Trial Report Mitigating fatigue in long COVID patients with MYPplus: a clinical observation, 2025, Yu-Jin Choi et al.

Abstract
Purpose
The COVID-19 pandemic has led to the emergence of a secondary public health crisis known as Long COVID. It is estimated that approximately 10% of individuals who contact COVID-19 develop Long COVID, with fatigue and brain fog being among the most commonly reported and debilitating symptoms. However, no standardized or effective treatments are currently available. This observational study aimed to evaluate the efficacy of MYPplus, an herbal formulation composed of Astragali Radix, Salviae Radix, and Aquilariae Lignum, in alleviating fatigue and brain fog in patients with Long COVID.

Methods
Subjects with a score of 60 or higher on the Modified Korean version of the Chalder Fatigue scale (mKCFQ11) or a brain fog rating of 5 or higher on the visual analogue scale (VAS) took two capsules of MYPplus (500 mg per capsule) twice daily for 4 weeks. Changes in symptoms were assessed using the mKCFQ11, Multidimensional Fatigue Inventory (MFI-20), Fatigue VAS, Brain fog VAS, and overall quality of life using the Short-Form Health Survey (SF-12). Additionally, levels of three cytokines (TNF-α, TGF-β, IFN- γ) and cortisol were measured.

Results
Fifty participants successfully completed the 4-week administration with MYPplus. At baseline, fatigue severity was 75.3 ± 10.9 in mKCFQ11, 70.9 ± 11.2 in MFI-20, 7.5 ± 1.2 in Fatigue VAS, 8.4 ± 1.1 in Brain fog VAS, and 45.3 ± 17.8 in SF-12. All parameters significantly improved (p < 0.01), with a decrease of 46% in mKCFQ11, 26% in MFI-20, 49% in Fatigue VAS, and 52% in Brain fog VAS, and an increase of 59% in SF-12, respectively. Unlikely others, the plasma level of TGF-β showed a declining pattern after MYPplus administration (from 765.0 ± 1759.7 to 243.9 ± 708.1 pg/mL, p = 0.07). No safety concerns were observed.

Conclusion
This pilot observational study suggests the clinical potential of MYPplus for managing patients with Long COVID, focusing on fatigue-related symptoms and quality of life. Further studies are required to confirm its efficacy and safety using large-scale randomized placebo-controlled trials in the future.

Protocol registration
This study has been retrospectively registered with the identifier number KCT0008948 on https://cris.nih.go.kr, as of 27/10/23.

Mitigating fatigue in long COVID patients with MYPplus: a clinical observation | BMC Infectious Diseases | Full Text

 

They did a study on this for ME/CFS in 2019 and got null results. Yet they claim that they proved efficacy here:

https://www.s4me.info/threads/the-e...omized-clinical-trial-2019-joung-et-al.11460/

The thread on the previous study consisted of praise for their clear reporting. It seems like they have changed…

Edit: they had null results in the primary endpoint and found something in a secondary subgroup analysis. It seems to be what they are referencing here.

 

A bit of info on what is in this preparation

Astragali Radix (root)
http://www.shen-nong.com/eng/herbal/huangqi.html
https://en.m.wikipedia.org/wiki/Astragalus_mongholicus

Salviae Radix (root)
http://www.shen-nong.com/eng/herbal/danshen.html
https://en.m.wikipedia.org/wiki/Salvia_miltiorrhiza

Aquilariae Lignum (resinous wood)
https://tcmly.com/chen-xiang/
https://en.m.wikipedia.org/wiki/Agarwood

 

They did measure a few things, the change in TGF-β seems notable?

Here’s before, after and change values.

TNF-α (pg/mL)
4.9 ± 26.3
4.0 ± 16.6
1.0 ± 13.5 (p = 0.60)

TGF-β (pg/mL)
765.0 ± 1759.7
243.9 ± 708.1
521.1 ± 1946.3 (p = 0.07)

IFN- γ (pg/mL)
11.7 ± 65.6
33.6 ± 214.3
21.8 ± 148.7 (p = 0.30)

Cortisol (ng/mL)
120.7 ± 30.1
110.7 ± 61.8
10.1 ± 63.8 (p = 0.27)

edit: Looking at the data (there’s an xls file and table in the supplementary data) the TGF-β values are all over the place and I don’t know what to make if it, but wonder if a couple of vey large outliers could have skewed things and these changes may just be due to them/time or something else?

 

Are you able to make a plot?

 

Any sort of statistical analysis or graph generation is a bit beyond me or my iPad at the moment

 

Ah, me too! I’m stuck with my phone