The Long COVID Reality: Why Proven Therapies Are Still Missing

With a reported 65 million people worldwide dealing with Long COVID at some point, we have enough research (about time) that indicates that a variety of mechanisms contribute to Long COVID including micro-clots in blood vessels and ongoing inflammation. However, despite a few years under our research belts and millions of people affected, the article points out that we still don’t have approved therapies for this debilitating condition. Despite the inability of the conventional medical world to approve therapies, the article points out that many therapies are showing promise in helping these millions.

Long COVID has become unavoidably accepted to be a condition lasting 2 months after the initial viral infection. Other infections have left patients with long term effects for decades: Lyme, EBV, and others. Yet COVID’s impact is so widespread that mainstream medicine cannot deny it. It includes a long list of symptoms which sound very much like biotoxin illness (think chronic Lyme and mold toxicity) and can be just as debilitating.

From a scientific perspective, the list of potential mechanisms by which Long COVID disrupts lives is very intriguing. From a clinical or patient standpoint, this list of multiple different mechanism exposes both how many symptoms Long COVID has and a variety of therapies, treatments with different effects on different people. The list of likely mechanisms include lingering virus, tiny blood clots from the spike protein, ongoing inflammation, triggering autoimmunity, mast cell activation, gut bacteria disruption, and mitochondrial problems. This variety also makes studying therapies a little difficult; no one size fits all.

Some researchers have focused on prevention, testing out the possibility that early treatment with antivirals or vaccines might prevent future Long COVID. Other therapies like low-dose naltrexone have shown some success, by lowering immune activation and lowering the ability of platelets to stick together and form clots. Some have tried to removed the micro-clots with a filtering process called apheresis.

A variety of other medications for other conditions are being studied also to see if they help Long COVID. Famotidine, a reflux medicine, may help through lowering mast cell activation triggered by the virus. IVIG, used for immune support and PANS/PANDAS, is being trialed to down regulate spike protein inflammation. Even the diabetes medicine metformin may prevent long COVID by lowering a signaling pathway involved in metabolism.

Many natural therapies are also getting attention. We have been using quercetin for a while to help with mast cell activation, but it also has antiviral and anti-inflammatory properties. Curcumin is a long time favorite for lowering inflammation. Probiotics and synbiotics (probiotic plus food for them) have shown benefits in many. Vitamin C, coQ10, Vitamin D, magnesium, and creatine have improved mitochondria function in others. Even hyperbaric oxygen therapy and acupuncture have shown some promise.

Beyond these possibilities mentioned by this article, we see some patients respond to other therapies. This includes the infamous horse dewormer, also known as ivermectin. It also includes addressing previously-existing toxicities the patient was unaware of until COVID set the dumpster on fire in their bodies. We also use natural enzymes to break down the micro-clotting that decreases blood flow to brain and muscles along with enzymes to break down the spike protein.

Of course, none of this is officially approved and we could just focus on physical therapy, on the very slow rehabilitation that many long COVID clinics offer. Many take this option and see slow improvement, but we have seen faster improvement with targeted therapies that match our patient’s symptoms and suspected mechanisms. That is the most critical key to remember: not all Long COVID patients are exactly the same. Separating them out into different groups definitely makes helping them much easier than trying to a one-size-fits-all approach.

Helping patients restore healthier, more abundant lives always requires a big scoop of individualizing the protocols.   

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Original Article:

Jingya Zhao, Yingqi Lyu, Jieming Qu. Insights into potential therapeutic approaches for long COVID. Frontiers of Medicine, 2025; 19 (5): 879 DOI: 10.1007/s11684-025-1149-z

Thanks to Science Dialy:

Higher Education Press. "Long COVID may be fueled by inflammation and tiny clots." ScienceDaily. ScienceDaily, 8 January 2026. www.sciencedaily.com/releases/2026/01/260107225532.htm