r/LongCovidTrials

Here's a pretty interesting study where young, healthy adults received a Bacillus Calmette-Guérin (BCG) vaccine during their acute COVID-19 infection.

BCG vaccines are currently the subject of interest because of their non-specific immunomodulatory effects.

In other words, what this means is that BCG vaccines change how the immune system works across any pathogen it encounters, rather than only tuberculosis (which is what it was designed for).

The BCG vaccine enhances innate immune memory, a phenomenon known as “trained immunity”.

The authors write,

>Trained immunity refers to the innate immune system’s ability to develop a form of immunological memory, resulting in more effective responses to subsequent pathogen exposures.^(30) This process involves the epigenetic and metabolic reprogramming of innate immune cells, particularly monocytes and macrophages, resulting in an enhanced capacity to produce pro-inflammatory cytokines in response to secondary stimuli.^(31)^(,)^(32) In the context of viral infections, including respiratory infections, both epidemiological and experimental studies have suggested that BCG vaccination may provide non-specific protection by reducing the incidence and severity of respiratory diseases.^(33)^(,)^(34)

When subjects received this vaccine during their acute COVID-19 infection, several changes were observed both during the active infection, and in the weeks to months afterward.

The vaccinated subjects demonstrated higher levels of markers TNF-α and sCD40L during their infection, which are consistent with mechanisms of trained immunity. However, these levels than gradually fell over the next weeks and months to levels that were LOWER than in the control group.

Essentially, the researchers believe that when subjects received the vaccine during active infection, it boosted their immune system's ability to respond in the moment - and then they experienced a more rapid resolution of symptoms afterward, perhaps because they got through the initial infection more quickly and with reduced viral load.

There are some pretty interesting takeaways and directions for future research here!

The authors do point out that the study population was young healthy adults, and that the outcome may be different for different patient demographics. BCG vaccines can also differ slightly among the bacterial strains they're designed to target.

So there is a lot more we would need to know before adapting this as a treatment - looking forward to seeing more research on this topic!

Here's a super interesting study out of Japan.

Researchers gave one of the 3 above antivirals to patients during their acute COVID infection. Most of the participants had mild initial infections, and had received 2 or more vaccine doses.

They found that antiviral use reduced the risk of post-COVID condition (PCC), which they defined as as "... persistent reporting of the same prespecified symptom (cough, shortness of breath [difficulty breathing], malaise [fatigue], smell disorder, or taste disorder) on both day 28 and day 84."

Across all 3 antivirals, adjusted analyses showed that the estimated PCC risk was 21.5% among participants receiving antivirals and 25.1% among those not receiving antivirals; accordingly, antiviral use was associated with a lower risk of PCC than no antiviral use.

More specifically, ensitrelvir (Xocova) and molnupiravir consistently reduced the rates of PCC.

Paxlovid (nirmaltrelvir/ritonavir) was also shown to reduce the rate of PCC, however the results did not reach statistical symptoms, which the authors explain may be due to the study's small sample size.

Importantly, they write:

>Our findings differ from those of recent trials evaluating treatment for established PCC, which did not demonstrate a benefit of antiviral therapy.^(26)^(,)^(27) This difference may reflect intervention timing, suggesting that treatment during the acute phase could influence PCC development, whereas later-stage viral suppression may have limited impact once symptoms are established. Although viral load was not evaluated in this study, the lower proportions of smell and taste disorders, hallmark symptoms of COVID-19,^(3)^(,)^(4)^(,)^(28) in participants receiving antivirals are consistent with findings from previous reports of accelerated viral clearance and symptom recovery with ensitrelvir.^(10)^(,)^(20) Because olfactory dysfunction is often underestimated and may contribute to neurocognitive sequelae, these results, together with accumulating evidence linking COVID-19–related olfactory dysfunction to structural and functional brain alterations, raise the possibility that early antiviral treatment may have broader clinical implications.^(28)^(-)^(30)

It's definitely been a bit surprising that, thus far, all of the clinical trials for antiviral use in Long COVID have failed to show results - even though antivirals taken during acute infection do seem to reduce the risk of LC.

