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Long COVID affects an estimated 65 million people worldwide and can damage the brain, heart, blood vessels, and immune system long after infection. Researchers now link symptoms to lingering virus, inflammation, micro-clots, and disrupted energy metabolism. While structured rehab and pacing can improve quality of life, a growing list of experimental treatments—from antivirals and metformin to microbiome therapies and biologics—shows early promise. Clear answers, however, are still limited by small studies and the lack of large, definitive trials.Long COVID is defined as symptoms that last at least two months after an initial SARS-CoV-2 infection, with no other clear medical explanation. An estimated 65 million people worldwide are now affected, yet there are still no approved, evidence-based treatments. Researchers are working to better understand what drives the condition and to test a wide range of possible therapies, from structured rehabilitation programs to antivirals, blood thinners, anti-inflammatory drugs, supplements, and new biologic treatments. Scientists believe long COVID is fueled by several overlapping biological problems. These include lingering virus in the body, ongoing low-level inflammation marked by elevated IL-1β, IL-6, and TNF-α, and the formation of tiny blood clots caused by interactions between the viral spike protein and fibrinogen. Other contributing factors include auto-immunity, disruptions in gut bacteria, and impaired mitochondrial function. Together, these processes can damage multiple organs, leading to blood vessel dysfunction, heart inflammation, neuro-inflammation, small-fiber neuropathy, ME/CFS-like fatigue, menstrual changes, problems with blood sugar regulation, and kidney or liver injury. Rehabilitation and Non-Drug Approaches For people with mild symptoms in the early stages, non-drug treatments remain the first option. Clinical trials show that online, group-based physical and mental rehabilitation programs can improve quality of life. Breathing exercises and inspiratory-muscle training have also been shown to boost heart and lung fitness. Additional strategies may include pacing daily activities, cognitive and speech therapy, smell retraining, and dietary counseling. However, exercise that is not carefully supervised can worsen inflammation. For this reason, activity programs need to be gradual and adjusted based on symptoms. Antivirals and Early Treatment Effects Antiviral drugs taken during the initial COVID-19 infection appear to slightly reduce the risk of developing long COVID. In Japan, ensitrelvir lowered long-COVID rates by 25% among out-patients. In high-risk individuals, nirmatrelvir/ritonavir and molnupiravir were linked to about a 25% reduction in risk, while favipiravir showed little benefit. Researchers are also studying monoclonal antibodies that target the spike protein for possible effects on neuro-toxicity, although phase-3 trial results are not yet available. Medications Targeting Specific Symptoms Some treatments focus on particular complications such as clotting, autonomic nervous system problems, and immune imbalance. Low-dose naltrexone has been shown to reduce fatigue and lower platelet aggregation. Apheresis can remove micro-clots and auto-antibodies from the blood, but it is expensive and its benefits tend to be short-lived. Other medications are being tested for symptom relief. β-blockers are used to treat postural-tachycardia syndrome. Famotidine, intravenous immunoglobulin, SGLT-2 inhibitors, and GLP-1 agonists are under investigation for neurological, immune-related, heart, and kidney symptoms. Targeting Inflammation at Its Source Reducing inflammation early appears to be one of the most active areas of research. When started within seven days of infection, metformin lowered the risk of long COVID by 41%, likely by reducing mTOR signaling. Plant-based supplements containing quercetin, curcumin, and piperine improved fatigue compared with placebo. Other approaches include sulphur-thermal-water inhalation and enzymatically liberated salmon oil, both of which lowered CRP levels and helped restore the lung's protective barrier. Baricitinib and rapamycin, which act on JAK and mTOR pathways, are now entering multi-centre trials aimed at interrupting widespread STAT3-driven inflammation. Gut Health, Supplements, and Energy Metabolism Adjusting the gut microbiome may also help. The synbiotic SIM01 eased overall symptoms after six months. Small randomized trials suggest that high doses of vitamins C and D, coenzyme Q10, magnesium, and creatine-glucose blends can improve cellular energy production and blood vessel function. Early-stage studies also report benefits from N-acetyl-cysteine and the amino-acid blend AXA1125, both of which improved mitochondrial respiration and reduced fatigue. Experimental Biologics and Emerging Therapies New biologic treatments are exploring the role of fibrin-driven neuro-inflammation. A humanized antibody that blocks the inflammatory region of fibrinogen is currently in phase-1 trials after animal studies showed protection against neuronal loss. Another experimental therapy, the DNA aptamer BC007, removes G-protein-coupled-receptor auto-antibodies and reversed fatigue and poor capillary blood flow in a single patient, though larger trials are still needed. Other non-drug approaches have shown potential. Hyperbaric oxygen therapy improved cognition, sleep, and pain in a six-month randomized trial. Case series of acupuncture reported reductions in brain-fog and joint pain. Vaccines and Long COVID Outcomes Vaccination provides limited protection against long COVID after breakthrough infections, lowering risk by about 15 to 41%. Among people who already had long COVID symptoms, outcomes after a booster were mixed. About 17% improved, 21% worsened, and 62% saw no change. Where the Science Stands Now Although many potential treatments are showing early promise, most evidence still comes from small or open-label studies that rely on indirect outcome measures. Large, adaptive randomized trials with consistent definitions and biomarker-based patient grouping are urgently needed. Until clearer answers emerge, experts support a flexible, team-based approach that includes early antiviral use, carefully graded exercise, targeted anti-thrombotic and anti-inflammatory treatments, gut microbiome support, and personalized rehabilitation. This strategy reflects the diverse, multi-system nature of long COVID while researchers continue searching for definitive, mechanism-based cures.

