Use of IVIG for long COVID is experimental, with some small studies showing IVIG may improve some symptoms. Large trials are currently underway. IVIG therapy may be considered in selected cases under specific circumstances.
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About Copay AssistanceWhat Is Long COVID?
Synonyms: Post COVID-19 Condition, Infection-associated chronic condition, long-haul COVID, post-COVID-19 syndrome, post-acute sequelae of SARS-CoV-2 (PASC)
Long COVID is a chronic (long-term) condition. It occurs when an individual affected by the SARS-CoV-2 infection continues to have or develops new symptoms 3 months after initial infection. These symptoms usually last for at least 2 months.
According to a 2022 WHO report, long COVID may affect 10% to 20% of individuals infected by the virus that causes COVID-19 [1].
Long COVID Symptoms
Research shows long COVID may have over 200 symptoms. Common symptoms can include:
- Excessive tiredness, typically after activity
- Brain fog (problems with memory)
- Dizziness
- Shortness of breath
- Changes in smell and taste
- Sleep problems
- Cough
- Headache
- Rapid or irregular heartbeat
- Digestive issues, such as loose stools or constipation
Scientists are studying how COVID-19 causes these symptoms. COVID-19 can affect almost every system in the body.
While the exact mechanism is unclear, long-term illness may result due to:
- Changes in immune system communication, causing the immune cells to attack the body’s healthy cells and tissues (autoimmunity)
- Reactivation of viruses that were previously dormant
- Unfavorable changes in the gut, blood vessels, and certain areas of the brain
IVIG for Long COVID: What Does the Latest Research Say?
Limited evidence suggests IVIG for long COVID may be an option. Below are the findings of the most recent studies.
2021
In a 2021 case report, a 12-year-old girl who developed burning pain, limb weakness, slurred speech, and impaired cognition following COVID-19 received IVIG 2 g/kg/month for 5 months. After IVIG therapy, she achieved overall initial improvement [2].
2023
In a 2023 study, researchers from the University of Kentucky administered IVIG to six participants with long COVID. The most common symptoms in the participants were brain fog, fatigue, chest pain, and shortness of breath.
IVIG treatment was initiated 101 days to 547 days after initial COVID infection. The IVIG dosage used in this study was 0.5 g/kg every 2 weeks for up to one year. At the end of the study, the researchers concluded that IVIG may bring meaningful benefits to patients with long COVID, such as improvements in neurological problems, chest pain, and fatigue [3].
Interestingly, nearly half of the participants in this study reported getting back to “almost normal.”
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2024
According to a 2024 study, IVIG might be a candidate treatment for improving neurological symptoms, fatigue, and disability risk in individuals with long COVID [4]. This study involved 21 participants who received 3 monthly courses of 0.5 g/kg IVIG, along with supportive therapy.
In the study, the control group (29 participants) received only supportive therapy.
Ongoing Research: IVIG for Long COVID
The National Institutes of Health (NIH) is currently conducting a large study to evaluate IVIG for long COVID. Known as Researching COVID to Enhance Recovery (RECOVER), it is one of the world’s largest studies dedicated to understanding, diagnosing, and treating long COVID.
This trial is evaluating three potential treatments:
- Gamunex-C (an IVIG preparation)
- Ivabradine (an oral medicine to lower heart rate)
- Coordinator-guided, non-pharmaceutical care
The result of this trial is scheduled to be presented at the American College of Cardiology (ACC) Annual Conference.
IVIG for Long COVID: What Are the Potential Advantages?
IVIG therapy has been found to be effective in over 100 hematologic, inflammatory, autoimmune, and infectious diseases. Moreover, many studies have established that IVIG can effectively regulate the immune system.
Also, a growing body of evidence suggests that autoimmunity might be one of the drivers of long COVID [5]. Given the demonstrated benefits of IVIG for autoimmune disorders, there is a potential for IVIG for long COVID as well.
IVIG for Long COVID: What Are the Limitations?
First and foremost, the efficacy of IVIG for long COVID has not been established in large trials. Available information about potential benefits is largely based on small studies. Besides, other factors like cost, accessibility, and a lack of standard dose/timing all seem to affect the routine use of IVIG for long COVID.
Current Treatments for Long COVID
Currently, there is no definitive treatment for long COVID. Treatment can vary depending on the bodily systems involved and an individual’s unique signs and symptoms.
Symptomatic treatment aims to relieve specific symptoms in an individual. For example, if they have a fever, a healthcare provider may give them acetaminophen. Likewise, vitamin C may be given to relieve fatigue.
Supportive treatment can include appropriate counseling and talk therapy, such as cognitive-behavioral therapy (CBT).
Other options can include rehabilitation for chronic cough, breathing exercises, and self-monitoring.
Key Takeaways
Because long COVID affects multiple bodily systems and has a wide range of symptoms, health experts agree that IVIG may not work as a standalone therapy. However, IVIG can be a valuable addition to a multidisciplinary treatment approach.
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Talk to a Specialist To Find OutIVIG for Long COVID: Frequently Asked Questions
What is the best treatment for long COVID symptoms?
There is no single best treatment for long COVID. Treatment can be symptomatic, supportive, and rehabilitative, depending on the specific situation. Long COVID treatment requires a multidisciplinary and individualized approach.
Is IVIG used for long COVID?
Studies evaluating IVIG for long COVID are underway. Some small studies show IVIG may improve certain symptoms of long COVID.
What are the top-rated IVIG brands for long COVID?
So far, studies have used only two IVIG brands for long COVID: Privigen and Gamunex-C.
Does insurance cover IVIG for long COVID?
Because the use of IVIG for long COVID is still experimental, it is unlikely that your insurance will cover it.
What medication is used for long COVID fatigue?
Some emerging therapies, such as low-dose naltrexone, are being explored for managing long COVID fatigue.
REFERENCES:
- World Health Organization: WHO. Post COVID-19 Condition (Long COVID). 7 Dec. 2022, www.who.int/europe/news-room/fact-sheets/item/post-covid-19-condition.
- Younger, David S. “Post-acute sequelae of SARS-CoV-2 infection (PASC): peripheral, autonomic, and central nervous system features in a child.” Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology vol. 42,10 (2021): 3959-3963. doi:10.1007/s10072-021-05345-5
- Thompson, John S et al. “Long-term high-dose immunoglobulin successfully treats Long COVID patients with pulmonary, neurologic, and cardiologic symptoms.” Frontiers in immunology vol. 13 1033651. 2 Feb. 2023, doi:10.3389/fimmu.2022.1033651
- Seibert, Felix; Wiemers, Lea; Stervbo, Ulrik; Bertram, Sebastian; Babel, Nina; Westhoff, Timm. INTRAVENOUS IMMUNOGLOBULINS LEAD TO FUNCTIONAL VASCULAR AMELIORATION IN LONG-COVID. Journal of Hypertension 42(Suppl 1):p e128-e129, May 2024. | DOI: 10.1097/01.hjh.0001020620.89001.4b
- Backman, Isabella. “New Evidence Supports Autoimmunity as One of Long COVID’s Underlying Drivers.” Yale School of Medicine, 22 July 2024, medicine.yale.edu/news-article/new-evidence-supports-autoimmunity-as-one-of-long-covids-underlying-drivers.
