What you need to know

Most people infected with SARS-CoV-2, the virus that causes COVID-19, recover within about a week. But others have symptoms that linger for weeks, months, or even years after diagnosis, or their symptoms go away but return months later. Known as Long COVID, this condition affects millions of people — as many as one in five who are infected with the virus. The symptoms are extremely variable, can involve nearly any bodily system, and can be debilitating.

As part of its Researching COVID to Enhance Recovery (RECOVER) Initiative, NIH has opened enrollment for clinical trials at sites around the country that will test potential treatments for Long COVID. Treatments include drugs, biologics, medical devices, and other therapies.

What is being tested?

The RECOVER clinical trials will be conducted using “platform protocols,” under which multiple treatments for a single disease can be tested simultaneously. As of August 2023, two protocols are active.

• RECOVER-VITAL will test whether a longer course of Paxlovid, an antiviral drug used to treat acute SARS-CoV-2 infection, is also effective at ridding the body of chronic SARS-CoV-2 infection. Researchers believe that the persistence of the virus in the body may lead to symptoms of Long COVID.

• RECOVER-NEURO will test brain-training and stimulation interventions for brain fog, memory and problem-solving issues, and other cognitive effects of Long COVID. Treatments tested will include web-based brain training and goal management programs and a device used to stimulate brain activity and blood flow.

Additional protocols will launch in the coming months.

• RECOVER-SLEEP will study treatments for changes in sleep patterns and the ability to sleep after having COVID-19. Treatments tested will include drugs that promote wakefulness (to treat excessive daytime sleepiness) and other interventions to improve sleep quality.

• RECOVER-AUTONOMIC will study treatments related to symptoms of the autonomic nervous system, which regulates heart rate, breathing, and digestion, among other functions. The first trials will focus on treatments for people who develop postural orthostatic tachycardia syndrome (POTS) following SARS-CoV-2 infection.

A fifth protocol is being developed to study interventions for exercise intolerance and fatigue associated with Long COVID.

Why is this research important?

Long COVID can wreak havoc on the physical and mental health of those suffering from the disease and continues to have a large impact on the health care system and society as a whole. As crucial as it is to uncover the condition’s causes and learn to prevent it, there is a great need for safe and effective therapies to treat patients currently suffering from the wide range of Long COVID symptoms.

Where can I go to learn more?

NIH Launches Long COVID Clinical Trials Through RECOVER Initiative, Opening Enrollment

• An NIH press release covers details about the new Long COVID study protocols and looks ahead to future ones.

Large Study Allows Researchers to Better Define Long COVID

• A study supported by the RECOVER Initiative identified the most common patient-reported symptoms of Long COVID.

What Long COVID Looks Like in Children and Young Adults

• At least 15 million kids in the United States have been infected with SARS-CoV-2, but it is unclear how many of them have had or are living with Long COVID.