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Fatigue pill: how to beat protracted COVID-19

Antihistamines, commonly used for allergies, can relieve symptoms of prolonged COVID-19, US scientists say. They described two cases where allergy pills helped patients who suffered months of weakness and cognitive impairment after COVID-19. Other similar situations are also known. The authors hope that further research will reveal more about the prospects of such therapy. Many people who recover from COVID-19, even in a mild form, subsequently experience fatigue, headache and muscle pain, cognitive impairment and other symptoms that last for months. To date, there are no effective means of combating protracted COVID-19. But antihistamines can become such, experts from the University of California at Irvine believe. In an article in the Journal for Nurse Practitioners, they described two cases in which patients with symptoms of prolonged COVID-19 experienced relief with allergy pills.

Antihistamines block histamine receptors, a neurotransmitter that is released during various pathological processes - allergic reactions and anaphylactic shock, burns, frostbite. When released, histamine can lead to mucosal edema, itching, colic, decreased pressure, and other symptoms.

Most often, antihistamines are used to relieve symptoms of allergies, but can be used to treat diseases of the stomach and some neurological diseases - for example, hydroxyzine hydrochloride is used in the treatment of anxiety disorders.

A health worker in her 40s contracted the coronavirus in January 2020. Three days after being infected, she experienced a headache and extreme fatigue. A few days later, a rash, chest pain, fever, night sweats appeared. Many of the symptoms persisted even after recovery, in March they were joined by a lack of clarity of consciousness.

In June 2020, a woman developed a cheese allergy and took an antihistamine. Suddenly she felt better, she felt "a significant retreat in fatigue and an improvement in the ability to concentrate."

Then she began to take 50 g of diphenhydramine per day, and a little later she informed her doctor about this. He recommended another drug, hydroxyzine pamoate, which also kept the symptoms under control.

Fatigue, brain fog, chest pains and other symptoms are almost completely gone. The woman was able to return to work and, according to her, reached 90% of her previous working capacity.

For now, however, she is still taking antihistamines and it is not known when they can be discontinued.

The second patient, a middle-aged teacher, has a similar story. A month after being infected with SARS-CoV-2, she still suffered from joint pain, insomnia, heart palpitations and difficulty concentrating. The symptoms persisted for over a year. All this time, the woman took the antihistamine fexofenadine, but then she decided to switch to diphenhydramine, which was easier to buy. The very next morning, the symptoms of prolonged COVID-19 receded slightly. The woman continued to receive, and soon, according to her, her condition improved by 95%. Now she continues to take both drugs.

These stories may seem surprising, but they are not the only ones of their kind, the researchers note.

The symptoms of prolonged COVID-19 are similar to those of myalgic encephalomyelitis, a chronic fatigue syndrome. This disease is poorly understood, but it is known that up to 24 million people worldwide suffer from it.

Now that the number of cases of COVID-19, including protracted ones, is growing, scientists are paying more attention to the similarity of symptoms.

Early attempts to treat chronic fatigue syndrome with antihistamines were unsuccessful (however, in those cases we were talking about small studies with a couple of dozen participants). But according to more recent data, patients with chronic fatigue syndrome show signs of hyperactive immune cells - so perhaps antihistamines may still be effective, at least in some cases.

A small 2021 study found that patients with prolonged COVID-19 also have immune systems on high alert. What's more, those participants who took antihistamines reported that their condition improved and their symptoms subsided.

“Most patients tell us that doctors didn’t recommend anything that would help,” admits nurse Melissa Pinto. —

If patients want to try over-the-counter antihistamines, I encourage them to do so under medical supervision. And since physicians may not be aware of potential new treatments, I would encourage patients to bring research results and case reports like ours to doctor appointments so they can help design a treatment regimen that will work.”

The authors of the work emphasize: in both cases, the patients did not take a test for COVID-19, because PCR testing was not yet widely practiced at that time and the diagnosis was made on the basis of symptoms. However, the researchers hope that this data will serve as a basis for further research and possibly find a way to help people suffering from symptoms of prolonged COVID-19.

Fatigue pill: how to beat protracted COVID-19