The authors note that the timing of intervention appears to be significant. The reduced rates of smell and taste dysfunction among antiviral users suggest that by limiting viral load, these drugs are able to limit the impact the virus has upon the brain.

This study adds to our growing knowledge about the timing of antivirals, and the differences between acute infection and Long COVID.

Of possible note is the fact that this study was funded by Shionogi.

Another recent study did find that BOTH ensitrelvir and Paxlovid reduced the rates of LC at similar rates.

We're excited to see our understanding of these topics growing. The FDA has set a decision date of June 16, 2026 for ensitrelvir, after which it may become available to the US market.

*****

As you may know, we are accepting submissions for our Patient Registry, where we're gathering data on treatment outcomes to submit to the FDA and hopefully increase access!
If you're interested in sharing your experience with any of these antivirals (or other LC treatments) please do let us know! (You can DM us here or email support@longcovidlabs).

Thank you!

On May 12, 2026 the FDA put out a call for a renewed focus on repurposed medications. They signaled their willingness to consider treatment data under existing legislation known as the Real World Evidence (RWE) pathway.  

Real World Evidence is a legal and regulatory pathway that allows the FDA to make decisions about drug approval based on the real life experiences of patients, rather than relying only on clinical trials.  

This pathway can be used to bring answers to patients more urgently.  In the past, RWE has been used to expand access to lifesaving medications based on small numbers of case studies, whereas a full placebo-controlled clinical trial wouldn’t have been ethical.  It has also been used to expand the eligibility criteria for who can receive a certain medication without waiting for expensive, multi-year clinical trials (source).  

In this recent announcement, the FDA signalled that they’re specifically looking to repurpose medications for these conditions - particularly for drugs which don’t currently have much commercial interest.

This is a perfect opportunity for those in the Long COVID Community to make ourselves heard!  

While it thankfully would be inaccurate to say there is no commercial interest in LC, we all know that pharmaceutical investment has been slow, as the companies say they are waiting for more established biomarkers before running trials.

We believe, as many researchers do, that there are existing medications currently sitting unused on shelves right now that could be treating, or even curing people, as in our founder Rohan’s personal experience. 

We are interested in repurposed treatments such as:

• Antivirals: Paxlovid, molnupiravir, anti-EBV medications,  ensitrelvir (which is under review for possible approval as post-exposure prophylaxis) 
• Monoclonal antibodies - Evusheld is what cured Rohan, see also this case study of recoveries from Regen-Cov, we are also gathering data from patients in our Patient Registry who’ve seen improvements on Pemgarda and Sipavibart
• IVIG
• Immunomodulators to increase antiviral immune response - PD-1 inhibitors are an existing treatment for cancer and are about to be studied for Long COVID in an upcoming clinical trial.

The FDA has requested public comment here.  You can share your thoughts and upload any supporting documentation.  The deadline to comment is June 11, 2026.

Long COVID Labs will be submitting a comment ourselves, along with anonymized data from the first round of patients who shared their experiences in our Patient Registry! (We’ll be sharing all of that data open-source with the community - stay tuned for that as well!).

For now we wanted to get the word out.  Anyone who wants the FDA to seriously consider repurposed medications for Long COVID, please do make your voice heard!

In this new paper, researchers from the NIH and UCFS, along with Long COVID patients themselves, argue for a priority shift in Long COVID research funding.

They emphasize that researchers should focus on clinical trials of the treatments most likely to have tangible, near-term results - rather than more abstractly broadening our understanding of the condition.

With a more immediate emphasis on disease-modifying medications, researchers are more likely to discover treatments that work, not only providing help and hope to patients, but also providing evidence to pharmaceutical companies and other potential stakeholders that there ARE answers to be discovered here, and that LC is worthy of future investment.

The authors also explain that the field of LC research has now arrived at a place where we have established a framework of understanding for different possible (and interrelated) disease mechanisms. They write, "The knowledge gained has helped identify possible disease-modifying treatment targets, including several types of immunomodulatory, neurological, antiviral and other drugs, as well as some other therapeutic approaches such as devices^(.")

