July 8, 2026

expert reaction to RCT on efficacy of anti-histamines, anti-inflammatory, and blood thinner drugs on long Covid-related fatigue

A randomised controlled trial published in Lancet Infectious Diseases looks at the efficacy of several drug types (anti-histamines, anti-inflammatory, and blood thinners) for Long Covid-related fatigue. 

Prof Daniel Altmann, Professor of Immunology, Imperial College London, said:

“Long Covid is estimated to affect some 400-million globally, with massive impact on patients’ lives and on economies, thus the huge incentive for well-designed clinical trials. The current treatment landscape, for those few able to access care, is a rather patchy one of symptom-based approaches. The field has been rather dogged by under-powered and poorly evidenced approaches. STIMULATE-ICP has been a landmark study in this context: a large-scale, evidence-based, randomised control trial. It really is considered a gold standard, benchmark study within the international Long Covid field.

“Using the best candidate drugs from earlier in the appraisal of this disease, the study shows rather modest, short-term benefit, simply showing what an exceptionally challenging condition this is. Disease-mechanism studies are still a work-in-progress. This comes shortly after disappointing findings from trials based on another key approach – using antivirals to eliminate any presumed long-term reservoir of the virus.  As many of the most severe patients are now 5-6 years into this disabling condition, they do need hope from large clinical trials. A number of further ones are in progress or planned.”

‘Efficacy and safety of rivaroxaban, colchicine, and famotidine–loratadine with specialist supportive clinical care for fatigue in patients with post-COVID-19 condition in the UK: a multisite, open-label, randomised controlled trial’ by Amitava Banerjee et al. was published in Lancet Infectious Diseases at 23:30 UK time on Wednesday 8th July. 

Declared interests

Prof Daniel Altmann: “DMA is lead investigator on the Rosetta Stone Study, which investigates shared mechanism in Long Covid and ME studies.”