Authors' objectives: To determine if there is any evidence on the efficacy and/or effectiveness of low-dose naltrexone in treating patients diagnosed with Post-COVID Conditions (Long COVID).

Authors' results and conclusions: Fourteen published studies were identified. Upon examination of the titles and abstracts of these fourteen studies, nine were thought to be relevant and were retrieved in full for further appraisal. One-hundred thirty-one studies were identified from a more general search on naltrexone. Upon examination of these 131 studies, one study was thought to be relevant and was retrieved in full for further appraisal. Hence, there were ten studies that were thought to be relevant and were retrieved in full for this systematic review. No further study was identified from the manual search. Of the ten studies that were retrieved in full, six were clinical trial protocols that were posted on the US National Institute of Health clinicaltrial.gov (https://clinicaltrials.gov/) website. Of these six clinical trial protocols, four studies recruited patients with COVID-19 instead of Post-COVID-19 and as such, these four studies were not relevant to the objective of this systematic review. Of the two protocols that are relevant, one study, investigating the efficacy of low-dose naltrexone plus nicotinamide adenine dinucleotide (NAD+) supplement, had completed its recruitment but has not posted any results. The other protocol , investigating low-dose naltrexone to treat post-COVID-19 fatigue syndromes had not started recruitment yet. Of the other four published studies, three were in the form of expert opinion which did not provide any relevant data. At present, there may be some low-level, low-quality evidence on the effectiveness of low-dose naltrexone to treat post-COVID-19 patients. However, the available evidence has to be interpreted with caution due to potential bias and chance that cannot be excluded from affecting the observed outcomes. Currently there are two relevant randomized controlled trial (one is still at listing only and one has not reported the outcome although has finished recruitment) that we will follow-up to update this systematic review.

Authors' methods: A comprehensive and systematic literature search was conducted on December 16, 2022. The search was done on commercial medical literature databases using a combination of keywords, as proposed by the Canadian Agency for Drugs and Technology in Health in 2021 to search for COVID-19 studies. No limitations, such as on the language of publication, were implemented in this literature search. 5 Lose-Dose Naltrexone as Treatment for Post-COVID Conditions – 2024 Update November 2024. A manual search on the references of the articles that were retrieved in full was also conducted.

Project Status: Completed

URL for project: https://www.worksafebc.com/en/about-us/research-services/evidence-based-medicine-and-systematic-reviews

Year Published: 2024

URL for published report: https://www.worksafebc.com/en/resources/health-care-providers/guides/low-dose-naltrexone-treatment-post-covid-conditions-update-2024?lang=en

English language abstract: An English language summary is available

Publication Type: Mini HTA

Country: Canada

Organisation Name: WorkSafeBC

Contact Address: 6591 Westminster Highway, Richmond, BC, V7C 1C6 Canada. Tel: 604-231-8417; Fax: 604-279-7698

Contact Name: ebpg@worksafebc.com

Contact Email: ebpg@worksafebc.com

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