Biomarker & Intervention Discovery

Long COVID / Post-Acute Sequelae of COVID-19 (PASC)

This page lists 7 druggable gene targets, 27 approved or trial-tested drug candidates and 15 recent clinical trials for Long COVID / Post-Acute Sequelae of COVID-19 (PASC), with each agent ranked by the strength of its evidence (clinical, mechanistic or correlative). Candidates include existing drugs that could be repurposed. Sources are linked so you can check every claim.

Spontaneous remissionSpontaneous resolution at 12 months: ~50-70% of patients; persistent symptoms at 2 years in 30-50%; severely…
Best-intervention remissionNo approved pharmacotherapy; Paxlovid (nirmatrelvir/ritonavir) — PANORAMIC trial showed no reduction in Long COVID…
Gap sizeVery large — no proven pharmacotherapy; enormous research investment but no approved treatment as of mid-2026
Primary barrierbiological (mechanism not fully understood) + practice (no evidence-based protocol)
Full remission profile →

Remission & chronicity

Spontaneous remission
Spontaneous resolution at 12 months: ~50-70% of patients; persistent symptoms at 2 years in 30-50%; severely debilitating long COVID in 10-15% at 1 year without intervention
Best-intervention remission
No approved pharmacotherapy; Paxlovid (nirmatrelvir/ritonavir) — PANORAMIC trial showed no reduction in Long COVID risk at 6 months if started in acute phase; BC007 (autoantibody neutraliser) — Phase 2 signal; low-dose naltrexone — observational data positive; antihistamine combination (famotidine + cetirizine) — anecdotal
Gap size
Very large — no proven pharmacotherapy; enormous research investment but no approved treatment as of mid-2026
Primary barrier
biological (mechanism not fully understood) + practice (no evidence-based protocol)
Long COVID is a heterogeneous syndrome with multiple proposed mechanisms (viral persistence, autoimmunity, microclotting, dysautonomia, mitochondrial dysfunction); no single treatment works for all patients; fragmented care with poor coordination; many clinicians still do not acknowledge Long COVID as a diagnosis

Biomarker Targets & Therapeutic Agents

Gene targets queried against DGIdb, Open Targets, ChEMBL, PubMed, and Europe PMC. Agents ranked: Clinical > Mechanistic > Correlative.

