Long COVID ActionCanada

Research that patients can assess · Beta

Long COVID treatment evidence.

Explore findings, evidence limits and Canadian access.

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Showing 21 treatments.

Canadian site listings come from trial registries. Confirm current enrolment, eligibility and the specific drug arm with the study team. Search is limited to these twenty-one entries.

AntiviralEstablished Long COVID

Ensitrelvir

Randomized registry results available

PREVAIL-LC has posted results from 40 participants. The posted primary outcome values alone do not establish a statistically reliable treatment benefit.

PREVAIL-LC registry and posted results

Evidence, trial details and Canadian access

What was found

Trial status

PREVAIL-LC
NCT06161688
active not recruiting

Not accepting new participants.

Registry updated 2026-04-02 · checked 2026-10-13

What remains uncertain

  • Small proof-of-concept trial; five-day regimen and short primary follow-up.
  • The analysis plan is now checked, but a full results report and the primary between-group uncertainty estimate remain unverified.
  • Generalizability to severe/housebound patients is not established by this pilot.
  • The statistical analysis plan was finalized on 21 February 2025, after the registry's 20 December 2024 primary-completion date. Unblinding timing is unverified; these dates alone do not establish outcome switching.

Canada

Canadian authorization, coverage and manufacturer-supported access have not been established in this pilot. SAP is a practitioner-requested process; drug-specific authorization and supply cannot be assumed.

Health Canada Special Access Program

Participation and safety context

PREVAIL-LC: Protocol includes walking, active-stand and cognitive assessments. A PEM questionnaire is included; its presence does not establish that exertional testing is safe for severe or housebound patients.

Missing or unverified harms data must not be interpreted as absence of harm. This pilot does not provide prescribing instructions.

Related LCAC campaign →
Campaign advocacy is separate from this evidence assessment.

Source check: 13 October 2026 · Not independently clinically reviewed · No formal certainty rating assigned

AntiviralIndirect evidence only

Obeldesivir

Acute-COVID results; no established Long COVID trial identified

The identified randomized trials treated acute COVID-19. Their findings do not demonstrate benefit for people with established Long COVID.

OAKTREE acute-COVID randomized trial results · BIRCH acute-COVID randomized trial results

Evidence, trial details and Canadian access

What was found

Trial status

completed

Acute COVID context; not an established Long COVID trial.

Registry updated 2024-12-24 · checked 2026-10-13
terminated

Acute COVID context; not an established Long COVID trial.

Registry updated 2024-12-20 · checked 2026-10-13

What remains uncertain

  • An all-condition obeldesivir registry search returned six studies, none identified as treatment of established Long COVID. This is not a global proof of absence.
  • Reduced viral measures during acute infection do not establish relief of established Long COVID.
  • No direct Long COVID efficacy estimate is calculated.

Canada

Gilead described obeldesivir as investigational in June 2026. A Canadian marketed product or manufacturer-supported Long COVID access route has not been verified. Acute-COVID trial authorization does not establish treatment availability.

Gilead June 2026 statement identifying obeldesivir as investigational

Participation and safety context

These contextual acute-COVID trials do not provide an open Long COVID participation route.

Missing or unverified harms data must not be interpreted as absence of harm. This pilot does not provide prescribing instructions.

Related LCAC campaign →
Campaign advocacy is separate from this evidence assessment.

Source check: 13 October 2026 · Not independently clinically reviewed · No formal certainty rating assigned

Symptom managementLong COVID-associated POTS

Ivabradine

Randomized conference results available; full report review pending

In RECOVER-AUTONOMIC, ivabradine did not significantly improve the main orthostatic symptom score overall. It reduced the heart-rate rise on standing. Conference results also suggest the symptom effect differed by care assignment.

Taub: RECOVER-AUTONOMIC ACC.26 presentation (slides 14 and 16) · RECOVER investigator results announcement

Evidence, trial details and Canadian access

What was found

  • Orthostatic symptom questionnaire. No statistically significant overall symptom difference at three months. Lower scores favour ivabradine; this conference result does not establish equivalence. Adjusted difference: −0.14 points (95% CI −0.72 to 0.43); p=0.63.
  • Change in standing-minus-supine heart-rate rise. The standing-related heart-rate rise decreased more with ivabradine. This physiological result is distinct from symptom improvement. Adjusted difference: −3.95 beats/min (95% CI −6.78 to −1.12); p=0.007.
  • Symptoms after treatment. Uncontrolled observational study; reported improvement is not a placebo-adjusted treatment effect. Reported improvement: 43/55 participants, without a control group.
  • Treatment-by-care interaction in orthostatic symptoms. Care-stratum drug-versus-placebo comparisons; these are not a direct comparison of the two ivabradine groups. Full report review is pending. Drug versus placebo: −1.03 points (95% CI −1.83 to −0.23) with coordinated care; 0.72 (−0.09 to 1.52) with usual care. Interaction p=0.004.

Trial status

RECOVER-AUTONOMIC ivabradine
NCT06305806
completed

Not currently recruiting.

Registry updated 2026-02-20 · checked 2026-10-13
unknown

Current recruitment unverified; last known recruiting status is outdated.

Registry updated 2023-11-29 · checked 2026-10-13

What remains uncertain

  • Numerical results are verified against investigator conference slides; a full peer-reviewed efficacy report was not identified in this scoped search.
  • The care interaction should not replace the overall primary result or be described as proof of universal symptom benefit.
  • COVIVA's 2025 publication is a protocol, not outcome evidence.
  • The platform registry's posted results are enrolment totals; zero-denominator safety rows cannot be read as zero adverse events.
  • Severe/housebound applicability and PEM-specific safety outcomes require further review.
  • A complete comparative harms table has not been verified. Study completion is not a safety outcome.

Canada

Lancora is marketed in Canada for specified chronic heart failure; Long COVID/POTS is not a listed indication. Ontario limited-use code 538 applies to qualifying heart failure, not Long COVID/POTS alone. Other coverage routes and provinces remain unverified.

