Opinion The next phase in Long COVID research: addressing the ethical challenges in trials of disease-modifying treatments, 2026, Hendriks

[rvallee]

The next phase in Long COVID research: addressing the ethical challenges in trials of disease-modifying treatments

https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(26)00166-5/fulltext

Spoiler: Authors

Saskia Hendriksa ∙ Christine Grady ∙ Megan L. Fitzgerald ∙ Rachel S. Gross ∙ Christine Maughan ∙ Michael J. Peluso ∙ Sumeeta Varma ∙ Avindra Nath ∙ Annette Rida

Summary

Almost five years after COVID-19 emerged, multiple scientific uncertainties remain about why some people experience ongoing symptoms long after being infected with SARS-CoV-2 (Long COVID). The pathophysiology underlying Long COVID and its potential to represent several endotypes are still under investigation. These scientific uncertainties around Long COVID have been cited as a reason to delay treatment trials until the disease is better understood. In this paper, a group of bioethicists, clinician-scientists and people with lived experience with Long COVID argue that it is ethically imperative to conduct trials of disease-modifying treatments for Long COVID now. Furthermore, we argue that although conducting such trials can pose ethical challenges, these challenges can be overcome through careful research priority-setting, rigorous trial design, fair participant selection, and ensuring that the risk-benefit profile is favorable.

 

[Utsikt]

There’s nothing special about LC in terms of urgency. All disease is urgent to the people it affects.

And there is nothing special about trialling drugs for LC compared to other diseases, other than that lots of trials are done in vain due to too broad inclusion criteria and/or poorly chosen outcome measurements.

 

[Jonathan Edwards]

Furthermore, we argue that although conducting such trials can pose ethical challenges, these challenges can be overcome through careful research priority-setting, rigorous trial design, fair participant selection, and ensuring that the risk-benefit profile is favorable.

Except that if you have no idea what the problem is you don't have anything you can justify trying. With vast numbers of people having LC there must be a few who have incidentally been put on almost every drug in the book and we have not heard of any dramatic improvements.

The risk-benefit profile for all drugs at present is negative.