Lithium Aspartate for Long COVID Fatigue and Cognitive Dysfunction: A Randomized Clinical Trial

Area of Science:

• Neurology
• Pharmacology
• Infectious Diseases

Background:

• Neurologic post-COVID-19 condition (PCC), or long COVID, significantly impacts millions with persistent fatigue and cognitive dysfunction.
• Current therapeutic options for neurologic PCC are limited and lack strong evidence-based support.

Purpose of the Study:

• To evaluate the efficacy of lithium aspartate in alleviating fatigue and cognitive dysfunction associated with neurologic PCC.
• To explore potential benefits of lithium aspartate in managing long COVID symptoms.

Main Methods:

• A randomized, double-blind, placebo-controlled trial (RCT) was conducted, followed by an open-label lithium dose-finding study.
• Participants with persistent fatigue or cognitive dysfunction post-COVID-19 were enrolled.
• Primary outcome was the change in combined Fatigue Severity Scale-7 (FSS-7) and Brain Fog Severity Scale (BFSS) scores.

Main Results:

• Lithium aspartate (10-15 mg/d) showed no significant improvement in fatigue or cognitive dysfunction compared to placebo in the RCT.
• No adverse events were attributed to lithium therapy during the study.
• Preliminary findings from the dose-finding phase suggested potential benefits with higher lithium aspartate dosages (40-45 mg/d).

Conclusions:

• Low-dose lithium aspartate (10-15 mg/d) is ineffective for treating neurologic PCC-related fatigue and cognitive dysfunction.
• Further RCTs are necessary to investigate the efficacy of higher lithium aspartate dosages for neurologic PCC.