USA: The RECOVER Initiative - Long Covid research

4/24/25, UAB Pathology: '"The Path to Understanding Long COVID" By Nathan Erdmann, M.D., Ph.D.

Erdmann: "In the field, but particularly in the media, there's been a lot of trash talk about RECOVER lighting money on fire and not delivering the goods, which I get because you have thousands of patients that are miserable and frustrated and aren't getting treatments - and yet it is a prospective study for a very, very complicated disease and the way perspective studies work, is you put a lot of front end in it and then it starts manifesting later. I get why that is not warmly received, but it is kind of a function of the agreement that we had in the beginning. There are things coming out of this and again we have a really cool trajectory paper that New England Journal actually gave favorable reviews to but then squashed, but it's going to find a home very soon and we'll be able to tell you about what the trajectory looks like of long COVID symptoms in RECOVER. i'm writing and need to be submitting soon, a paper on what happens for people that do and don't have long COVID with their symptoms when they get reinfected.”
 
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VCU Health: 'New study reveals unique long COVID symptoms for young children – what parents need to know'

'Two researchers looking deeper at these issues are Virginia Commonwealth University School of Nursing’s Amy Salisbury, Ph.D., professor and associate dean of research, along with Patricia Kinser, Ph.D., professor and dean of the school, who are part of the Researching COVID to Enhance Recovery (RECOVER) initiative, a nationwide project funded by the National Institutes of Health to better understand how long COVID affects children, teens and young adults. They contributed to a recently publish study in the Journal of the American Medical Association that reveals new symptoms for young children..."
 
Univ. of Utah: 'Research Groundbreakers: What’s Behind Long COVID? Dr. Yue Lu is on The Case'

'Dr. Lu, an Assistant Professor in the Department of Molecular Pharmaceutics at the University of Utah, and a member of the Experimental Therapeutics Program at the Huntsman Cancer Institute, is leading a new research project funded by a RECOVER Pathobiology Award from the National Institutes of Health. Her focus: whether a reawakened virus in the body, Epstein–Barr virus (EBV), might be a hidden driver behind Long COVID'

'Dr. Lu and her team’s long-term goal is to enhance the understanding of Long COVID and related post-infectious syndromes, as well as enable the development of advanced diagnostic tools and precise therapeutic approaches—ultimately improving patient outcomes.'
 
7/2: 'RECOVER’s mid-year milestones: A look at 2025 progress'

"During the first half of the year, RECOVER met enrollment goals for 1 of its clinical trials, launched new pathobiology studies, and continued seeking participants for additional clinical trials and its autopsy study."

'Both the RECOVER-VITAL and RECOVER-NEURO trials have officially closed. Data from these trials are currently under review, with results expected later this year.'

'The RECOVER-AUTONOMIC Severe POTS (IVIG) and RECOVER-AUTONOMIC Moderate POTS (Ivabradine) trials have exceeded monthly enrollment goals for 5 consecutive months. Both trials are on track to complete enrollment this summer. '

'The RECOVER-ENERGIZE Post-Exertional Malaise (Structured Pacing) trial completed enrollment of 300 participants in May—2 months ahead of schedule. The RECOVER-ENERGIZE Exercise Intolerance (Personalized Cardiopulmonary Rehabilitation) trial continues to actively recruit participants at more than 40 sites across the country.'

'RECOVER-SLEEP Hypersomnia (Modafinil/Solriamfetol) and RECOVER-SLEEP Complex Sleep Disturbances (Melatonin + Light Therapy)—the 2 largest RECOVER clinical trials—are making steady progress with enrolling participants at more than 45 sites in the US.'
 
Dakota15 said:
7/2: 'RECOVER’s mid-year milestones: A look at 2025 progress'

"During the first half of the year, RECOVER met enrollment goals for 1 of its clinical trials, launched new pathobiology studies, and continued seeking participants for additional clinical trials and its autopsy study."

'Both the RECOVER-VITAL and RECOVER-NEURO trials have officially closed. Data from these trials are currently under review, with results expected later this year.'

'The RECOVER-AUTONOMIC Severe POTS (IVIG) and RECOVER-AUTONOMIC Moderate POTS (Ivabradine) trials have exceeded monthly enrollment goals for 5 consecutive months. Both trials are on track to complete enrollment this summer. '

'The RECOVER-ENERGIZE Post-Exertional Malaise (Structured Pacing) trial completed enrollment of 300 participants in May—2 months ahead of schedule. The RECOVER-ENERGIZE Exercise Intolerance (Personalized Cardiopulmonary Rehabilitation) trial continues to actively recruit participants at more than 40 sites across the country.'

