I have persistent symptoms after COVID-19 infection or confirmed long COVID, Should I use low-dose naltrexone (LDN) (1.5–6 mg) or continue without LDN?
Research results
Below you will find the results of a group of patients who received LDN compared to patients not taking LDN. The balance between health benefits and harms is a major consideration decide whether or not to make a recommendation about LDN for the treatment of long COVID.
Because the data is not from people with long COVID, it should be interpreted with caution. Real effects in long COVID may differ. Continuous values are pooled using Mean Difference (MD) if all trials have the same scoring system (e.g., a 0–10 scale for pain) with higher values indicating a higher score. If trials use different scales (e.g., 0–10 vs. 0–100 for pain), a Standardized Mean Difference (SMD) is used to pool the data and an SMD of 0.2 is small, 0.5 is moderate, and 0.8 is large effect.
Events per 1000 patients
Taking LDN
Not taking LDN
Health-related quality of life
(4.76 lower to 7.36 higher)
Certainty
Physical functioning
(3.16 lower to 2.36 higher)
Certainty
Pain intensity
(0.49 lower to 0.44 higher)
Certainty
Fatigue
(0.72 lower to 0.52 higher)
Certainty
Mortality
Certainty
Complete recovery
Adverse events
Certainty
*Mean Difference (MD): If all trials use the same scoring system (e.g., a 0–10 scale for pain), the MD is reported in the units of that scale.
**Standardized Mean Difference (SMD): If trials use different scales (e.g., 0–10 vs. 0–100 for pain), data can be converted to SMD for pooled analysis. An SMD of 0.2 is small, 0.5 is moderate, and 0.8 is large.
Comparison
Taking LDN compared to not taking LDN for long COVID
Benefits
Current evidence on using LDN for long COVID is very limited and based on small indirect studies in fibromyalgia and chronic pain. These studies suggest that there is low certainty about the benefits of using LDN. LDN may result in little to no difference in quality of life, physical functioning, pain intensity, and fatigue. The evidence is very uncertain about the effect of LDN on adverse events. The evidence suggests 21 fewer patients per 1000 may experience an adverse event when taking LDN.
The chance of dying is likely the same whether or not you take LDN.