ACE2 147IFNL3 25IL6 181NOS3 0TLR3 18TNF 287TRPV1 187
Therapeutic Agent Effect Direction Evidence Tier Potency Source
MLN-4760 ↓ inhibits Mechanistic
ABZ-SER-PRO-TYR(NO2)-OH ? unclear Mechanistic
BCY15291 ↓ inhibits Mechanistic
ALUNACEDASE ALFA ? unclear Mechanistic
LISINOPRIL ANHYDROUS ? unclear Mechanistic
XNT [PMID: 18391097] ↑ activates Mechanistic
ORE-1001 ? unclear Mechanistic 0.44 nM (IC50)
COMPOUND 28 [PMID: 18324760] ↓ inhibits Mechanistic
DX600 ↓ inhibits Mechanistic
CPS4 ? unclear Mechanistic
CHEMBL252391 ↓ inhibits Mechanistic 1.5 nM (Ki)
CHEMBL252009 ↓ inhibits Mechanistic 84.0 nM (Ki)
CHEMBL251809 ↓ inhibits Mechanistic 35.0 nM (Ki)
CHEMBL251808 ↓ inhibits Mechanistic 0.85 nM (Ki)
CHEMBL398771 ↓ inhibits Mechanistic 2.0 nM (Ki)
CHEMBL254911 ↓ inhibits Mechanistic 2.5 nM (Ki)
CHEMBL254703 ↓ inhibits Mechanistic 2.7 nM (Ki)
CHEMBL254495 ↓ inhibits Mechanistic 2.4 nM (Ki)
CHEMBL254493 ↓ inhibits Mechanistic 6.0 nM (Ki)
CHEMBL254282 ↓ inhibits Mechanistic 2.2 nM (Ki)
CHEMBL252003 ↓ inhibits Mechanistic 5.8 nM (Ki)
CHEMBL251804 ↓ inhibits Mechanistic 0.9 nM (Ki)
CHEMBL401397 ↓ inhibits Mechanistic 2.2 nM (Ki)
CHEMBL398545 ↓ inhibits Mechanistic 37.0 nM (Ki)
CHEMBL253428 ↓ inhibits Mechanistic 2.4 nM (Ki)
CHEMBL400527 ↓ inhibits Mechanistic 2.2 nM (Ki)
CHEMBL253224 ↓ inhibits Mechanistic 1.3 nM (Ki)
CHEMBL400526 ↓ inhibits Mechanistic 1.5 nM (Ki)
CHEMBL254900 ↓ inhibits Mechanistic 14.0 nM (Ki)
CHEMBL401086 ↓ inhibits Mechanistic 90.0 nM (Ki)
CHEMBL252417 ↓ inhibits Mechanistic 62000.0 nM (IC50)
CHEMBL398940 ↓ inhibits Mechanistic 57000.0 nM (IC50)
CHEMBL436639 ↓ inhibits Mechanistic 10.0 nM (IC50)
CHEMBL350414 ↓ inhibits Mechanistic 86.0 nM (Ki)
CHEMBL402987 ↓ inhibits Mechanistic 860.0 nM (Ki)
CHEMBL272925 ↓ inhibits Mechanistic 550.0 nM (Ki)
CHEMBL271224 ↓ inhibits Mechanistic 420.0 nM (Ki)
CHEMBL271223 ↓ inhibits Mechanistic 7.1 nM (Ki)
CHEMBL271225 ↓ inhibits Mechanistic 1.4 nM (Ki)
CHEMBL437595 ↓ inhibits Mechanistic 84.0 nM (Ki)

Showing top 40 of 147 agents ranked by evidence tier.