'RECOVER-SLEEP Hypersomnia (Modafinil/Solriamfetol) and RECOVER-SLEEP Complex Sleep Disturbances (Melatonin + Light Therapy)—the 2 largest RECOVER clinical trials—are making steady progress with enrolling participants at more than 45 sites in the US.'
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There has been no word on Recover TLC for a while. It would be good to know what drugs they are planning to try although not holding my breath after the drug choices for the first round of trials.
 
V.R.T. said:
There has been no word on Recover TLC for a while. It would be good to know what drugs they are planning to try although not holding my breath after the drug choices for the first round of trials.
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They have uploaded this timeline recapping major activities. I believe agent review for the Neurological working group has been completed, one of the patient representatives who is a neurologist and mother to a child with severe Long Covid posted an update on twitter a few weeks ago.

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Drugs being considered and working group members are listed here: https://fnih.org/our-programs/recover-tlc-will-advance-long-covid-research/recover-tlc-therapeutics/

Edit: This is the post I was referring to
 
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Has anyone seen anything about the status of the large studies? The $1.15B stuff? Such as how many of them have completed? How many are left to publish? They communicate many things but frankly they don't say much that's actually informative. I am definitely not informed, despite looking out for it.

I can't say that what I've seen so far adds up to much more than the usual stuff we've seen coming out of pre-LC budgets. For sure we've learned nothing we didn't already know, and they love to say how much they've learned, so I really wonder what the hell they're talking about.
 
Source NM: '‘It’s not over’: New Mexico doctor discusses the lasting effects of COVID-19'

'UNM promotes Long COVID researcher to distinguished professor'

She led clinical trials for acute COVID treatments, including those that established the effectiveness of antiviral remdesivir and anti-inflammatory baricitinib.

Those led Harkins and her team to become involved in the National Institutes of Health’s RECOVER study, which is due to end in October. She and her colleagues have been observing 148 adult patients as part of that study.

Harkins said her team has finished a clinical trial for the oral antiviral Paxlovid, and are currently running two other trials, RECOVER-ENERGIZE Post-Exertional Malaise and RECOVER-SLEEP Complex Sleep Disturbances.

In August, Harkins, Parada and UNM nurse practitioner Debora Bear will join leading Long COVID and other infection-associated chronic condition researchers at a conference in Santa Fe, where they will meet others who manage the disease.
 
'Save the Date for the Second Annual RECOVER-TLC Workshop'

The second annual RECOVER-TLC Workshop is planned for Sept. 9-10, 2025. The workshop will again be hybrid — with in-person and virtual options. This year, we are making several changes based on feedback from the inaugural 2024 workshop:
  • To ensure greater accessibility, the in-person part of the meeting will be held at the Bethesdan Hotel in Bethesda, Md.
  • A room block has been secured at the hotel to accommodate people from outside the region who prefer to attend in person.
Look for updates soon with a meeting agenda, registration link, and more information about hotel accommodations.
 
7/25/25, NIH: 'The NIH RECOVER Program Announces Plan to Request Ancillary Studies’

Issued by National Heart, Lung, and Blood Institute (NHLBI)

'Ancillary studies will build on RECOVER’s robust infrastructure while addressing gaps in knowledge regarding the natural history, pathophysiological mechanisms, and evaluate and validate potential diagnostics or interventions identified through utilization of existing RECOVER biospecimens, data and ongoing long-term follow-up of individuals living with Long-COVID participating in the RECOVER program.’
 
7/30/25, Institute for Systems Biology: 'Unraveling Long COVID: New Insights, Trials, and Hope for the Future'

RECOVER Pacific Townhall

Dr. Jason Goldman
Dr. Katherine Tuttle
Julie Wallick
Lea Dahlke
Ethan Pascual

An in-depth town hall on the latest in long COVID research. This session explores:
  • The launch of RECOVER 2.0, extending research to track long-term outcomes.
  • New findings on sex-based differences in long COVID risk.
  • Links between autoimmune diseases and post-COVID conditions.
  • Patient reflections on living with long COVID and participating in clinical studies.
  • A look ahead at emerging clinical trials targeting inflammation, viral persistence, and symptom management.
Stay informed, hear directly from researchers and coordinators on the front lines of this nationwide effort, and learn what’s next in the search for answers and treatments"

Jason Goldman: "The NIH has given the go-ahead for RECOVER 2.0"

Ethan Pascual: "there's a recent study that came out that a lot of these long COVID patients, they have a higher proportion of fast-twitch fibers, which are basically highly fatiguable fibers, and they can't exert themselves or they'll be exhausted..."