They also argue that we now have enough of an evidence base to suggest that many of the treatment candidates are likely to be safe for LC patients, whether that is through evidence generated through past clinical trials (as in the case of monoclonal antibodies) or evidence gained through observing use in other diseases (such as GLP-1 agonists).

Additionally, they argue that in the absence of real, established treatments, many LC patients will continue to experiment with unproven, potentially dangerous self-treatments - posing a real risk of harm.

What do you think?

We know the LC community has a range of different opinions on this topic. Some have argued for clinical trials of medications to be top priority (as argued in this paper). Yet we know many others believe we need a more detailed understanding of the mechanisms of Long COVID, as well as biomarkers to know which patients belong to each subgroup, before clinical trials are likely to truly discover meaningful results.

Where do you fall on this range of opinions? Let us know in the comments below!

Lc trial (completion date)

• Tvgn489. Ph2 tbd

• 5b8 / thn391. Ph1 Alzheimer

• Maraviroc 2026 04 DL

• Lumbrokinase 2026 12 DL

• Sipavibart. 2026 12

• Truvada 2026 12 DL

• Vyd2311. Tbd ph2 start mid 2026

• Anktiva 2026 10

• Barticinib 2027 12 / 2029? (Ph3)

• Upadacitinib & pirfenidone 2027 12 (Ph 3)

• Abrocitinib 2026 10

• ensitrelvir 2026 12 DL

• Larazotide 2027 04

• daratumumab tbd ph2 2028?

• Rapamycine 2x 2026 06, 2026 12

• Mestinon 2026 11 (& ldn)

• Vericiguat 2026 12 DL

• Inebilizumab / Uplizna ??

• Bezisterim 2026 08 DL

• semaglutide ??

• Tirzepatide 2027 01

• Anakinra 2028 03

• Pembrolizumab (Keytruda) ?? Ph1

So just wanted to share a list of trials that im following and that have potential in symptom relief or cures. DL means delayed. This is mainly phase 2 trials.

Dates are estimated end dates from clinicaltrial.gov

My personal favorite 5b8 is unclear if it will even be trialled for LC. Anyway thought you guys might like this.

Great to see Nature highlighting the importance of a post-exposure prophylaxis!

Ensitrelvir is currently under review by the FDA with a decision date listed of June 16, 2026. Very much hoping for a positive outcome here!

Paywall free version

​Hi everyone! I’m researching a protocol involving Nattokinase, Serrapeptase, Famotidine, Loratadine, EGCG, and Curcumin for microclots and inflammation. If you’ve tried this combo or a similar regimen, I’d love to hear about your experience. Which dosages worked best for you, whose protocol did you follow, and how long did it take to see results? Any insights on what to expect or specific side effects would be greatly appreciated. Thanks for sharing.

Sooo, since i flooded this sub the past month with questions like “will i be ok???” and “are there any people who experienced the same thing?” I thought it would also be nice to post some positive story.

So today exactly a month ago i received my right sided sgb. I was extremely nervous on beforehand. Not for the treatment itself (honestly, easy peasy, i would rather have 1000 sgb’s at the same time then 1 more labour) but for the outcome and how i would feel after it. My main problem on beforehand was, I just cant describe it otherwise, a fucked nervous system. Whether it was due to myself, stress, covid etc etc, I truly believe that that is the root core. Your nervous system not being able to chill anymore die to whatever reason. I know I Will make enemies by saying this (but i am an MD myself so i kinda also see it from both sides) but also things as mcas, pots, dysautonomia? Wracked/deep fried nervous system. In my opinion at least.

That being sad, my complaints on beforehand were hyperaurasal (higher resting heart rate), fatique after doing nothing, brain fog, anxiety. The usual. I also experience palpitaitons after eating. It all started after I got COVID in the first wave (easy when you’re in the front line) and exacerbated after I gave labour to our daughter. Back then I thought it was post partum anxiety and received high dose Zoloft, which actually worked after five weeks. The next five years i would fluctuate betwreen Allright and good. But I quit my job as an md and never fully recovered.
Because I had a flare last year and did not recover fully yet I decided to try the sgb.
My doc had super good results en believed this could help me.

