The improvements ranged from small steps forward to the complete disappearance of the symptoms associated with post-covid (also called long covid), says lead researcher Wendy Scholten-Peeters, professor at the Vrije Universiteit Amsterdam.
She says that 28 of the 30 complaints decreased, including nerve pain and neurological complaints. This concerns, for example, complaints such as brain fog, malaise after exertion (PEM) and overstimulation. They have had all kinds of patients in the group, including very serious cases of people who were in bed for 19 to 20 hours a day. On average, people had post-covid complaints for 2.5 years.
‘Fog in my head lifted’
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One of the patients who received the drug is documentary maker Jessica Villerius. She says on Instagram that the treatment gave her a large part of her life back after ‘four miserable years’.
“After a week, the fog in my head suddenly cleared. I was able to have normal conversations again and tolerate light and noise. Every day I gained something. I have not recovered 100 percent, but it is a night and day difference.”
Lidocaine
The drug in question is called lidocaine. This has been used for years as an anesthetic and pain-relieving medicine, but in an adapted form it also appears to be able to reduce post-covid complaints. This was discovered by chance by doctors at Excellent Care Clinics, an independent pain clinic in Velsen-Noord.
This clinic has been treating people with neuropathic pain through an IV for many years. Also people suffering from post-covid. Because it was burdensome for these patients to always come to the clinic, they developed a way so that patients could inject it under their skin themselves.
The medication is prepared manually at the pharmacy because it consists of different components. The drug costs 27 euros per time. Because it must be administered several times a day, the treatment is still quite expensive, namely more than 3,000 euros per month. This has a surprisingly positive effect: post-covid complaints decreased and the quality of life of patients increased.
It is hopeful news for the estimated 90,000 people with post-covid in the Netherlands. There is no approved treatment. This study is not yet the same.
The study recently appeared in the scientific journal eClinical Medicine. This is a so-called interrupted-time series study, an observational study. This means that researchers only observe what happens and compare it to the period before treatment started.
Scientifically, you cannot say with certainty that the treatment is the cause of the improvement, but it can provide a strong indication, especially if almost no change was visible in the four weeks before the treatment.
‘Read with great interest’
Alfons Olde Loohuis, former GP and medical advisor of aftercare organization C-Support, read the study with ‘great interest’. He explains that the immune system in post-covid patients is often overactive. The hypothesis is that the anesthetic lidocaine inhibits the dysregulated immune mechanism, thereby reducing inflammation in various organs.
Olde Loohuis sees the drug as ‘one of the branches on the tree’, a possible treatment that can be used for people with post-covid. “What you see is that the nervous system that ensures stress, relaxation, temperature regulation, moods, has become out of balance in post-covid patients. It has to do too much at the same time, and those people are no longer able to do that. Lidocaine apparently works a little on those structures, allowing the immune system to become calmer.”
More research needed
Additional clinical research is needed to determine exactly how effective the treatment is and what the optimal dosage is. Until then, the treatment does not appear to be reimbursed.
Professor Scholten-Peeters: “We have not had a separate control group. If this drug is included in the basic package, insurers will want a randomized clinical trial.”
Marc Bonten, professor of molecular epidemiology of infectious diseases at UMC Utrecht, also points this out. On LinkedIn he makes some comments about the study. “Because there is no control group, it cannot be determined what the normal course of complaints would have been without treatment, or if participants had received a placebo and were blinded to it.”
Treatment not reimbursed
The larger study is therefore still to come. This research must then answer questions such as: for which patient groups does the drug work and for which group does it not? Professor Scholten-Peeters can already say something about it: “If I go by the experience of the doctors at Excellent Care Clinics, people with obesity generally respond less well. We want to investigate this further.”
Another interesting question is also whether people should continue to use the drug. According to the professor, some patients have stopped, but they have retained the health gains. Patients in the research group who want to continue with the medication must pay thousands of euros per month for this. Documentary maker Villerius calls on health insurers: “Make this accessible to everyone.”