Therapeutic Agent Effect Direction Evidence Tier Potency Source
GRAZOPREVIR ? unclear Mechanistic
TELAPREVIR ? unclear Mechanistic
RITONAVIR ? unclear Mechanistic
ASUNAPREVIR ? unclear Mechanistic
FALDAPREVIR ? unclear Mechanistic
BOCEPREVIR ? unclear Mechanistic
LEDIPASVIR ? unclear Mechanistic
INTERFERON ALFA-N1 ? unclear Mechanistic
OMBITASVIR/PARITAPREVIR/RITONAVIR ? unclear Mechanistic
OMBITASVIR ? unclear Mechanistic
ATORVASTATIN ? unclear Mechanistic
ELBASVIR ? unclear Mechanistic
SOFOSBUVIR ? unclear Mechanistic
SOFOSBUVIR/VELPATASVIR ? unclear Mechanistic
PEGINTERFERON ALFA-2B ? unclear Mechanistic
DELEOBUVIR ? unclear Mechanistic
VOXILAPREVIR ? unclear Mechanistic
DASABUVIR ? unclear Mechanistic
PEGINTERFERON ALFA-2A ? unclear Mechanistic
SOFOSBUVIR / VELPATASVIR / VOXILAPREVIR ? unclear Mechanistic
ELBASVIR/GRAZOPREVIR ? unclear Mechanistic
DACLATASVIR ? unclear Mechanistic
PARITAPREVIR ? unclear Mechanistic
SIMEPREVIR ? unclear Mechanistic
VELPATASVIR ? unclear Mechanistic
Therapeutic Agent Effect Direction Evidence Tier Potency Source
CLAZAKIZUMAB ↓ inhibits Mechanistic
MIDOSTAURIN ? unclear Mechanistic
ECHINACEA EXTRACT ? unclear Mechanistic
NELFINAVIR ? unclear Mechanistic
SELECTIVE ESTROGEN RECEPTOR MODULATOR ? unclear Mechanistic
SIGNAL TRANSDUCTION INHIBITOR ? unclear Mechanistic
OLOKIZUMAB ? unclear Mechanistic
IBUDILAST ? unclear Mechanistic
VITAMIN A PALMITATE ? unclear Mechanistic
IFOSFAMIDE ? unclear Mechanistic
SITAGLIPTIN ? unclear Mechanistic
METRONIDAZOLE ? unclear Mechanistic
PEGINTERFERON ALFA-2A ? unclear Mechanistic
PACIBEKITUG ↓ inhibits Mechanistic
PEGINTERFERON ALFA-2B ? unclear Mechanistic
SIRUKUMAB ↓ inhibits Mechanistic
HMG-COA REDUCTASE INHIBITOR ? unclear Mechanistic
SAFINGOL ? unclear Mechanistic
ENZYME INHIBITOR ? unclear Mechanistic
CISPLATIN ? unclear Mechanistic
GALLIUM NITRATE ? unclear Mechanistic
RITUXIMAB ? unclear Mechanistic
INFLIXIMAB ? unclear Mechanistic
C326 ? unclear Mechanistic
GEMFIBROZIL ? unclear Mechanistic
ZILTIVEKIMAB ? unclear Mechanistic
INSULIN, REGULAR, HUMAN ? unclear Mechanistic
OSIMERTINIB ? unclear Mechanistic
BINETRAKIN ? unclear Mechanistic
ALOGLIPTIN ? unclear Mechanistic
TENELIGLIPTIN ? unclear Mechanistic
CHINESE HERBS ? unclear Mechanistic
TOCILIZUMAB ? unclear Mechanistic
LINAGLIPTIN ? unclear Mechanistic
DOCETAXEL ANHYDROUS ? unclear Mechanistic
VILDAGLIPTIN ? unclear Mechanistic
LINEZOLID ? unclear Mechanistic
SELENIUM ? unclear Mechanistic
SAQUINAVIR ? unclear Mechanistic
PAREGORIC ? unclear Mechanistic

Showing top 40 of 181 agents ranked by evidence tier.

Pipeline results not yet available for this target. Run the pipeline to populate.

