A A Harandi et al 2024
Scientific Reports
Extracts
Abstract
Many COVID-19 survivors experience lingering post-COVID-19 symptoms, notably chronic fatigue persisting for months after the acute phase. Despite its prevalence, limited research has explored effective treatments for post-COVID-19 fatigue. This randomized controlled clinical trial assessed the impact of Amantadine on patients with post-COVID-19 fatigue. The intervention group received Amantadine for two weeks, while the control group received no treatment. Fatigue levels were assessed using the Visual Analog Fatigue Scale (VAFS) and Fatigue Severity Scale (FSS) questionnaires before and after the trial. At the study's onset, VAFS mean scores were 7.90 ± 0.60 in the intervention group and 7.34 ± 0.58 in the control group (P-value = 0.087). After two weeks, intervention group scores dropped to 3.37 ± 0.44, significantly lower than the control group's 5.97 ± 0.29 (P-value < 0.001). Similarly, FSS mean scores at the trial's commencement were 53.10 ± 5.96 in the intervention group and 50.38 ± 4.88 in the control group (P-value = 0.053). At the trial's end, intervention group scores decreased to 28.40 ± 2.42, markedly lower than the control group's 42.59 ± 1.50 (P-value < 0.001). In this study, we report the safety, tolerability, and substantial fatigue-relieving effects of Amantadine in post-COVID-19 fatigue. The intervention demonstrates a statistically significant reduction in fatigue levels, suggesting Amantadine's potential as an effective treatment for this persistent condition.
Discussion
Amantadine's effectiveness in relieving MS-related fatigue has been frequently shown, and its prescription is recommended by the German MS Society as well as in clinical practice guidelines published by NICE. Given the high incidence rate of post-COVID-19 fatigue and lack of treatment options, the satisfactory result obtained in our study with treatment with Amantadine is considerable. However, to our knowledge, there is no study investigating the effect of Amantadine on fatigue in post-COVID-19 patients to compare their results with ours.
Results
Our results showed a significant difference in the improvement of fatigue in patients receiving Amantadine compared to the control group. This improvement was evident in the FSS and the VAFS scores since the average of both reached less than half of the initial value after two weeks of treatment with Amantadine.
In conclusion, our study demonstrated that consuming Amantadine has a favorable effect on relieving post-COVID-19 fatigue. Our results reveal the safety and tolerability of two-weeks treatment with Amantadine in post-COVID-19 patients. We recommend well-designed double-blind, randomized studies with placebo and larger sample sizes to validate our results.
MEA Comment
Amantadine is an interesting drug that is normally used to treat Parkinson's disease. It has already been claimed to help reduce fatigue in both multiple sclerosis and ME/CFS
As the paper points out, there are a number of reasons why amantadine, which acts on chemical transmitter systems in the brain and also has anti-inflammatory effects, might be of use in treating fatigue
And whilst the results from clinical trials in multiple sclerosis do indicate that it could be of benefit here, clinical trial results in ME/CFS are not that impressive
Consequently, the NICE guideline committee decided that it could not recommend amantadine as a treatment for ME/CFS fatigue in our current state of knowledge.
Consequently, the NICE guideline committee decided that it could not recommend amantadine as a treatment for ME/CFS fatigue in our current state of knowledge. The positive results from this Long Covid trial need to be viewed with a considerable degree of caution for the reasons listed in the discussion
However, they do indicate that a further and more robust clinical trial of amantadine would be worthwhile in Long Covid
If positive, this is a drug that probably needs to be re-evaluated in relation to ME/CFS fatigue.
Dr Charles Shepherd,
Trustee and Hon. Medical Adviser to the ME Association.
Member of the 2018-2021 NICE Guideline Committee.
Member of the 2002 Independent Working Group on ME/CFS.