Health Canada Lancora marketed product record · Health Canada Lancora product monograph · Ontario ivabradine 5 mg limited-use criteria, code 538

Participation and safety context

RECOVER-AUTONOMIC ivabradine: Standing assessments and symptom/function measures; do not advertise this completed trial as recruiting.

COVIVA: Requires confirmation from current investigator information.

Missing or unverified harms data must not be interpreted as absence of harm. This pilot does not provide prescribing instructions.

Source check: 13 October 2026 · Not independently clinically reviewed · No formal certainty rating assigned

AntiviralEstablished Long COVID

Paxlovid

Three published randomized trials; no significant primary benefit

STOP-PASC, PAX LC and RECOVER-VITAL did not show statistically significant improvement on their primary Long COVID outcomes with the tested regimens. These findings concern established Long COVID, not treatment of a new acute infection.

STOP-PASC randomized trial (2024) · PAX LC randomized trial (2025) · RECOVER-VITAL randomized trial (August 2026)

Evidence, trial details and Canadian access

What was found

  • STOP-PASC: symptoms at 10 weeks. A 15-day course did not significantly improve the pooled six-symptom primary outcome versus placebo plus ritonavir. The publication randomized 155 people; the registry count of 168 includes those who consented and were screened.
  • PAX LC: physical health at day 28. Adjusted difference −0.55 PROMIS-29 points (95% CI −2.32 to 1.21; p=0.54), after 15 days of treatment. No significant primary benefit.
  • RECOVER-VITAL: symptoms at day 90. The August 2026 publication reported no significant primary benefit with either 15 or 25 days in cognitive, autonomic or exercise/PEM phenotypes. For 25 days, adjusted differences in clinically significant improvement were 3.2 percentage points (95% CI −10.4 to 16.8), −6.4 (−18.5 to 5.7) and −7.8 (−19.5 to 3.8), respectively.
  • Reported harms. PAX LC reported drug-related events in 35/46 treated participants versus 27/49 controls, commonly altered taste; no serious events through six weeks. RECOVER-VITAL Table 3 reports any adverse event in 212/323 (25-day), 204/320 (15-day) and 185/320 (placebo–ritonavir). Treatment-related serious events affected one participant per group. These descriptive counts do not establish equivalent safety.

Trial status

RECOVER-VITAL full report: Results and Table 3

STOP-PASC
NCT05576662
completed

Trial completed; not recruiting.

Registry updated 2025-09-04 · checked 2026-10-13
completed

Trial completed; not recruiting.

Registry updated 2024-12-02 · checked 2026-10-13
RECOVER-VITAL
NCT05965726
completed

Trial completed; not recruiting.

Registry updated 2026-03-27 · checked 2026-10-13

What remains uncertain

  • Results concern the studied regimens and populations; they do not rule out every antiviral strategy or subgroup.
  • Full-report review confirms that 31 participants belonged to multiple symptom clusters; the phenotype counts must not be summed as unique people. Table 3 supplies arm-level safety counts. Independent clinical interpretation remains pending.
  • Acute treatment and prevention trials are excluded from the Canadian Long COVID treatment recruitment filter.

Canada

Health Canada authorized Paxlovid for acute COVID-19 in people at high risk of severe disease. That does not establish a Long COVID indication or coverage for extended courses. Important drug interactions require clinician/pharmacist review.

Health Canada: Paxlovid acute-COVID authorization · Health Canada: Paxlovid interactions

Participation and safety context

STOP-PASC: 15 days; primary assessment at 10 weeks. Five clinic visits over 15 weeks.

PAX LC: 15 days; primary assessment at day 28. Decentralized US trial with no required site visits.

RECOVER-VITAL: 15 or 25 days; primary assessment at day 90. Symptom and performance assessments.

Missing harms data must not be interpreted as absence of harm. This pilot does not provide prescribing instructions.

Source check: 13 October 2026 · Not independently clinically reviewed · No formal certainty rating assigned

Immune-directed researchLong COVID fatigue; selected ME/CFS overlap

Low-dose naltrexone (LDN)

Observational findings; randomized results pending

A small retrospective study reported symptom improvements, but it cannot establish treatment benefit. The Canadian randomized trial is completed with no registry results posted; LIFT also studies LDN.

Bonilla et al.: retrospective LDN cohort (2023) · BC low-dose naltrexone trial registry · LIFT registry

Evidence, trial details and Canadian access

What was found

  • Retrospective symptom and function changes. Among 59 people with paired questionnaires, LDN use was associated with improvements in fatigue, PEM, sleep and function. Composite symptom scores improved in 32 and worsened in 19. This selected, uncontrolled analysis cannot separate medication effects from other changes.
  • Canadian randomized evidence. The BC trial enrolled 160 participants and completed in February 2026. Its primary outcome measures fatigue at 16 weeks. No registry results were posted when checked; completion and the published protocol are not outcome evidence.
  • LIFT: shared trial with pyridostigmine. One four-arm trial tests LDN, pyridostigmine, their combination and placebo in ME/CFS with orthostatic intolerance, including eligible Long COVID patients. No results posted. The planned 160 participants are shared across the trial. An August 2026 peer-reviewed protocol describes the study design, not treatment results or confirmed current recruitment. An August 2026 peer-reviewed protocol describes the study design, not treatment results or confirmed current recruitment.

Trial status

LIFT peer-reviewed protocol (12 August 2026)

BC low-dose naltrexone trial
NCT05430152
completed

Trial completed; not recruiting.

Registry updated 2026-03-20 · checked 2026-10-13
recruiting

Registry says recruiting but was last updated October 2025; estimated September 2026 primary completion has passed. Current availability requires confirmation.

Registry updated 2025-10-22 · checked 2026-10-13

What remains uncertain

  • Observational findings are vulnerable to selection bias, missing follow-up and confounding.
  • LIFT’s population is narrower than Long COVID as a whole.
  • Comprehensive comparative harms and formal certainty assessment are pending.

Canada

The BC trial used compounded low-dose capsules and is completed. Routine Canadian access, compounding costs and coverage are unverified. LIFT is based in Boston; Canadian participation is not established.

BC low-dose naltrexone trial registry · LIFT registry

Participation and safety context

BC low-dose naltrexone trial: 16-week trial with fatigue questionnaires and blood measures. Completed.

