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Pharmacological and non-pharmacological management of long COVID

Kanwal Khalid1, Amar Daud Iskandar Abdullah2, Hui Xuan Lim3,4

  • 1Department of Biological Sciences, University of Alberta, Edmonton, AB, T6G 2E9, Canada.

Virology Journal
|March 21, 2026
PubMed

Insights

Long COVID, a condition following SARS-CoV-2 infection, is linked to gut dysbiosis. Probiotics show promise in improving symptoms like fatigue and gastrointestinal issues, but more research is needed.

Area of Science:

  • Microbiology
  • Immunology
  • Gastroenterology

Background:

  • Long COVID (post-acute sequelae of SARS-CoV-2 infection) presents diverse symptoms, including autonomic dysfunction, cardiovascular, and neurological impairments.
  • Pathophysiological mechanisms of Long COVID are unclear, with potential roles for immune dysregulation, viral reservoirs, inflammation, gut dysbiosis, and vascular dysfunction.
  • Current treatment options for Long COVID are limited and lack standardized guidelines, with non-pharmacological and pharmacological approaches showing variable efficacy.

Purpose of the Study:

  • To explore the potential of probiotics as an intervention for Long COVID.
  • To review existing clinical evidence on probiotic efficacy in managing Long COVID symptoms.
  • To highlight the association between gut dysbiosis and Long COVID.

Main Methods:

  • Review of clinical studies investigating probiotic interventions in Long COVID patients.
  • Analysis of specific probiotic strains (e.g., Bacillus coagulans, Lactobacillus acidophilus, Bifidobacterium species) and their reported effects.
  • Assessment of symptom improvement in fatigue, gastrointestinal health, and overall well-being.

Main Results:

  • Probiotic interventions, including specific Bacillus and Lactobacillus species, have demonstrated potential to improve fatigue and gastrointestinal health in Long COVID.
  • These probiotics may also enhance overall physical and mental well-being in affected individuals.
  • Evidence suggests a strong link between gut dysbiosis and the development or persistence of Long COVID symptoms.

Conclusions:

  • Probiotics represent a promising therapeutic avenue for managing Long COVID, particularly for symptoms related to gut dysbiosis.
  • Further large-scale randomized controlled trials are essential to validate the efficacy and establish standardized guidelines for probiotic use in Long COVID.
  • Validating probiotic efficacy could significantly reduce the health burden on individuals and healthcare systems.

Keywords:
COVID-19Long COVIDNon-pharmacologicalPharmacologicalProbioticsSARS-CoV-2

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