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University of Nebraska Medical Center

NIH opens long COVID trials to evaluate treatments for autonomic nervous system dysfunction

NIH

Two phase 2 clinical trials to test the safety and effectiveness of three treatments for adults with autonomic nervous system dysfunction from long COVID have begun. The autonomic nervous system acts largely unconsciously and regulates bodily functions, such as heart rate, digestion and respiratory rate. Symptoms associated with autonomic nervous system dysfunction have been among those that patients with long COVID say are most burdensome. The trials are part of the National Institutes of Health’s Researching COVID to Enhance Recovery (RECOVER) Initiative, a nationwide research program to fully understand, diagnose and treat long COVID. Other RECOVER phase 2 clinical trials testing treatments to address viral persistence and neurological symptoms, including cognitive dysfunction (like brain fog), launched in July 2023.

“As a long COVID patient, I know firsthand how disruptive and frightening symptoms including rapid heart rate, dizziness and fatigue can be. Patient representatives across RECOVER have also shared that these symptoms are some of the most debilitating symptoms of long COVID,” said Heather Marti, co-chair of the RECOVER National Community Engagement Group. “These trials are giving me and others with long COVID hope that it will restore our health and get us back to the lives we so desire.”

The two trials, collectively known as RECOVER-AUTONOMIC, are testing three potential treatments in adults who, following COVID-19, now have postural orthostatic tachycardia syndrome (POTS). An autonomic nervous system disorder, POTS is characterized by unexpected fast heart rate, dizziness, fatigue or a combination of these symptoms when a person stands up from sitting or lying down. 

“The trials were developed with input from people living with long COVID, caregivers, community representatives, clinicians and scientists all with unique expertise in the field,” said Gary H. Gibbons, M.D., director of the National Heart, Lung, and Blood Institute at the NIH and co-chair of RECOVER. “We are grateful for their collective involvement which significantly shaped the trials and the choice of interventions.”

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