LIFT: Approximately three months, three in-person Boston visits and four virtual visits; two submaximal cardiopulmonary exercise tests, blood and urine collection. Exertional testing can be burdensome with PEM; discuss accommodations and suitability with the study team.

Missing harms data must not be interpreted as absence of harm. This pilot does not provide prescribing instructions.

Source check: 13 October 2026 · Not independently clinically reviewed · No formal certainty rating assigned

Immune-directed researchSelected neurological and autonomic Long COVID

Intravenous immunoglobulin (IVIG)

Small observational signal; randomized results pending

A small nonrandomized study reported improvement in post-COVID small-fibre neuropathy. RECOVER-AUTONOMIC’s IVIG trial is completed with no posted results. An NIH neurological study enrols by invitation.

McAlpine et al.: post-COVID small-fibre neuropathy (2024) · RECOVER-AUTONOMIC IVIG registry · NIH neurological Long COVID IVIG study registry

Evidence, trial details and Canadian access

What was found

Trial status

RECOVER-AUTONOMIC IVIG
NCT06305793
completed

Trial completed; not recruiting.

Registry updated 2026-07-31 · checked 2026-10-13
NIH neurological Long COVID IVIG study
NCT05350774
enrolling by invitation

No Canadian site listed; cross-border eligibility not established.

Registry updated 2026-10-13 · checked 2026-10-13

What remains uncertain

  • Biopsy-confirmed small-fibre neuropathy and selected trial populations do not represent all Long COVID.
  • An observational response comparison is not a randomized treatment effect.
  • Full comparative harms are pending; absent results do not establish safety.

Canada

No Canadian site is listed in these two selected trials. Routine Canadian eligibility, product access and provincial funding for Long COVID are not established in this review.

RECOVER-AUTONOMIC IVIG registry · NIH neurological Long COVID IVIG study registry

Participation and safety context

RECOVER-AUTONOMIC IVIG: Repeated IV infusions over nine months, followed by three months of follow-up; orthostatic symptoms assessed at nine months.

NIH neurological Long COVID IVIG study: Invitation-only NIH study requiring prior protocol participation. Procedures include infusion courses, lumbar puncture, tilt testing and neurological assessments; up to four months.

Missing harms data must not be interpreted as absence of harm. This pilot does not provide prescribing instructions.

Source check: 13 October 2026 · Not independently clinically reviewed · No formal certainty rating assigned

Symptom managementME/CFS with orthostatic intolerance, including eligible Long COVID

Pyridostigmine

Trial listed as recruiting; current availability unconfirmed

LIFT tests pyridostigmine alone and with LDN in people with ME/CFS and orthostatic intolerance, including qualifying Long COVID patients. No results are posted. Current recruitment needs confirmation.

LIFT registry

Evidence, trial details and Canadian access

What was found

  • LIFT factorial trial. The planned 160-person, four-arm trial measures function and exercise-related physiology. It is shared with the LDN entry, not a second independent trial. Registry status says recruiting, but its October 2025 update is old and estimated primary completion has passed. An August 2026 peer-reviewed protocol describes the study design, not treatment results or confirmed current recruitment. An August 2026 peer-reviewed protocol describes the study design, not treatment results or confirmed current recruitment.

Trial status

LIFT peer-reviewed protocol (12 August 2026)

recruiting

Registry says recruiting but was last updated October 2025; estimated September 2026 primary completion has passed. Current availability requires confirmation.

Registry updated 2025-10-22 · checked 2026-10-13

What remains uncertain

  • Trial registration cannot establish benefit.
  • Eligibility requires ME/CFS and orthostatic intolerance; applicability to all Long COVID is uncertain.
  • Exercise testing and travel may limit participation for people with PEM or severe illness.

Canada

LIFT is based in Boston with no Canadian site listed. Cross-border eligibility, routine Canadian prescribing access and coverage are not verified here.

LIFT registry

Participation and safety context

LIFT: Approximately three months, three in-person Boston visits and four virtual visits; two submaximal cardiopulmonary exercise tests, blood and urine collection. Exertional testing can be burdensome with PEM; discuss accommodations and suitability with the study team.

Missing harms data must not be interpreted as absence of harm. This pilot does not provide prescribing instructions.

Source check: 13 October 2026 · Not independently clinically reviewed · No formal certainty rating assigned

Immune-directed researchEstablished Long COVID

Upadacitinib

Canadian sites listed as recruiting; no results posted

LC-REVITALIZE tests upadacitinib and pirfenidone against matched placebo. Its registry lists recruiting sites in Montreal and Sherbrooke. No results are posted; availability of the upadacitinib arm needs confirmation.

LC-REVITALIZE registry

Canadian trial sites listed: Montreal · Sherbrooke
Registry updated 6 October 2026. Specific drug-arm availability unconfirmed.

Evidence, trial details and Canadian access

What was found

  • LC-REVITALIZE platform. The initial phase plans 348 participants across two drugs and placebo groups. The primary outcome tracks the worst baseline symptom domain during follow-up; the registry specifies enrolment through month six. This is not an upadacitinib-only sample, and authorization to run a trial is not evidence of benefit.

Trial status

LC-REVITALIZE
NCT06928272
recruiting

Registry lists Canadian sites as recruiting; site and specific drug-arm availability require confirmation.

Institut de Recherches Cliniques de Montréal (IRCM) — Montreal
Centre de Recherche du CHUS (CRCHUS) — Sherbrooke

Registry updated 2026-10-06 · checked 2026-10-14

What remains uncertain

  • No randomized efficacy or safety results posted when checked.
  • Eligibility criteria and exclusions limit who can participate.
  • A recruiting site listing does not guarantee an open local drug arm, eligibility or enrolment.

Canada

Health Canada lists an authorized LC-REVITALIZE trial. ClinicalTrials.gov lists IRCM in Montreal and CRCHUS in Sherbrooke as recruiting (updated 6 October 2026). Confirm the site, eligibility and upadacitinib arm with the study team. Routine Long COVID access and coverage are not established. Recherche Santé Québec also lists these locations as open but identifies ClinicalTrials.gov as its data source; this is not independent site confirmation. Recherche Santé Québec also lists these locations as open but identifies ClinicalTrials.gov as its data source; this is not independent site confirmation.

