The lack of well-documented treatments for long COVID continues to shape both research and clinical practice.
Fatigue, sleep disturbances, and cognitive problems are among the most common symptoms, but the evidence behind most proposed interventions remains limited.
According to Mass General Brigham, cited by Science Daily, the healthcare system is therefore facing a situation with high demand for solutions and few reliable answers.
A biological focus
Some research has turned its attention to the body’s energy metabolism.
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NAD+ is a key molecule in cellular energy production and in the regulation of immune function and inflammation.
According to researchers at Mass General Brigham, previous studies suggest that COVID-19 may disrupt NAD+-related processes, which could potentially contribute to neurological symptoms in people with long COVID.
This has led to interest in nicotinamide riboside, a vitamin B3 derivative that can increase NAD+ levels in the body.
At the same time, the use of dietary supplements for long-term effects remains controversial, as the supporting evidence is often uncertain and effects can be difficult to distinguish from placebo.
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A trial without clear answers
The randomized study, conducted at Massachusetts General Hospital and published in eClinicalMedicine, included 58 people with long COVID.
Participants received either nicotinamide riboside or a placebo, and researchers assessed memory, fatigue, sleep, and mood over a period of up to 20 weeks.
The primary analyses showed no significant differences between the groups on key cognitive measures.
As a result, the study could not demonstrate a clear effect of the treatment compared with placebo.
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A cautious takeaway
In subsequent analyses that were not planned from the outset, improvements were nevertheless observed in self-reported fatigue, sleep, and depressive symptoms among participants who had received the substance for at least 10 weeks.
Some also showed improvements in executive functions, such as planning and task switching.
Because such analyses are considered uncertain, the researchers emphasize that the results cannot be used as a basis for treatment.
For patients with long COVID, this means that the dietary supplement is not a solution, but rather a possible focus for further research.
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Sources: Science Daily, Mass General Brigham, and eClinicalMedicine.
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