Long COVID refers to symptoms that persist or emerge weeks to months after the initial COVID-19 infection and include profound fatigue, cognitive difficulties ("brain fog"), breathlessness, and autonomic dysfunction. It affects an estimated 10–20% of people after COVID-19 infection and remains poorly understood.
What's actually going on in research
Antiviral treatment for Long COVID is in large trials after early studies suggested some patients have persistent virus driving their symptoms. Anti-inflammatory approaches targeting mast cell activation, complement, and microbiome dysbiosis are in trials. Autonomic rehabilitation including structured pacing, heart rate variability training, and low-dose beta-blockers are being tested for the heart rate and fatigue symptoms of postural tachycardia syndrome (POTS) associated with Long COVID.
Antiviral treatment trials
If persistent SARS-CoV-2 viral reservoirs drive Long COVID symptoms, antiviral drugs could help. Trials are testing extended-course antivirals for fatigue, cognitive symptoms, and breathlessness.
Mast cell and immune targeting
Mast cell stabilizers, antihistamines, low-dose naltrexone, and complement inhibitors are being studied based on evidence of ongoing immune dysregulation in Long COVID patients.
Autonomic rehabilitation
Structured pacing programs, compression garments, increased salt and fluid intake, and low-dose beta-blockers are being tested for Long COVID-associated POTS and orthostatic intolerance.
What to know before you search
Eligibility requires persistent symptoms for at least 12 weeks after confirmed COVID-19 infection, specific symptom domains affected, and often exclusion of other explanatory diagnoses.
What types of trials are currently open
- Antiviral trials — Testing whether antivirals targeting viral reservoirs improve Long COVID fatigue and cognitive symptoms.
- Immune modulation trials — Evaluating anti-inflammatory drugs, mast cell stabilizers, and complement inhibitors for Long COVID.
- Rehabilitation trials — Testing pacing protocols, graded exercise (carefully designed to avoid exacerbation), and physiotherapy.
- Autonomic disorder trials — Testing POTS management strategies including beta-blockers, fludrocortisone, and compression.
- Observational studies — Characterizing Long COVID phenotypes, biomarkers, and natural history to guide drug development.
Recently added Long Covid trials
Physical Functions and Lifestyle Behaviours in Post-COVID-19 Syndrome Based on Circadian Rhythms
Post-COVID-19 syndrome is associated with persistent symptoms such as fatigue, reduced physical activity, and impaired respiratory function. Circadian rhythm differences (chronotype) may influence lifestyle behaviors including physical activity, nutrition, and sleep patterns. This observational cross-sectional study aims to compare respiratory muscle strength, physical activity levels, and nutritional habits among individuals with post-COVID-19 syndrome according to their chronotype (morning, intermediate, and evening types). Additionally, genetic analysis of the CLOCK gene polymorphism will be performed to support objective evaluation of circadian rhythm differences. The findings of this study may help to better understand the role of circadian rhythm in post-COVID-19 syndrome and contribute to the development of individualized rehabilitation and lifestyle interventions.
Long-Term Health Effects of Previous COVID-19 in Patients Undergoing Preoperative Anesthesia Evaluation
The COVID-19 pandemic has resulted in persistent health problems in a significant proportion of individuals after recovery from the acute infection. These long-term manifestations, commonly referred to as post-COVID condition or long COVID, may involve respiratory, cardiovascular, neurological, psychological, and general health domains. Understanding these sequelae is particularly important in patients undergoing preoperative anesthesia evaluation, as residual symptoms may influence perioperative risk assessment and clinical decision-making. This cross-sectional observational study aims to evaluate the long-term clinical and health effects of previous COVID-19 infection in adult patients presenting to the preoperative anesthesia clinic. Patients aged 18 years and older who report a history of confirmed COVID-19 infection will be included. Clinical data related to the acute infection period (disease severity, hospitalization, intensive care unit admission, oxygen therapy, and radiological findings) will be retrospectively obtained from hospital records. At the time of preoperative assessment, participants will complete a structured post-COVID clinical questionnaire to evaluate persistent symptoms across multiple organ systems. The study seeks to determine the prevalence and characteristics of long-term post-COVID symptoms and to explore potential associations between acute disease severity and ongoing health complaints. No additional medical intervention will be performed as part of this research.
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