Therapeutic Agent Effect Direction Evidence Tier Potency Source
BEVASIRANIB SODIUM ↑ activates Mechanistic
POLY ICLC ? unclear Mechanistic
RINTATOLIMOD ? unclear Mechanistic
BINETRAKIN ? unclear Mechanistic
MEASLES VACCINE ? unclear Mechanistic
ASPIRIN ? unclear Mechanistic
HYDROXYCHLOROQUINE ? unclear Mechanistic
BEVASIRANIB ↑ activates Mechanistic
RECOMBINANT INTERLEUKIN-13 ? unclear Mechanistic
POLY(I:C) ↑ activates Mechanistic
CHEMBL4064228 ↑ activates Mechanistic 42500.0 nM (EC50)
CHEMBL4074408 ↑ activates Mechanistic 4800.0 nM (EC50)
CHEMBL4105063 ↑ activates Mechanistic 22300.0 nM (EC50)
CHEMBL4636498 ↓ inhibits Mechanistic 5440.0 nM (IC50)
CHEMBL4647818 ↓ inhibits Mechanistic 2160.0 nM (IC50)
CHEMBL4795714 ↓ inhibits Mechanistic 2400.0 nM (IC50)
CHEMBL19954 ↓ inhibits Mechanistic 110.0 nM (IC50)
CHEMBL4303728 ↓ inhibits Mechanistic 3440.0 nM (IC50)
Therapeutic Agent Effect Direction Evidence Tier Potency Source
DICLOFENAC SODIUM ? unclear Mechanistic
RDP58 ? unclear Mechanistic
METHYLENE BLUE ? unclear Mechanistic
ORTATAXEL ? unclear Mechanistic
CERTOLIZUMAB PEGOL ↓ inhibits Mechanistic
OZORALIZUMAB ↓ inhibits Mechanistic
THALIDOMIDE ? unclear Mechanistic
HUANG LIAN ? unclear Mechanistic
GOLIMUMAB ↓ inhibits Mechanistic
CYCLOSPORINE ? unclear Mechanistic
DOCETAXEL ANHYDROUS ? unclear Mechanistic
HALOFUGINONE ? unclear Mechanistic
ETANERCEPT ↓ inhibits Mechanistic
ISIS 104838 ? unclear Mechanistic
GEMCITABINE ? unclear Mechanistic
INDOMETHACIN ? unclear Mechanistic
INSULIN, REGULAR, HUMAN ? unclear Mechanistic
DIDANOSINE ? unclear Mechanistic
5,7-DIHYDROXY-4-METHYLCOUMARIN ? unclear Mechanistic
SOBLIDOTIN ? unclear Mechanistic
STAVUDINE ? unclear Mechanistic
CISPLATIN ? unclear Mechanistic
MEROPENEM ANHYDROUS ? unclear Mechanistic
AMPHOTERICIN B LIPOSOMAL ? unclear Mechanistic
MIDAZOLAM HYDROCHLORIDE ? unclear Mechanistic
RIFAMPIN ? unclear Mechanistic
AVX-470 ? unclear Mechanistic
KETOROLAC TROMETHAMINE ? unclear Mechanistic
PRAZOSIN HYDROCHLORIDE ? unclear Mechanistic
RISPERIDONE ? unclear Mechanistic
BENZO[E]PYRENE ? unclear Mechanistic
ETHAMBUTOL HYDROCHLORIDE ? unclear Mechanistic
REMTOLUMAB ↓ inhibits Mechanistic
SPIRONOLACTONE ? unclear Mechanistic
OMEPRAZOLE ? unclear Mechanistic
CARBOPLATIN ? unclear Mechanistic
MITOMYCIN C ANALOG KW-2149 ? unclear Mechanistic
NAFAMOSTAT ? unclear Mechanistic
ABBV-3373 ~ modulates Mechanistic
BACILLUS CALMETTE-GUERIN ANTIGEN ? unclear Mechanistic

Showing top 40 of 287 agents ranked by evidence tier.

Therapeutic Agent Effect Direction Evidence Tier Potency Source
RHTX ↑ activates Mechanistic
ABT-102 ↓ inhibits Mechanistic
ASIVATREP ↓ inhibits Mechanistic
BCTC ↓ inhibits Mechanistic
MAVATREP ↓ inhibits Mechanistic
POLYGODIAL ? unclear Mechanistic
ALLICIN ↓ inhibits Mechanistic
JTS-653 ↓ inhibits Mechanistic
SB452533 ↓ inhibits Mechanistic
MR-1817 ↓ inhibits Mechanistic
GRC-6211 ↓ inhibits Mechanistic
ACETAMINOPHEN ↑ activates Mechanistic
DWP05195 ↓ inhibits Mechanistic
STREPTOZOCIN ? unclear Mechanistic
CAPSAICIN ↑ activates Mechanistic 19.95 nM (EC50)
AMG517 ↓ inhibits Mechanistic
5S-HETE ↑ activates Mechanistic
BENZYL ISOTHIOCYANATE ? unclear Mechanistic
MASOPROCOL ? unclear Mechanistic
[3H]RESINIFERATOXIN ↑ activates Mechanistic
[3H]A778317 ↓ inhibits Mechanistic
CAPSAZEPINE ↓ inhibits Mechanistic 120.0 nM (Ki)
NABIXIMOLS ? unclear Mechanistic
H+ ↑ activates Mechanistic
RECOMBINANT TUMOR NECROSIS FACTOR FAMILY PROTEIN ? unclear Mechanistic
NADA ↓ inhibits Mechanistic
ZUCAPSAICIN ↑ activates Mechanistic
SB366791 ↓ inhibits Mechanistic
GRC-15300 ? unclear Mechanistic
MRS-1477 ~ modulates Mechanistic
ANANDAMIDE ↑ activates Mechanistic
JNJ17203212 ↓ inhibits Mechanistic
LEVODOPA ? unclear Mechanistic
INDOMETHACIN ? unclear Mechanistic
AZD1386 ↓ inhibits Mechanistic
CAMPHOR OIL ↑ activates Mechanistic
ISOPROPYL ISOTHIOCYANATE ? unclear Mechanistic
VOACANGINE ? unclear Mechanistic
FERRUGINENE B ? unclear Mechanistic
PHENYLACETYLRINVANIL ↑ activates Mechanistic