Julie: "we are hoping to open in the next couple months a study with BioVie under Dr. Goldman...it's an anti-inflammatory, and we're specifically looking at people with some cognitive impairment and fatigue. So that will be the cohort we're looking at. And I guess for folks interested, we'll be putting up information once we're open on the Swedish website."

Goldman: "I would say in general, the most exciting trials I think from my perspective are the ones that are looking at antiviral approaches and anti-inflammatory approaches. And, you know, the Bezisterim is one of the interventions, that's the BioVie intervention that Julie was mentioning that does cross the blood-brain barrier, and it works on inflammation. There's, you know, lots of other studies on inflammation that are under investigation now, including some pretty strong immunosuppressive drugs."
 
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'RECOVER-Treating Long COVID (TLC) 2nd Annual Workshop: Pathways to Treatments'

'Draft Agenda - Subject to Change'

'September 9-10, 2025 at The Bethesdan Hotel in Bethesda, Maryland'

Based on the draft agenda, it seems that RECOVER-TLC has selected the following 4 agents to trial next for Long COVID treatment:

Low-Dose Naltrexone
Baricitinib
GLP-1 Receptor Agonists
Stellate Ganglion Block
 
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Maybe i should reply on bluesky but LDN and Baricitinib are already being thoroughly trialed (although I guess LDN is being trialed in ME). GLP1 is an interesting idea I suppose, not sure what the rationale is. As for SGB, I am really skeptical, but I suppose it's better to have a trial than not so we have a clear result.

Deeply disappointing lineup imo.
 
V.R.T. said:
Deeply disappointing lineup imo.
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Agreed. And in anycase I’d rather have it go towards solid biomed research than another treatment trial with long covid (which is such a vague clinical construct very unlikely a treatment works for most cases). If they’re insisting on treatment trial much rather they’d do a well defined subset.

Pinging @Dakota15 given they were interested in knowing people’s opinions.
 
From Ezra Spier (LC Patient Advocate was at Keystone Symposium) on Bluesky:

'A couple important Long COVID clinical trial announcements from Keystone that I want to share!"

"1. BioVie has announced that they changed their protocol and are now allowing people who have had LC for more than 2 years to participate. Here’s the press release: investors.bioviepharma.com/news/news-de...More study sites have been added and more are still to come. More at addresslongcovid.com"

"2. Wes Ely announced that his National Institute of Aging-funded REVERSE-LC trial of baricitinib will now be cosponsored by NIAID as part of RECOVER-TLC and will expand from 4 to 15 sites. The sites are currently being selected, but more info on the trial is here: www.reversinglongcovid.org"

3. "Finally, just a comment from me: the researchers at the conference were incredibly enthusiastic and committed to the field. Funding, logistical, and scientific challenges remain, but the enthusiasm and creativity on display was so energizing (and I've got LC so that really means something)."

 
Dakota15 said:
2. Wes Ely announced that his National Institute of Aging-funded REVERSE-LC trial of baricitinib will now be cosponsored by NIAID as part of RECOVER-TLC and will expand from 4 to 15 sites. The sites are currently being selected, but more info on the trial is here:
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This trial has been enrolling people for a while right? Does this imply they are seeing positive responses? Ofc they wouldn't know if it was drug or placebo at this point, but thats a big expansion and a big investment for RECOVER. Not that they have used their previous funding wisely...
 
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From Bluesky:

'NIH researchers are collecting tissue from people with and without long COVID to see if viral remnants of SARS-CoV-2 persist in the body and whether they differ in type or amount between the two groups.'



8/3/25, NINDS: 'Cross-Sectional Evaluation of Persistence of SARS-CoV-2 Remnants After Recovery From Acute Infection'

Study Contacts: Avindra Nath, M.D. & Angelique A Gavin
 
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