_{This content has been medically reviewed by Dr. Thomas Berk}

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Long COVID is a complex and often frustrating condition that can cause a variety of lingering symptoms, including fatigue, brain fog, and exercise intolerance. While there's no one-size-fits-all cure, a range of treatment modalities are being explored to manage symptoms and improve quality of life.

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Pharmacological options

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Medications are often used to target specific Long COVID symptoms:

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• Pain: Over-the-counter pain relievers (analgesics) like acetaminophen or ibuprofen, or stronger prescription medications like gabapentin or pregabalin for nerve pain.
• Fatigue: Stimulants like modafinil may be helpful for some, while others might benefit from certain types of antidepressants that also improve energy levels.
• Respiratory issues: Inhalers can help with breathing difficulties, and in some cases, oxygen therapy may be necessary.
• Sleep disturbances: Sleep aids or melatonin can help improve sleep quality.
• Mood disorders: Antidepressants and anti-anxiety medications can help manage mood changes and anxiety.
• Cognitive impairment: Certain medications may be used to target brain function, memory, and attention.

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Low-dose naltrexone (LDN)

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LDN, typically used for chronic pain and autoimmune conditions, is being investigated for its potential to reduce inflammation and improve fatigue, tremors, and PEM in Long COVID. It may work by modulating the immune system and potentially targeting overactive microglia in the brain.

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Physical and occupational therapy

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Physical therapists can create a personalized exercise plan to help you gradually improve your stamina without triggering post-exertional symptoms. It's crucial to work with a therapist who understands exercise intolerance and is able to adjust your treatment plan.

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Occupational therapists can help you with daily tasks and energy conservation. They can teach you how to modify activities, use assistive devices, and pace yourself to stay within your limits.

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‍Psychotherapy

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Cognitive behavioral therapy (CBT) is a type of therapy that can help you change unhelpful thinking patterns and develop coping strategies for managing Long COVID fatigue, brain fog, and emotional challenges.

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Vestibular rehabilitation therapy (VRT)

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VRT is a specialized type of physical therapy that can help improve balance and reduce dizziness, which are common Long COVID symptoms. It uses exercises to retrain the brain to better process sensory information from the inner ear and the eyes.

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Nutritional support

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Eating a nutritious diet is essential for overall health and can help support energy levels, immunity, and brain function. Maintaining adequate vitamin D levels may help reduce Long COVID severity and improve fatigue and cognitive function.

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Certain supplements may be helpful for managing specific Long COVID symptoms, but it's important to talk to your doctor before starting any new supplements. Some potentially beneficial options include:

• NAC (N-acetylcysteine): An antioxidant that may help with fatigue and brain fog.
• Magnesium: Supports energy production and muscle function, which can help with fatigue and aches.
• Probiotics: May help regulate the immune system and reduce inflammation.
• B vitamins: Important for energy production and nerve function, and may help improve cognitive function.

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Emerging therapies

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Researchers are actively exploring new treatment avenues for Long COVID, including:

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• Antivirals: To target persistent viral reservoirs in the body.
• Immunomodulatory therapies: To regulate the immune system and reduce inflammation.
• Monoclonal antibodies: To neutralize the virus or its inflammatory effects.
• Plasmapheresis: To remove antibodies from the blood, potentially helpful for those with autoimmune-like symptoms.
• Hyperbaric oxygen therapy: To improve oxygenation and reduce fatigue.

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Supportive care

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While we await a definitive cure for Long COVID, supportive care plays a vital role in managing symptoms and improving quality of life:

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• Pacing: Balancing activity and rest to avoid overexertion and PEM.
• Stress management: Reducing stress through relaxation techniques, mindfulness, and other coping strategies.
• Support groups: Connecting with others who understand the challenges of Long COVID can provide emotional support and practical advice.
• Patient education: Learning about Long COVID, its potential long-term effects, and self-management strategies.
• Sleep hygiene: Improving sleep quality through healthy sleep habits.
• Self-advocacy: Learning to advocate for your needs in healthcare and other settings.

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A note from Neura

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Long COVID remains a mystery with no known cure.

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Treatment is individual to each patient, based upon what is evidence-based, and what is most appropriate for their conditions, comorbidities, goals, and needs.

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Please note that we're NOT a Long COVID clinic.

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However, we're dedicated to helping patients find ways to manage lingering neurological symptoms after COVID infection, reduce their impact, and find meaninful improvements in quality of life.

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Book a video visit with a Neura provider today.

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