Antihistamines improve cardiovascular manifestations and other symptoms of long-COVID attributed to mast cell activation, 2023, Salvucci et al

[forestglip]

Antihistamines improve cardiovascular manifestations and other symptoms of long-COVID attributed to mast cell activation

Fabrizio Salvucci, Roberto Codella, Adriana Coppola, Irene Zacchei, Gabriella Grassi, Maria Luisa Anti, Nicolita Nitisoara, Livio Luzi, Carmine Gazzaruso

Introduction
Long-COVID is a broadly defined condition and there are no effective therapies. Cardiovascular manifestations of long-COVID include high heart rate, postural tachycardia, and palpitations. Previous studies have suggested that mast cell activation (MCA) may play a role in the pathophysiology of long-COVID, including in the mechanisms of its cardiovascular manifestations. The present study aimed to evaluate the effectiveness of a treatment with blockers of histamine receptors in patients with long-COVID who did not respond to other therapies.

Methods
In all, 14 patients (F/M = 9/5; 49.5 ± 11.5 years) and 13 controls (F/M = 8/5; 47.3 ± 8.0 years) with long-COVID symptoms attributed to MCA were evaluated. Patients were treated with fexofenadine (180 mg/day) and famotidine (40 mg/day). Fatigue, brain fog, abdominal disorders, and increased heart rate were evaluated in treated and untreated patients at baseline and 20 days later.

Results
Long-COVID symptoms disappeared completely in 29% of treated patients. There was a significant improvement in each of the considered symptoms (improved or disappeared) in all treated patients, and the improvement grade was significantly greater in treated patients compared to controls. No significant differences in the outcomes were observed in the controls.

Conclusions
Our data confirm that histamine receptors blockade may be an effective target to successfully treat long-COVID. Our finding supports the underlying role of MCA in the pathophysiology of long-COVID.

Link | PDF (Frontiers in Cardiovascular Medicine) [Open Access]

 

[Yann04]

I kind of get this study. But it kind of feels like they are saying a band aid treats a wound.

The large majority of people in online communities with long COVID already report having tried antihistamines.

 

[forestglip]

This study used information previously collected during normal care (with no intention to use it for research purposes at the time of collection).

Not placebo controlled. They looked at records of patients who had and had not taken antihistamines.

 

[SNT Gatchaman]

Or any other medications, which might even extend to things like not following advice to limit activity.

As the control group, 13 patients with the same inclusion and exclusion criteria and matched by sex, age, and BMI were selected from our database of approximately 1,000 patients with long-COVID. Controls were not treated with antihistamines, as they refused further pharmacological treatment.

 

[Kiwipom]

Not placebo controlled. They looked at records of patients who had and had not taken antihistamines.

And such small numbers. Easy to do better here with a prospective RCT and more participants

 

[darrellpf]

Histamines and inflammatory (ctyokine) processes are related.

At one time Dr. Bruce Patterson was working really hard at tamping down inflammatory cytokines in COVID and ME/CFS.

My feeling is the approach helps symptoms in the short term, but in the long term a different inflammatory process ensues.