The Briefing provides an at-a-glance view of some important developments in the information universe surrounding COVID-19. The views presented here are solely those of ECRI Horizon Scanning and have not been vetted by other stakeholders.

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In the United States, to date, an estimated 800 000 people have died from COVID-19, and about 50 million people have contracted the disease. In North America, long COVID or Post-Acute Sequelae of COVID-19 (PASC) is prevalent in about 30% of COVID-19 survivors and is characterized by new or continued debilitating symptoms, such as fatigue, shortness of breath, cough, cognitive impairments, and mood disorders, that persist for months after acute infection.

Although vaccines and boosters might reduce the prevalence of long COVID by limiting the spread of COVID-19, and new treatments for mild to moderate COVID-19 (eg, molnupiravir, Paxlovid) might prevent progression to severe disease, there is still a need to treat the millions of patients living with this new, chronic condition. As such, treatments must address damage across various organ systems, including pulmonary, cardiovascular, neurologic, renal, and musculoskeletal systems (see Topics to Watch for 3 potentially disruptive interventions).

Some reports also suggest that the United States is experiencing a rise in youth mental health issues, more diagnoses of prolonged grief disorder, and a growing number of people with long COVID. The consequences of long COVID might include adults who can no longer work and children who can no longer play.

Allogeneic Mesenchymal Stem Cells to Treat Moderate to Severe Pulmonary Symptoms in Long COVID

At a Glance

  • COVI-MSC is a stem-cell-based therapy being investigated to reduce persistent pulmonary symptoms in adults with long COVID.
  • At least one-third of patients with long COVID continue to be affected by breathing difficulty or related lung problems months after acute COVID-19 infection.
  • COVI-MSC might help relieve lingering respiratory symptoms by reducing inflammation and fibrosis in lung tissue.
  • A phase 2 clinical trial is studying the safety and efficacy of COVI-MSC to improve exercise capacity and lung function in adults with moderate to severe long COVID respiratory symptoms. Primary completion is expected in April 2022.

RSLV-132 to Treat Long COVID

At a Glance

  • RSLV-132 is a novel RNase-Fc fusion protein designed to remove proinflammatory RNA in circulation to reduce inflammation in patients with long COVID.
  • Patients with long COVID often experience symptoms such as fatigue and brain fog. Persistent immune disturbances have been associated with these long-lasting symptoms.
  • RSLV-132  digests extracellular RNA to prevent the overactivation of the immune system via Toll-like receptors and the interferon pathway.
  • The treatment is being studied in a phase 2 clinical trial in 70 adults with long COVID, with an estimated primary completion date in March 2022.

Sodium Pyruvate Nasal Spray (N115) to Treat Long COVID

At a Glance

  • Sodium pyruvate nasal spray (N115) is under investigation to treat long COVID symptoms in adults.
  • Sodium pyruvate is a natural antioxidant with anti-inflammatory properties. It is also known to increase endothelial nitric oxide, which has been found to be lowered in COVID-19.
  • A recently completed, open label, single-arm, phase 2/3 clinical trial found that treatment with sodium pyruvate increased oxygen levels and reduced coughing, sneezing, headaches, body aches, and shortness of breath in 22 adults with long COVID.
  • In October 2021, the drug nasal spray’s manufacturer announced that it had submitted data from 17 clinical trials to the U.S. Food and Drug Administration (FDA) to support its use for treating a broad collection of lung and sinus diseases. However, as of mid-December, it appeared that data regarding people with long COVID had not yet been submitted to the FDA.

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Commentary in this COVID-19 Scan reflects preliminary views of ECRI Horizon Scanning and internal ECRI stakeholders.
The information contained in this document has not been vetted by other stakeholders.

We welcome your comments on this Scan. Send them by email to [email protected].

Posted: December 28, 2021

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