Parent Company of Doctor's Best Secures Coveted NDI Letter for NMN Supplement Sales TUSTIN, Calif., Jan. 7, 2026 /PRNewswire/ -- Doctor's Best, a leading nutritional supplement company, announces that its parent company, Xiamen Kingdomway Group, has received a New Dietary Ingredient (NDI) letter from the Food and Drug Administration (FDA) for its beta-Nicotinamide Mononucleotide (NMN) supplements. This FDA action permits the sale of NMN products by Kingdomway and marks a pivotal moment for the company and the broader supplement market. Continue Reading Doctor's Best currently offers three NMN formulations: NMN + Coq10 (150 mg), NMN+ (200 mg), and NMN Delayed Release (400 mg). "We applaud the FDA's decision reaffirming that NMN is lawful and safe for use in dietary supplements," said David Jiang, Chairman of Xiamen Kingdomway Group. "Our NDI recognition marks an important achievement for Kingdomway and reflects our dedication to new ingredient research and development, regulatory compliance, and ingredient efficacy across the industry." Key highlights of the FDA's decision include: Authorization for the sale of beta-Nicotinamide Mononucleotide (NMN) in dietary supplements Reversal of a prior regulatory interpretation that had restricted NMN's market presence Enables Doctor's Best to relaunch its NMN product line and support consumer choice "The FDA's decision reaffirms consumer choice and access to NMN supplements in their pursuit of improved health and longevity," said Gale Bensussen, CEO of Doctor's Best. "It also establishes an important precedent for how DSHEA is interpreted moving forward. Greater regulatory clarity will continue to drive innovation and competitiveness across the nutraceutical sector, ultimately benefiting consumers." Nicotinamide Mononucleotide (NMN) is a bioactive precursor to nicotinamide adenine dinucleotide (NAD+), a coenzyme essential for cellular energy production and metabolic function. Scientific and consumer interest in NMN continues to grow, driven by its potential role in supporting metabolic health and healthy aging. Industry analyses forecast that the NMN supplement category could achieve double-digit compound annual growth over the next decade. Recent research on NMN has shown benefits for muscle function in humans and for neurocognitive function in mouse models, with additional human trials now underway. 1, 2 While the FDA's decision confirms NMN's status under DSHEA, each company must still comply with the New Dietary Ingredient Notification (NDIN) process, applicable labeling, safety, and manufacturing requirements before marketing NMN products. Doctor's Best proudly adheres to the current federal guidelines governing the sale of NMN to consumers. Doctor's Best currently offers three NMN formulations, including NMN + Coq10 (150 mg), NMN+ (200 mg) and NMN Delayed Release (400 mg). To learn more about NMN, Doctor's Best, or to explore the relaunched product line, please visit and follow @DoctorsBestVitamins on Instagram, TikTok and Facebook. 1 NPJ Aging. 2022 May 1;8(1):5. doi: 10.1038/s41514-022-00084-z. 2 Front Pharmacol. 2025 Apr 10:16:1545585. doi: 10.3389/fphar.2025.1545585. About Kingdomway USA Corp. Kingdomway USA Corp. is the U.S. subsidiary holding company of Xiamen Kingdomway Group Company ("XKDW"), a high-tech enterprise of China's National Torch Project. Located in Xiamen, China, XKDW has been publicly listed on the Shenzhen Stock Exchange since October 28, 2011. Since its establishment in November 1997, XKDW has developed and expanded its business of manufacturing pharmaceutical raw materials, and today is considered a leader in the dietary supplement and sports nutrition manufacturing industries. Information with respect to Kingdomway and XKDW's business may be obtained at or in XKDW's profile on the Shenzhen Stock Exchange at . About Doctor's Best® Doctor's Best is a leading, science-based nutritional supplement company driven by a mission to empower families to lead a healthy lifestyle and thrive outside of the doctor's office. Founded by a physician more than 30 years ago, Doctor's Best offers more than 200 products. It has built a stellar reputation in the nutritional supplement industry for using branded ingredients and for demonstrating proven potency, safety, and clinically studied efficacy. All Doctor's Best products are manufactured and rigorously tested exclusively at Current Good Manufacturing Practice (cGMP) certified facilities in the United States. Based in Tustin, California, Doctor's Best products are found on retail sites such as Amazon and iHerb, as well as major retailers and specialty chains, including Walmart.com and Sprouts. For more information, please visit . Media Contact: Marissa Sanchez Buntz, [email protected] SOURCE Doctor's Best 21% more press release views with Request a Demo