Common over-the-counter medications may provide relief for people with long COVID-19 symptoms

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Widely available over-the-counter antihistamines have the potential to restore daily function.

Antihistamines can bring relief to the millions of people suffering from the painful and debilitating symptoms of long COVID-19[female[feminine that interfere with day-to-day functioning. That’s the conclusion of a case report on the experiences of two such patients co-authored by nursing scholars at the University of California, Irvine.

The effects of COVID-19 on individuals range from mild symptoms to several weeks of illness, to conditions such as brain fog, joint pain, exercise intolerance and fatigue that last for months after the onset of illness. initial infection. The clinical term for these long lingering effects of COVID-19 is post-acute sequelae of SARS-CoV-2for which there is no standard treatment.

“Patients tell us that they wish more than anything to be able to work and do the most basic activities they were used to before getting sick with long COVID. They are desperate for something to help them get back on their feet,” said the report’s corresponding author, Melissa Pinto, associate professor of nursing at UCI. “Currently, there is no cure for PASC, only symptom management. A number of options are being tried, including antihistamines. The possibility that an easily accessible over-the-counter medication may Alleviating some of the symptoms of PASC should give hope to the estimated 54 million people around the world who have been in distress for months or even years.

Melissa Pinto

“Patients with long-term COVID are desperate to get back on their feet and get relief from symptoms that affect their ability to function. The case report describes the experiences of two PASC patients and shows the potential benefits of using antihistamines, under medical supervision, to treat their symptoms,” says Melissa Pinto, UCI Associate Professor of Nursing. Credit: Sue & Bill Gross School of Nursing / UCI

The case report, recently published in The Nurse Practitioner Journal, describes two healthy, active middle-aged women with PASC who discovered, by chance, that antihistamines produced a dramatic improvement in daily function, now maintained for almost a year. Both took over-the-counter antihistamines to treat other conditions – the first had triggered her dairy allergy by eating cheese, and the other had run out of allergy medication she usually took – and experienced improved cognition and much less fatigue the next morning. The first woman’s long COVID-19 symptoms also included exercise intolerance, chest pain, headache, rash and bruising, while the second faced joint and abdominal pain, as well than to rashes and sores called “COVID toes.”

In the first case, the woman did not take another antihistamine for 72 hours; when her symptoms returned, she took the medicine and again found relief. With advice from her primary health care provider, who prescribed an antihistamine, she started a daily dose that significantly reduced her other long-running COVID-19 symptoms. She said she had regained 90% of her pre-COVID-19 daily functions.

In the second case, the woman took another over-the-counter antihistamine to replace what she had been taking for years to manage her seasonal allergies. After noticing that her long-term fatigue and cognition related to COVID-19 had improved, she continued to take it daily along with other allergy medications. Her treatment, which now includes both over-the-counter medications, has also significantly reduced her long, additional symptoms of COVID-19. She reported that she had regained 95% of her pre-illness functioning.

Previous studies, including those of Journal of Investigative Medicine and Pulmonary and Therapeutic Pharmacologyalso showed the potential benefit of antihistamines in the treatment of PASC.

“Most patients tell us that providers didn’t recommend anything that helped them. If patients wish to try over-the-counter antihistamines, I urge them to do so under medical supervision. And because providers may not be aware of potential new treatments, I would encourage patients to be active in their care and to consider taking research and case reports like ours to appointments with providers so they can help create a plan that will work,” Pinto said. “The next steps in this antihistamine treatment research are to conduct large-scale trials to assess efficacy and to develop dosing regimens for clinical practice guidelines.”

Reference: “Antihistamines for post-acute sequelae of SARS-CoV-2 infection” by Melissa D. Pinto, Natalie Lambert, Charles A. Downs, Heather Abrahim, Thomas D. Hughes, Amir M. Rahmani, Candace W. Burton and Rana Chakraborty, February 7, 2022, The Nurse Practitioner Journal.
DOI: 10.1016/j.nurpra.2021.12.016

Other co-authors of the report are Amir Rahmani and Candace Burton, associate professors of nursing at UCI; UCI graduate nursing students Thomas Hughes and Heather Abrahim; Natalie Lambert, research associate professor of biostatistics and health data science at Indiana University School of Medicine; Dr. Rana Chakraborty, pediatric infectious disease specialist at the Mayo Clinic; and Charles Downs, associate professor in the School of Nursing & Health Studies at the University of Miami.

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