Showing top 40 of 187 agents ranked by evidence tier.


Clinical Trials

Drug, biologic and supplement trials (treatment or prevention) from ClinicalTrials.gov whose main condition is Long COVID / Post-Acute Sequelae of COVID-19 (PASC): recruiting, active or completed, most recently updated first. Data retrieved 2026-10-28.

NCT06305780 Phase: 2 Started: 2024-03-11

This study is a platform protocol designed to be flexible so that it is suitable for a wide range of settings within health care systems and in community settings where it can be integrated into COVID-19 programs and subsequent treatment plans. This protocol is a prospective, multi-center, multi-arm...

NCT06305793 Phase: 2 Started: 2024-05-08

This study is a platform protocol designed to be flexible so that it is suitable for a wide range of settings within health care systems and in community settings where it can be integrated into COVID-19 programs and subsequent treatment plans. This protocol is a prospective, multi-center, multi-arm...

NCT06404112 Phase: 2 Started: 2024-07-31

The platform protocol is designed to be flexible so that it is suitable for a range of study settings and intervention types. Therefore, the platform protocol provides a general protocol structure that can be shared by multiple interventions and allows comparative analysis across the interventions. ...

NCT06404099 Phase: 2 Started: 2024-08-12

The platform protocol is designed to be flexible so that it is suitable for a range of study settings and intervention types. Therefore, the platform protocol provides a general protocol structure that can be shared by multiple interventions and allows comparative analysis across the interventions. ...

NCT06960928 Phase: 3 Started: 2025-04-18

The study is conducted in New York, New York at The Cohen Center for Recovery from Complex Chronic Illness at Mount Sinai. This is an IND-exempt, off-label, multi-ascending, randomized, placebo-controlled clinical trial of sirolimus (also known as rapamycin) in adults with Long COVID. There are 2 ar...

NCT05965726 Phase: 2 Started: 2023-07-26

This is an appendix of master protocol (NCT05595369) designed to be flexible so that it is suitable for a wide range of settings within health care systems and in community settings where it can be integrated into COVID-19 programs and subsequent treatment plans. This sub-study is a prospective, mul...

NCT06305806 Phase: 2 Started: 2024-03-11

This study is a platform protocol designed to be flexible so that it is suitable for a wide range of settings within health care systems and in community settings where it can be integrated into COVID-19 programs and subsequent treatment plans. This protocol is a prospective, multi-center, multi-arm...

NCT06055244 Phase: 2 Started: 2023-12-07

This study will look at the effects of amantadine on cognitive function in persons with Long COVID. It will also collect specimens to study possible causes of cognitive symptoms in Long COVID, and whether any lab tests can predict who will respond better to amantadine.

NCT06404086 Phase: 2 Started: 2024-07-31

The platform protocol is designed to be flexible so that it is suitable for a range of study settings and intervention types. Therefore, the platform protocol provides a general protocol structure that can be shared by multiple interventions and allows comparative analysis across the interventions. ...

NCT05595369 Phase: 2 Started: 2023-07-26

This study is a platform protocol designed to be flexible so that it is suitable for a wide range of settings within health care systems and in community settings where it can be integrated into COVID-19 programs and subsequent treatment plans. This protocol is a prospective, multi-center, multi-arm...

