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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Some researchers are using electronic health records (EHRs) to tease out the many unknown details about post-COVID conditions (PCC, also known as long COVID). A recent research paper preprint found that PCC symptoms correlated with certain previously recorded sets of health issues (i.e. other symptoms or conditions) either before or while patients were seen for acute COVID-19. These correlations might be useful to create a tool to predict a patient’s risk of developing PCC and to gauge the potential need for future PCC treatment (see Topics to Watch for one emerging option).

Patients with PCC-like symptoms recorded in their EHR were more likely to have pre-COVID-19 records containing irritable bowel syndrome, concussion, nausea/vomiting, shortness of breath, respiratory abnormalities, allergic reactions to food, or circulatory disease. During the acute period of COVID-19, patients with PCC symptoms were more likely to have experienced any of 69 health issues recorded in their EHR. The most common of these were respiratory, circulatory, neurological, digestive, and mental health disorders. 

Additionally, mental health continues to be a casualty of the pandemic and new treatments are needed (see Topics to Watch). Since the Household Pulse Study began in April 2020, about 29 to 43 percent of US adults have reported symptoms of anxiety or depressive disorder compared with an estimated 10 to 12 percent that reported symptoms of anxiety and/or depressive disorder in 2019.

Low-Dose Naltrexone to Treat Post-COVID Conditions

At a Glance

  • Naltrexone is an opioid receptor antagonist approved by the FDA to treat alcohol and opioid use disorders. It is currently being investigated at a low-dose formulation for the treatment of post-COVID conditions (PCC).
  • Low-dose naltrexone has previously demonstrated efficacy in regulating immune function and reducing pain and inflammation in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and fibromyalgia, two conditions which share key features of and might be related to PCC. Pilot studies for PCC further suggest potential benefit.
  • Two phase 2 clinical trials of low-dose naltrexone to treat PCC are ongoing, with primary completion dates before the end of the year. Also, the treatment has been added to a priority list of interventions to be investigated as part of the National Institute of Health’s RECOVER initiative.
  • Generic naltrexone is available from multiple manufacturers and is relatively inexpensive. However, because the FDA has not approved low-dose naltrexone for any condition, it is currently only available from compounding pharmacies.

SAINT Neuromodulation System to Treat Treatment-Resistant Depression

At a Glance

  • The SAINT neuromodulation system is a non–invasive neurostimulation technology intended to treat adults with treatment-resistant depression by helping to restore healthy neural networks.
  • The system delivers an accelerated form of transcranial magnetic stimulation (TMS) to a targeted area of prefrontal cortex, which is involved in regulating mood, and is commonly less active in patients with depression. The SAINT protocol is administered for 5 days, compared with traditional TMS, which typically requires 4 to 6 weeks of treatment.
  • In clinical trials, the SAINT neuromodulation system led to remission rates of 80% to 90% after 5 days of treatment, and an average time to remission in under 3 days.
  • On September 6, 2022, one of its developers announced that the SAINT neuromodulation system received 510(k) clearance from the FDA and plans a limited commercial launch in late 2023.

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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: November 4, 2022

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