. I was able to cook and my husband and kids were able to have a normal mom.”

Looking Forward to Relief

Patterson is thrilled with the results. “Over 80% of our patients get back to 90% or more of their pre-COVID levels,” he said. “The caveat is that they are going to have some level of effects from being debilitated or sedentary for months on end. They will still need to get back in physical shape when their immune system has returned to normal.”

As for Erlanson, in the two months following her last dose of the drug, her symptoms have returned in stages. “I had forgotten how bad it was and how much everything hurt,” she said. “This drug is a shining light.”

CytoDyn, the manufacturer of leronlimab, is awaiting approval for a Phase 3 trial in the U.S. It’s already conducting two Phase 3 trials in Brazil. 

*Drummond, C. (2021, July 5). Existing Drugs May Be Capable of Helping COVID Long-Haulers Recover. Verywell Health. https://www.verywellhealth.com/long-covid-existing-treatment-patient-story-5189914?

Much about the novel coronavirus, i.e., COVID-19, is still not fully understood. As research progresses and our knowledge of the virus increases, information can change rapidly. We strive to update all of our articles as quickly as possible, but there may occasionally be some lag between scientific developments and our revisions.