LC-REVITALIZE registry · Health Canada: LC-REVITALIZE authorization

Participation and safety context

Recherche Santé Québec: LC-REVITALIZE site listings

LC-REVITALIZE: Three months of study medication with follow-up to six months. Confirm eligibility, visits, monitoring and the locally available drug arm with the study team.

Missing harms data must not be interpreted as absence of harm. This pilot does not provide prescribing instructions.

Source check: 13 October 2026 · Not independently clinically reviewed · No formal certainty rating assigned

Symptom managementEstablished Long COVID fatigue

Famotidine + loratadine

Randomized results; small short-term difference

The tested antihistamine combination produced a small additional fatigue-score improvement at 12 weeks. The difference was not sustained at 24 weeks, and sensitivity analyses weakened confidence in the finding.

STIMULATE-ICP drug trial — full published report (2026)

Evidence, trial details and Canadian access

What was found

Trial status

STIMULATE-ICP drug trial
ISRCTN10665760
completed

Completed UK study; not a Canadian recruitment opportunity.

Published full report; not a fresh registry-status check · checked 2026-10-14

What remains uncertain

  • Open-label study with self-reported fatigue; expectations and missing data can affect estimates.
  • Sensitivity analyses addressing missing data or full treatment completion did not retain statistical significance for the small colchicine and antihistamine differences.
  • No sustained between-group fatigue difference at 24 weeks. This does not establish a cure or benefit for every Long COVID symptom.
  • This trial tested famotidine and loratadine together. It cannot establish either component's independent effect or benefit from all antihistamines.

Canada

Canadian authorization for this use, supply, cost and coverage were not verified in this update. Availability for another condition would not establish benefit for Long COVID.

Participation and safety context

STIMULATE-ICP drug trial: Study drugs for 12 weeks; fatigue questionnaires at baseline, 12 and 24 weeks. Published trial regimens are research descriptions, not prescribing instructions.

Missing harms data do not mean absence of harm. This resource does not provide prescribing instructions.

Evidence source check: 14 October 2026 · Not independently clinically reviewed · No formal certainty rating assigned

Immune-directed researchEstablished Long COVID

Colchicine

Randomized results differ by outcome and timepoint

A UK trial found a small, short-term fatigue difference. A separate placebo-controlled trial in India did not demonstrate better walking-distance improvement at 52 weeks. These findings do not establish a broadly effective treatment.

STIMULATE-ICP drug trial — full published report (2026) · Colchicine randomized trial — India (2025)

Evidence, trial details and Canadian access

What was found

Trial status

STIMULATE-ICP drug trial
ISRCTN10665760
completed

Completed UK study; not a Canadian recruitment opportunity.

Published full report; not a fresh registry-status check · checked 2026-10-14
Colchicine trial — India
CTRI/2021/11/038234
completed

Completed study; not a Canadian recruitment opportunity.

Published completed trial report · checked 2026-10-14

What remains uncertain

  • Open-label study with self-reported fatigue; expectations and missing data can affect estimates.
  • Sensitivity analyses addressing missing data or full treatment completion did not retain statistical significance for the small colchicine and antihistamine differences.
  • No sustained between-group fatigue difference at 24 weeks. This does not establish a cure or benefit for every Long COVID symptom.
  • The trials used different regimens, populations, comparators and outcomes; their estimates should not be pooled casually.
  • The Indian study permitted enrollment from 22 days after infection, although the median interval was much longer. The report uses 346 for the treated population and 319 for the primary outcome analysis.

Canada

Canadian authorization for this use, supply, cost and coverage were not verified in this update. Availability for another condition would not establish benefit for Long COVID.

Participation and safety context

STIMULATE-ICP drug trial: Study drugs for 12 weeks; fatigue questionnaires at baseline, 12 and 24 weeks. Published trial regimens are research descriptions, not prescribing instructions.

Colchicine trial — India: 26 weeks of study medication; primary walking-distance outcome at 52 weeks. Walking assessments may not represent what severely affected or housebound patients can tolerate.

Missing harms data do not mean absence of harm. This resource does not provide prescribing instructions.

Evidence source check: 14 October 2026 · Not independently clinically reviewed · No formal certainty rating assigned

Anticoagulant researchEstablished Long COVID fatigue

Rivaroxaban

Randomized trial did not demonstrate primary-outcome benefit

STIMULATE-ICP did not demonstrate a fatigue benefit over no study drug at 12 weeks. Bleeding events were reported. This trial does not support a general claim that anticoagulation treats Long COVID.

STIMULATE-ICP drug trial — full published report (2026)

Evidence, trial details and Canadian access

What was found

  • Fatigue at 12 weeks. Adjusted difference: −1.06 FAS points (95% CI −2.47 to 0.35); the interval includes no difference. No between-group fatigue difference was demonstrated at 24 weeks.
  • Reported harms. 70/197 participants versus 21/196 receiving no study drug reported adverse events. Minor bleeding or heavy menstrual bleeding was reported in 26/197 rivaroxaban participants. Five serious events in three rivaroxaban participants were judged unrelated to the study drug by investigators.

Trial status

STIMULATE-ICP drug trial
ISRCTN10665760
completed

Completed UK study; not a Canadian recruitment opportunity.

Published full report; not a fresh registry-status check · checked 2026-10-14

What remains uncertain

  • Open-label trial; fatigue and adverse-event reporting can be affected by knowledge of treatment.
  • A confidence interval crossing zero does not prove every possible regimen has no effect.
  • This is one rivaroxaban regimen, not evidence about every anticoagulant or treatment combination.

Canada

Canadian authorization for this use, supply, cost and coverage were not verified in this update. Availability for another condition would not establish benefit for Long COVID.

Participation and safety context

STIMULATE-ICP drug trial: Study drugs for 12 weeks; fatigue questionnaires at baseline, 12 and 24 weeks. Published trial regimens are research descriptions, not prescribing instructions.

Missing harms data do not mean absence of harm. This resource does not provide prescribing instructions.

