Pharmacotherapy from pre-COVID to post-COVID: longitudinal trends and
predictive indicators for long COVID symptoms
Abstract
Aim: Approximately 10% of all COVID-19 cases experience persistent
symptoms after the acute infection phase, a condition known as long
COVID or post-acute sequelae of COVID-19. Approved prevention and
treatment options for long COVID are currently lacking. Given the
heterogeneous nature of long COVID, a personalized medicine approach is
essential for effective disease management. This study aimed to describe
trends in pharmacotherapy from pre-COVID to post-COVID phases to gain
insights into COVID-19 treatment strategies and assess whether pre-COVID
pharmacotherapy can predict long COVID symptoms as a health status
indicator. Methods: In the Precision Medicine for more Oxygen (P4O2) –
COVID-19 study, 95 long COVID patients were comprehensively evaluated
through post-COVID outpatient clinics and study visits. The study
focused on descriptive analysis of the pharmacotherapy patterns across
different phases: pre-COVID-19, acute COVID, and post-COVID.
Furthermore, associations between pre-COVID medication and long COVID
outcomes were analyzed with regression analyses. Results: We observed
peaks in the use of certain medications during the acute infection
phase, including corticosteroids and antithrombotic agents, with a
decrease in the use of renin-angiotensin inhibitors. Consistent high use
of alimentary tract medications was noted across all phases. Notably,
pre-COVID respiratory medications were associated with fatigue symptoms,
while antiinfectives and cardiovascular drugs were linked to fewer
persisting long COVID symptom categories. Conclusion: Our findings
provide longitudinal descriptive pharmacotherapy insights and suggest
that medication history can be a valuable health status indicator in
characterizing patients for personalized disease management strategies,
addressing the heterogeneous nature of long COVID.