NCT05576662 Phase: 2 Started: 2022-11-08

The purpose of this study is to compare whether being treated with nirmatrelvir plus ritonavir for 15 days works better than being treated with placebo plus ritonavir to reduce severe symptoms of Long Covid. Participants will have 5 planned visits to the study clinic over 15 weeks and will take the ...

NCT06620406 Phase: N/A Started: 2024-12-09

Gut microbiome dysbiosis has been noted in patients with Post-acute sequelae (PASC) of Severe Acute Respiratory Syndrome-CoronaVirus -2 (SARS-CoV-2). A study performed at Columbia found that plasma levels of the short chain fatty acid (SCFA), butyric acid, remained lower in people with Neuropsychiat...

NCT05638620 Phase: 1 Started: 2023-01-03

The main purpose of this study is to gather data and assess changes in patient-reported outcomes with the stellate ganglion blocks as treatment for their sympathetically-mediated long COVID symptoms.

NCT06316843 Phase: 2 Started: 2023-10-15

To explore the safety and efficacy of daily doses of celecoxib + valacyclovir in the treatment of patients with prolonged symptoms caused by COVID-19.

NCT05047952 Phase: 2 Started: 2021-09-16

A randomized, double-blinded, placebo-controlled trial will be conducted to evaluate vortioxetine, an antidepressant with established pro-cognitive properties, for the treatment of cognitive deficits which develop during or after an infection consistent with COVID-19, continue for 2+ months, and are...


Agents Found By Disease-Level Search

Searched directly from “Long COVID / Post-Acute COVID Sequelae (PACVS)” via ClinicalTrials.gov interventions and Open Targets' disease→drug data — independent of the 7-gene target panel above. This surfaces agents whose mechanism doesn't route through a curated gene (combination therapies, standard-of-care drugs, targets outside the panel).

27 agents shown (approved or with trial evidence) — 27 not found by the gene-target search above.

ImmunoadsorptionNOT in gene-target list

· 2 trials · source: ClinicalTrials.gov
NCT05841498 NCT05710770

ModafinilNOT in gene-target list

Phase 2 · 1 trial · source: ClinicalTrials.gov, Open Targets
NCT06404086

SolriamfetolNOT in gene-target list

Phase 2 · 1 trial · source: ClinicalTrials.gov, Open Targets
NCT06404086

MelatoninNOT in gene-target list

Phase 2 · 1 trial · source: ClinicalTrials.gov, Open Targets
NCT06404086

WATER+CTNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT06142253

Inspiratory muscle trainerNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT04919031

SpirometryNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT05077982

6-minute walkNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT05077982

Vitamin K2 (MK-7)NOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT05356936

Vitamin D3NOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT05356936

N-Tidal C handsetNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT04939558

Complementary self-help strategies in addition to treatment as usualNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT05798221

Physical FatigueNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT07278388

ActiveNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT06063031

Hyperbaric Oxygen therapyNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT06452095

Levels of inflammatory cytokine ( IL-6) in post-COVID-19 POTS and controlsNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT05421208

Levels of inflammatory cytokine ( IL-6) in controlsNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT05421208

SonlicromanolNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT07298005

Treatment as usualNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT05793736

Computed Tomography of the ChestNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT05866952

DAOIBNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT05764538

COVAXINNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT05142319

NuvaxovidNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT05142319

Probiotic AgentNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT06643299

ubiquinol (reduced coenzyme Q10)NOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT05178225

2x14 ml of peripheral blood collected in a tube with anticoagulantNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT05178225

Institutional standard treatment for xerostomia and Long CovidNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT05760092

Generated by the Open Source Medicine Foundation Biomarker Pipeline — 2026-10-08. Data sources: DGIdb, Open Targets, ChEMBL, PubMed, ClinicalTrials.gov. Not medical advice.