Evidence source check: 14 October 2026 · Not independently clinically reviewed · No formal certainty rating assigned

Oxygen therapyEstablished Long COVID

Hyperbaric oxygen therapy (HBOT)

Mixed randomized findings; protocols differ

A 40-session trial reported short-term cognitive improvement. Two later 10-session trials did not demonstrate benefit on their main comparisons. Different protocols and outcomes prevent a simple conclusion that more sessions work better.

HBOT 40-session randomized trial (2022) · HOT-LoCO 10-session randomized trial (2025) · Belgian four-group oxygen trial (2025)

Evidence, trial details and Canadian access

What was found

  • 40 sessions: cognitive outcome. The 2022 trial reported a group-by-time difference in global cognition (effect size d=0.495; p=0.038), assessed 1–3 weeks after treatment. Its Results section reports 79 randomized and 73 analyzed.
  • 10 sessions: HOT-LoCO. Among 80 randomized participants, the 13-week between-group differences were 0.63 points for physical functioning (95% CI −7.04 to 8.29) and 2.35 for physical role limitations (−5.95 to 10.66). Neither primary comparison demonstrated benefit.
  • 10 sessions: Belgian four-group trial. 101 participants were randomized to different oxygen/pressure conditions. No significant between-group differences in symptoms, function or cognitive performance were reported after treatment.
  • Reported harms and burden. The 2022 report recorded side effects in 35.1% of HBOT and 38.9% of control participants. HOT-LoCO reported adverse events in 19 HBOT and 18 placebo participants, including a seizure judged probably related to HBOT and a placebo-group death judged unrelated. Four Belgian-trial participants stopped because of middle-ear pressure injury. These findings do not establish that HBOT is safe for everyone.

Trial status

HBOT 40-session trial — Israel
NCT04647656
completed

Completed study; not a current recruitment opportunity.

Published completed trial report · checked 2026-10-14
HOT-LoCO — Sweden
NCT04842448
completed

Completed study; not a current recruitment opportunity.

Published completed trial report · checked 2026-10-14
Four-group oxygen trial — Belgium
HBOT-BELGIUM-2025
completed

Completed study; not a current recruitment opportunity.

Published completed trial report · checked 2026-10-14
recruiting

Canadian registry site listed as recruiting; confirm current openings and eligibility with the team.

Registry updated 2026-02-23 · checked 2026-10-13
Hyperbaric oxygen for post-COVID symptoms
NCT06082518
Canadian study details and contacts
active not recruiting

Ongoing follow-up; registry lists no new recruitment.

Registry updated 2026-09-02 · checked 2026-10-13

What remains uncertain

  • Small studies, differing oxygen pressures, sham procedures, populations and outcomes limit comparison.
  • The 2022 abstract and Results section differ on the randomized count; this summary uses the Results section and keeps analyzed participants separate.
  • Short-term results do not establish durable benefit. The 2022 authors disclosed commercial relationships with AVIV Scientific.
  • Repeated chamber visits and testing can be burdensome. Applicability to severe, housebound or PEM-affected patients needs assessment.
  • HOT-LoCO also reported a later secondary responder finding at 52 weeks; this is distinct from its negative primary 13-week comparisons and requires cautious interpretation.

Canada

The Canadian directory lists RECLAIM HBOT at UHN in Toronto as recruiting and the Sunnybrook study as ongoing without recruitment (registry checks: 13 October 2026). Confirm openings, visits, eligibility and accommodations with the team. Routine Canadian coverage and treatment costs were not verified.

RECLAIM HBOT registry · Sunnybrook HBOT registry · RECLAIM investigator intervention page

Participation and safety context

HBOT 40-session trial — Israel: 40 chamber sessions; outcomes assessed 1–3 weeks after treatment. The Results section reports 79 randomized and 73 analyzed; the abstract calls 73 randomized.

HOT-LoCO — Sweden: 10 chamber sessions over six weeks; primary physical-health outcomes at 13 weeks.

Four-group oxygen trial — Belgium: 10 chamber sessions with four oxygen/pressure conditions; repeated cognitive and walking tests. Travel and attendance burden were reported.

RECLAIM — hyperbaric oxygen: Tests hyperbaric oxygen for Long COVID cognitive symptoms. Ask the team about chamber visits, travel and the assessment schedule. Ask the study team about visits, time, travel, compensation, accessibility and any exertion or testing requirements.

Hyperbaric oxygen for post-COVID symptoms: Studies hyperbaric oxygen treatment for post-COVID symptoms. Follow-up is ongoing; the registry says new participants are not being accepted. Ask the study team about visits, time, travel, compensation, accessibility and any exertion or testing requirements.

Missing harms data do not mean absence of harm. This resource does not provide prescribing instructions.

Evidence source check: 14 October 2026 · Not independently clinically reviewed · No formal certainty rating assigned

Supplement researchEstablished Long COVID; adult and adolescent studies

Taurine

Biomarker association; treatment results pending

Blood taurine levels have been associated with symptom burden, but this does not show that taking taurine improves Long COVID. Canadian adult and adolescent studies are testing different questions; neither registry has posted results.

Taurine biomarker study — observational (2024) · Taurine Supplementation in Long COVID — registry · Taurine Supplementation in Adolescents With Post-COVID Condition — registry

Evidence, trial details and Canadian access

What was found

Trial status

recruiting

Canadian sites listed as recruiting; eligibility and current local openings require team confirmation.

Registry updated 2026-09-18 · checked 2026-10-14
not yet recruiting

Canadian-led; not yet recruiting. Study sites and actual start require confirmation.

Registry updated 2026-08-13 · checked 2026-10-14

What remains uncertain

  • Association does not establish that a deficiency causes symptoms or that supplementation reverses them.
  • Findings from adults initially hospitalized with COVID-19 may not apply to all Long COVID populations.
  • The adolescent study has no placebo group. Blood-level change is not equivalent to clinical improvement.

Canada

The adult trial lists recruiting sites in Alberta, British Columbia, Ontario and Quebec. The adolescent registry says not yet recruiting, has no posted sites and retains an estimated September 2026 start date that has passed. Confirm openings and eligibility with the team. Retail availability does not establish Long COVID benefit; Canadian product authorization and coverage were not assessed.

