Low-dose naltrexone use for the management of post-acute sequelae of COVID-19

Int Immunopharmacol. 2023 Nov;124(Pt B):110966. doi: 10.1016/j.intimp.2023.110966. Epub 2023 Oct 5.

Abstract

The global prevalence of Post-Acute Sequelae of SARS-CoV-2 Infection (PASC) stands at approximately 43 % among individuals who have previously had acute COVID-19. In contrast, in the United States, the National Center for Health Statistics (NCHS) estimates that around 11 % of individuals who have been infected with SARS-CoV-2 go on to experience long COVID. The underlying causes of PASC remains under investigation, and there are no currently established FDA-approved therapies. One of the leading hypotheses for the cause of PASC is the persistent activation of innate immune cells with increase systemic inflammation. Naltrexone is a medication with anti-inflammatory and immunomodulatory properties that has been used in other conditions that overlap with PASC. We performed a retrospective review of a clinical cohort of 59 patients at a single academic center who received low-dose naltrexone (LDN) off-label as a potential therapeutic intervention for PASC. The use of LDN was associated with a fewer number of symptoms, improved clinical symptoms (fatigue, post-exertional malaise, unrefreshing sleep, and abnormal sleep pattern), and a better functional status. This observation warrants testing in rigorous, randomized, placebo-controlled clinical trials.

Keywords: LDN; Long COVID; Long haulers; Naltrexone; PASC; Post-acute sequelae of COVID-19; Treatment.

MeSH terms

  • COVID-19*
  • Disease Progression
  • Humans
  • Naltrexone / therapeutic use
  • Post-Acute COVID-19 Syndrome
  • SARS-CoV-2

Substances

  • Naltrexone