Evidence-based therapeutic approaches on Long COVID

Which treatment approaches for Long COVID are scientifically evaluated and recommended?

The wide range of symptoms makes it difficult to develop targeted therapies. Therefore, current treatment usually consists of a combination of different approaches that must be individually tailored.

Evidence-based therapeutic approaches

In addition to symptom-oriented treatments, research is examining several conservative and medical procedures that may help relieve symptoms or restore functioning.

• Blood purification procedures (Apheresis):
  Various methods (e.g., HELP apheresis, Inuspheresis, immunoadsorption) aim to remove certain substances, clots, or antibodies from the blood. The scientific evidence is still insufficient; these methods are considered experimental.

• Medications and new substances:
  Some compounds, such as BC007 (Rovunaptabin), are intended to neutralize specific autoantibodies that may play a role in the disease process. These treatments are still under investigation.

• Hyperbaric oxygen therapy:
  In a pressure chamber, patients inhale pure oxygen to increase oxygen levels in the blood. Initial study results are mixed, and clear evidence of efficacy is still lacking.

• Nicotine patches:
  Nicotine is thought to reactivate certain receptors in the body that may have been blocked by the virus. So far, there is no reliable clinical data supporting their effectiveness.

• Mind-body programs:
  Combinations of mindfulness, breathing exercises, relaxation, and meditation may help stabilize the nervous system and reduce physical hyperarousal. The goal is to lessen stress responses and improve overall well-being.

• Activity management (“Pacing”):
  Pacing is a key component in the treatment of Long COVID and ME/CFS. Patients learn to manage their energy carefully, balance physical and mental activity, and recognize early warning signs of overexertion. This helps prevent “crashes,” or severe fatigue episodes triggered by strain.
  Psychotherapeutic support can help patients practice pacing, develop effective routines, and improve self-observation.

• Cognitive Behavioral Therapy (CBT):
  Alongside pacing strategies, CBT can help reduce psychological distress that often arises as a consequence of prolonged illness. It focuses on dealing with physical and emotional challenges in ways that support quality of life despite ongoing symptoms.

Further information on Long COVID treatments is available from Science Cops.