Taurine Supplementation in Long COVID — registry · Taurine Supplementation in Adolescents With Post-COVID Condition — registry

Participation and safety context

RECLAIM — taurine: 12 weeks of taurine or placebo followed by 12 weeks of follow-up; fatigue and cognitive testing plus other assessments. Confirm visit and exertion requirements with the team.

TaurineLCPeds: Three months of supplementation with blood sampling and symptom/cognitive assessments. Ask about study locations, visit schedule, accessibility, travel and current opening date. The primary outcome is change in blood taurine, not proof of symptom benefit.

Missing harms data do not mean absence of harm. This resource does not provide prescribing instructions.

Evidence source check: 14 October 2026 · Not independently clinically reviewed · No formal certainty rating assigned

Antifibrotic researchLong COVID research; separate post-pneumonia lung-fibrosis evidence

Pirfenidone

Related-condition randomized results; Long COVID platform results pending

A trial after severe COVID-19 pneumonia did not demonstrate better lung recovery with pirfenidone than placebo. That population differs from Long COVID more broadly. LC-REVITALIZE is testing symptom outcomes and has no posted registry results.

FIBRO-COVID randomized trial — post-pneumonia lung fibrosis · LC-REVITALIZE registry

Evidence, trial details and Canadian access

What was found

  • FIBRO-COVID: primary outcome. Of 113 randomized participants, 103 were analyzed. At 24 weeks, the composite improvement outcome occurred in 79.7% receiving pirfenidone and 82.3% receiving placebo. The trial did not demonstrate superiority.
  • Reported harms. Four pirfenidone participants and three placebo participants stopped because of toxicity. The report described similar adverse-event and hospitalization rates and no deaths. This does not establish safety for every patient.
  • LC-REVITALIZE. The planned 348 participants span upadacitinib, pirfenidone and matched placebo groups. This is one shared platform, not 348 people receiving pirfenidone. No registry results were posted when checked.

Trial status

FIBRO-COVID
NCT04607928
completed

Completed Spanish study; not a Canadian recruitment opportunity.

Published completed-trial report; not a new registry-status check · checked 2026-10-14
recruiting

Registry lists Canadian sites as recruiting; site and specific drug-arm availability require confirmation.

Registry updated 2026-10-06 · checked 2026-10-14

What remains uncertain

  • FIBRO-COVID enrolled people with CT lung changes after severe hospitalized pneumonia, 30–90 days after recovery/discharge; it is not a general Long COVID fatigue or brain-fog trial.
  • Most participants were also receiving low-dose prednisone. Improvement within both groups does not establish a drug effect.
  • The 2026 correction adds an author affiliation; it does not change the reported outcomes. Read the correction

Canada

LC-REVITALIZE lists Montreal and Sherbrooke as recruiting. Confirm whether the pirfenidone arm is available locally. Authorization to run a study does not establish treatment benefit or routine Long COVID access; coverage and supply were not verified.

LC-REVITALIZE registry

Participation and safety context

FIBRO-COVID: 24 weeks of treatment with lung function, CT imaging and other assessments; enrolled after severe COVID-19 pneumonia.

LC-REVITALIZE: Three months of study medication with follow-up to six months. Confirm eligibility, visits, monitoring and the locally available drug arm with the study team.

Missing harms data do not mean absence of harm. This resource does not provide prescribing instructions.

Evidence source check: 14 October 2026 · Not independently clinically reviewed · No formal certainty rating assigned

Oxygen therapyPost-COVID cognitive symptoms

Hi-OxSR breathing device

Uncontrolled pilot abstract; randomized results pending

A small open-label pilot reported cognitive and symptom improvements, but without a control group it cannot establish benefit. A Canadian randomized study is testing the device; no results are posted in its registry.

Hi-OxSR open-label pilot abstract — manufacturer-hosted copy · Effect of Hi-OxSR for the Treatment of Post COVID Condition — registry

Evidence, trial details and Canadian access

What was found

Trial status

recruiting

Canadian sites listed as recruiting; eligibility and current local openings require team confirmation.

Older registry marks Edmonton and Sherbrooke not yet recruiting; RECLAIM website lists enrollment open. Confirm the site with the study team.

Registry updated 2025-09-15 · checked 2026-10-14

What remains uncertain

  • The pilot's claims of safety and effectiveness exceed what an uncontrolled abstract can establish.
  • The registry describes participants as knowing group allocation while being masked to the study hypothesis; this should not be presented as a fully blinded trial.
  • Hi-OxSR is distinct from hyperbaric oxygen. Findings from HBOT cannot be transferred to this device.

Canada

The registry lists UHN Toronto as recruiting, while Edmonton and Sherbrooke remain not yet recruiting in the older record. RECLAIM's website lists enrollment open; confirm the specific site. Routine device access, cost and coverage were not verified.

Effect of Hi-OxSR for the Treatment of Post COVID Condition — registry · RECLAIM investigator intervention page

Participation and safety context

RECLAIM-HiOxSR: Three device-use groups over two or four weeks with cognitive follow-up to two months. Device training, monitoring and site visits require confirmation. This is not HBOT or a home-use instruction.

Missing harms data do not mean absence of harm. This resource does not provide prescribing instructions.

Evidence source check: 14 October 2026 · Not independently clinically reviewed · No formal certainty rating assigned

Procedure researchPost-COVID smell distortion; broader Long COVID studies

Stellate ganglion block (SGB)

Parosmia randomized trial negative; broader symptom evidence uncontrolled

A placebo-controlled trial did not demonstrate benefit for persistent post-COVID smell distortion. Uncontrolled studies report broader symptom improvements but cannot establish causation. Canadian trials are testing symptom and functional outcomes.

Stellate ganglion block randomized parosmia trial (2025) · Stellate ganglion block retrospective cohort (2025) · Stellate Ganglion Block for Long COVID Symptoms: A Randomized Controlled Trial — registry · Cervicothoracic Sympathetic Block Evaluation for Post COVID Condition — registry

Evidence, trial details and Canadian access

What was found

Trial status

Stellate ganglion block for post-COVID parosmia
NCT06253806
completed

Completed US study; not a Canadian recruitment opportunity.