Unfortunately, the sgb did not have the outcome i hoped. I became super anxious, my heart rate went up after wards and i was so stressed that I was nausious all the time (also diarrhea). That lasted maybe for about three weeks and i would describe it as hell. I was bedbound, and could not take care of our daughter. I slept very poorly and woke up 3 times a night with palpitations. My conclusion (again, don’t get mad): the sgb was just too much for my nervous system or I was so anxious on beforehand I triggered myself into a flare. Eitherway, it sucked.

This last saturday however I started to feel some very light changes. My heart rate went a little down (less high in mornings after waking up and I started to eat a little bit), i could go downstairs for a while and actually play (whilst laying on the couch) with my girl and started Walking outside. The past few days I slowly slowly became better and better.
I am totally not there yet. Definately not. But I am out of that never ending loop of constant stress and anxiety. It comes Rather in waves now.

And I thought it was good to let this sub this know, as they maybe also read my panic posts.

I am not saying you should or shouldnt get the block (tbh if you would ask me right now I don’t think I would do it again, but ask me again In a month?), i am just telling my story hoping it will help people make a proper descision or just that they can read this when they experience the same. I contacted some redditors during my lowest of which some of them were super super sweet so I want to give something back as well.
Just know, you Will be ok. It will get better. And I hope I will for the next days. You can always ask me Anything!

————-
Edit 8/5: I did not expect this post to blow up like this, but I am glad it resonated. As i sad I am totally not a baseline yet (and today is actually a little mweh again) but i will keep hoping to improve the next days/weeks! Feel free to send me a message whenever you need it!

(Xocova= Covid antiviral) I believe I read that it's before the FDA in June for approval. Is this correct? Does anyone know more? Has anyone in the US tried it before? Does anyone know where to obtain it if you live in the US? I've obtained drugs from Canada, so I know it's possible. Curious about any experiences within the CC community with trying it or obtaining it.

Great piece from Dr. W. Michael Brode, an internal medicine doctor who treats LC patients.

He writes that while we are not there yet, the day when we have a real, established biomarker for Long COVID is coming.

This will be amazing news for the LC community, when it happens. We'll finally have a test doctors can order to show what's going on with us. Numerous reachers have noted that pharma companies won't be excited to invest in LC *until* there is a biomarker to show what's going on. So it's encouraging that Dr. Brode doesn't think we're too far off.

However, the downside that we need to be prepared for is that any biomarker test may not be perfect. It may not be able to pick up on everything that's going on with every single patient - and it's not too soon to start acknowledging that. As Dr. Brode writes, "The time to prepare is now, not after people are left behind."

He goes on to explain,

>"Clinics and health systems need clear policies, created in partnership with people with Long COVID and other IACCs, that spell out how care continues when a test comes back negative. That includes protocols for ongoing evaluation, treatment access, and thoughtful referral so that no one is denied the care they need. Researchers should study how treatments perform in people without biomarker positivity: supervised access programs, open-label extensions, and dedicated follow-up groups that collect real-world evidence. "

This is such an important point - we should start laying the groundwork now for how a test will change what care looks like for LC - and for what exactly we should expect for a test.

A test that only tests positive for some patients, but no others whose symptoms are very real, shouldn't be used to exclude those who do test negative.

All this said, it is very encouraging to see a doctor in the Long COVID space say it's not too soon to think about this, and that a biomarker is on the horizon!

Thanks Dr. Brode and The Sick Times for calling attention to this!

Quote of the year (decade?!)

Men’s Health: “Do you think we’ll ever have a cure for long COVID?”

Dr. Peluso: “I wouldn't be working on this if I didn't think that we were going to eventually get to the endgame of having a cure for long COVID. Now I don't think that we're going to have a single cure. I think we'll probably have a set of diagnostic tests to figure out what approach is most likely to work for a specific individual. Then we’ll have a series of treatments or cures based on those diagnoses.”