Published completed-trial report; not a new registry-status check · checked 2026-10-14
recruiting

Canadian sites listed as recruiting; eligibility and current local openings require team confirmation.

Registry updated 2026-02-09 · checked 2026-10-14
recruiting

Canadian sites listed as recruiting; eligibility and current local openings require team confirmation.

Registry updated 2026-10-09 · checked 2026-10-14

What remains uncertain

  • Small, symptom-specific randomized evidence cannot settle effectiveness for every Long COVID presentation.
  • Uncontrolled improvement does not separate treatment effects from other changes.
  • The parosmia paper's abstract and Table 2 differ in the reported response-difference confidence interval. This summary reports the Table 2 counts and does not reproduce a disputed contrast.
  • No serious event reported in a small trial is not proof that an invasive procedure is risk-free.

Canada

STAR-CO lists Trois-Rivières as recruiting. The Toronto registry lists Toronto Western recruiting and Women's College not yet recruiting. Confirm the site, protocol, eligibility and procedural risks with the study team. Routine Long COVID access and coverage were not verified.

Stellate Ganglion Block for Long COVID Symptoms: A Randomized Controlled Trial — registry · Cervicothoracic Sympathetic Block Evaluation for Post COVID Condition — registry

Participation and safety context

Stellate ganglion block for post-COVID parosmia: A single ultrasound-guided injection, with symptom follow-up at one and three months. Canadian protocols differ.

STAR-CO: Injection procedure with primary symptom/function assessments at four weeks and follow-up through 26 weeks. Ask about procedural risks, monitoring and travel.

CeASE: Two injection procedures over six weeks; symptom and autonomic assessments afterward. Toronto Western is listed recruiting; Women's College is not yet recruiting.

Missing harms data do not mean absence of harm. This resource does not provide prescribing instructions.

Evidence source check: 14 October 2026 · Not independently clinically reviewed · No formal certainty rating assigned

Symptom managementCognitive symptoms in established Long COVID

Guanfacine + N-acetylcysteine (NAC)

Uncontrolled reports; benefit remains uncertain

A small uncontrolled report described cognitive improvements with guanfacine plus NAC. It does not establish that the combination caused the improvement. Low blood pressure and dizziness led some patients to stop treatment.

Guanfacine + NAC: 12-patient case series (online 2022)

Evidence, trial details and Canadian access

What was found

  • Combination: 12-patient case series. Eight of 12 patients reported cognitive improvement. Four discontinued: two for unspecified reasons and two because of low blood pressure and/or dizziness. There was no control group or blinded assessment.
  • Guanfacine alone: separate case report. A 2024 report described improved symptoms and cognitive test performance in one patient over six months. NAC was not part of that treatment. This is not confirmation of the combination or evidence of an average treatment effect.
  • Patient survey: research context. A 2025 ME/CFS and Long COVID survey included the combination. Self-selected, retrospective treatment experiences can inform research questions but do not establish efficacy; concurrent treatments, recall and selection bias limit interpretation.

Trial search

No trial of this combination for Long COVID cognition was identified in the recorded searches. The Long COVID query returned no records; a broader guanfacine search was also screened. Other conditions and guanfacine-only studies do not establish benefit for this combination.

ClinicalTrials.gov: guanfacine and Long COVID search · ClinicalTrials.gov: guanfacine across conditions

What remains uncertain

  • Eight reported improvements out of 12 is not a reliable success rate for future patients. Without a comparison group, natural changes, expectations and other treatments cannot be separated from a drug effect.
  • The case series does not isolate the contribution of guanfacine from NAC. The separate guanfacine-only case must not be pooled as another combination recipient.
  • These small reports cannot establish safety, lasting benefit, or applicability to people with severe disease or post-exertional malaise.
  • No controlled trial of this combination for Long COVID cognition was identified in the recorded search. This targeted search is not proof that none exists.

Canada

No Canadian trial of this combination was identified in this targeted registry search. Canadian authorization for this use, availability and coverage have not been verified. This entry provides no dosing or prescribing instructions.

Evidence source check: 14 October 2026 · Not independently clinically reviewed · No formal certainty rating assigned

Metabolic researchPlanned trial in established Long COVID

Dapagliflozin

Upcoming Canadian trial; no posted registry results

The planned Canadian DALCO trial will compare dapagliflozin with placebo in adults with Long COVID. The registry still says not yet recruiting and has no posted results; it does not establish a Long COVID treatment benefit.

DALCO dapagliflozin trial registry

Evidence, trial details and Canadian access

What was found

  • Planned randomized comparison. The registry plans 192 participants, with dapagliflozin or placebo over 12 months. Its primary outcome is the six-month change in an EQ-5D-derived health utility score. These are design details, not results.
  • Recruitment and evidence status. The record remained not yet recruiting when checked on 15 October 2026. The estimated September 2026 start date has passed, but an estimated date does not establish that recruitment opened. No results are posted in this registry record.

Trial status

Not yet recruiting DALCO · NCT06907251

Canadian study details and contacts

What remains uncertain

  • This entry describes one registered planned study, not a completed evidence review of all dapagliflozin research.
  • There are no posted trial outcome or adverse-event results to interpret. Absence of results is not evidence of safety or benefit.
  • The study excludes several groups, including people with diabetes, prior heart failure or severe renal impairment. Applicability outside the eligibility criteria cannot be assumed.

Canada

The University of Ottawa Heart Institute is the listed Canadian site. Confirm recruitment with the study team. This trial listing does not establish approval for Long COVID, coverage or routine treatment access.

Source check: 15 October 2026 · Not independently clinically reviewed · No formal certainty rating assigned

Symptom managementSleep symptoms after COVID

Modafinil or solriamfetol

Completed trial; no posted registry results

RECOVER-SLEEP tested wakefulness medicines for excessive daytime sleepiness after COVID. The trial is completed, but its registry has no posted results. Long COVID benefit remains unestablished.

RECOVER-SLEEP Modafinil or solriamfetol registry

Evidence, limits and access

What the sources show

Study design. Participants received modafinil or placebo; people unable to take modafinil could receive solriamfetol or placebo. The medicines form one wakefulness-treatment comparison, not two independent trials.

RECOVER-SLEEP Modafinil or solriamfetol registry

Results and harms. No results are posted in this registry record as of 16 October 2026. Completion and enrolment counts are not evidence of benefit or safety.

RECOVER-SLEEP Modafinil or solriamfetol registry

Trial status

completed

361 participants recorded; not enrolling.

Registry updated 2026-06-03 · checked 2026-10-16

What remains uncertain

  • This is a scoped registry summary, not an exhaustive publication review.
  • Effects on PEM, severe Long COVID and long-term functioning cannot be inferred from the study design.
  • Sleepiness, fatigue and post-exertional symptom worsening are different problems; these findings cannot be assumed to apply to all three.

Access and care

This completed study lists US sites only. Canadian Long COVID authorization, supply and coverage have not been verified; a research listing is not a prescribing recommendation.

RECOVER-SLEEP Modafinil or solriamfetol registry

Source check: 16 October 2026 · Not independently clinically reviewed · No formal certainty rating assigned

Symptom managementSleep symptoms after COVID

Melatonin + light therapy

Completed trial; no posted registry results

RECOVER-SLEEP tested melatonin and tailored light for sleep problems after COVID. The completed trial has no posted registry results. This does not establish a Long COVID treatment benefit.

RECOVER-SLEEP Melatonin + light therapy registry

Evidence, limits and access

What the sources show

Study design. The trial compared active or placebo melatonin and active or control light, alongside a tailored sleep schedule. It studied the treatment components within one trial.

RECOVER-SLEEP Melatonin + light therapy registry

Results and harms. No results are posted in this registry record as of 16 October 2026. Completion and enrolment counts are not evidence of benefit or safety.

RECOVER-SLEEP Melatonin + light therapy registry

Trial status

completed

469 participants recorded; not enrolling.

Registry updated 2026-07-08 · checked 2026-10-16

What remains uncertain

  • This is a scoped registry summary, not an exhaustive publication review.
  • Effects on PEM, severe Long COVID and long-term functioning cannot be inferred from the study design.
  • Sleepiness, fatigue and post-exertional symptom worsening are different problems; these findings cannot be assumed to apply to all three.

Access and care

This completed study lists US sites only. Canadian Long COVID authorization, supply and coverage have not been verified; a research listing is not a prescribing recommendation.

RECOVER-SLEEP Melatonin + light therapy registry

Source check: 16 October 2026 · Not independently clinically reviewed · No formal certainty rating assigned

Symptom managementSupportive care for post-exertional symptoms

Pacing and energy management

Symptom-management guidance; not a cure

Pacing adapts activity and rest to a person’s limits to reduce post-exertional symptom flare-ups. It is supportive care, not evidence that Long COVID is cured.

CDC Long COVID clinical guidance · CDC ME/CFS activity-management guidance

Evidence, limits and access

What the sources show

Clinical guidance. CDC Long COVID guidance links to activity-management approaches for PEM. Its ME/CFS resource describes balancing rest and activity within individual limits.

CDC Long COVID clinical guidance · CDC ME/CFS activity-management guidance

What remains uncertain

  • Guidance does not provide a randomized Long COVID effect estimate.
  • Individual limits differ and can change. Physical and mental activity can both trigger delayed symptoms.
  • Pacing should not be turned into fixed activity increases or instructions to push through symptoms.

Access and care

Discuss an individual plan and support needs with a clinician familiar with PEM. This entry does not prescribe an activity target or a graded exercise programme.

CDC ME/CFS activity-management guidance

Source check: 16 October 2026 · Not independently clinically reviewed · No formal certainty rating assigned

Find Canadian clinical trials and studies →
Browse 36 research listings, including recruiting and upcoming studies, with province and participation filters.

Latest evidence update

14 October 2026: Added famotidine + loratadine, colchicine, rivaroxaban and hyperbaric oxygen. Summaries include negative findings, reported harms and study limitations. The Canadian directory retains its separate recruitment-check dates.

Canadian research connections — 14 October 2026

Added taurine, pirfenidone, Hi-OxSR and stellate ganglion block, with direct links to Canadian study listings. The directory now includes an adolescent taurine study marked not yet recruiting; its start date and sites need confirmation.

For information only—not medical advice, diagnosis or treatment. This tracker has not been independently clinically reviewed. Listing a treatment does not recommend it or establish that it is safe or effective. Discuss treatment decisions with a qualified healthcare professional.

How we check evidence

Public beta: Each summary separates study findings, trial recruitment and Canadian access. This is a curated research resource with independent clinical review not performed.

We checked primary publications, investigator reports, ClinicalTrials.gov records and official Canadian information. The initial registry searches were performed on 13 October 2026. Eight summaries were added on 14 October after targeted source checks. Evidence types range from biomarker studies and a pilot abstract to randomized reports; each summary identifies its evidence type and limitations. Search records and unresolved questions are included in the downloadable data. This is not a systematic review or a census of all trials.

A protocol is not a result, and posted enrolment is not proof of efficacy. LIFT is one shared trial linked to both LDN and pyridostigmine. STIMULATE-ICP is one drug trial linked to three treatment summaries, with a shared control group. LC-REVITALIZE is one platform linked to upadacitinib and pirfenidone; its planned total is not an arm-specific sample. Platform parents and drug appendices are linked rather than counted as independent studies.

Canadian recruitment is shown only when a selected Long COVID treatment trial and at least one Canadian site are listed as recruiting. That filter links to LC-REVITALIZE, RECLAIM HBOT, adult taurine, Hi-OxSR and the two Canadian nerve-block trials. Selected registry checks are dated 13–14 October 2026; each trial retains its own date. Site and drug-arm availability require confirmation; the completed BC LDN trial and acute-COVID prevention trials are excluded.

Outdated or conflicting information remains visible. LIFT’s recruiting status needs an update; COVIVA remains unknown. Effect estimates, patient-reported outcomes and physiological measures are kept distinct. No formal certainty ratings are assigned.