Authors' objectives: To determine whether there is any evidence on the efficacy and/or effectiveness of IV Ketamine in treating patients diagnosed with Post-COVID Conditions (Long COVID; PACS).

Authors' results and conclusions: Twenty-nine published studies were identified. Upon examination on the titles and abstracts of these 29 studies, 10 studies were retrieved in full for further appraisal. No further study was identified from the manual searches conducted on the references of these ten studies that were retrieved in full. Of the 10 studies that were retrieved in full, nine studies were not relevant or did not provide relevant data to the objective of this systematic review and will not be discussed further. A case report (level of evidence 4) on 50-year-old man diagnosed with post-Covid 19 patient with refractory fatigue that was treated with ketamine infusion was reported. The patient reported generalized fatigue that was refractory to care and treatment. He was tired all day, with malaise limiting any physical activity and reported the worsening of his fatigue with physical or mental effort. The patient also had constant headaches and had undergone a stellate ganglion block with successful improvement but no change to the fatigue symptoms. The patient received ketamine infusion (sub-dissociative dosing of 0.25 mg/kg over 40 minutes) and reported approximately 30% improvement in fatigue at the 2-week follow-up (it is not clear how fatigue was assessed). He then underwent a repeat infusion at 4 weeks and noted > 75% improvement in his fatigue symptoms with improved activity level including walks of over 1 mile at a time. At 6 months, the patient reported approximately 75% improvement of his fatigue. It should be noted that it was not clear how this patient was selected for the report and it was not clear the effect of cointervention, if any, in this patient. At present, there is a case report, level of evidence 4 on the effectiveness of IV ketamine in treating post-Covid-19 fatigue. There are also reports on cholestatic liver injury due to ketamine infusion in ventilated patients with Covid-19.

Authors' methods: A comprehensive and systematic literature search was conducted on February 4, 2025. The search was done on commercial medical literature databases employing a combination of keywords as proposed by the Canada’s Drug Agency (formerly Canadian Agency for Drugs and Technology in Health). No limitations, such as on the language of publication, were implemented in this literature search. 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: 2025

URL for published report: https://www.worksafebc.com/en/resources/health-care-providers/guides/iv-ketamine-therapy-for-long-covid?lang=en&origin=s&returnurl=https%3A%2F%2Fwww.worksafebc.com%2Fen%2Fforms-resources%23sort%3DDate%26q%3DIV%2520Ketamine%2520Therapy%2520for%2520Long%2520COVID%26f%3Alanguage-facet%3D%5BEnglish%5D%26tags%3DGuide%7C2d7eb4b30f6a4a319e0d40565c9abbab%2CHealth%2520Care%2520Provider%7C13468b0b3f074f6bade3f57ac3cdfb8e%2CSystematic%2520Review%7Cf78c29d570c14ec3b5a394385905df70&highlight=IV%20Ketamine%20Therapy%20for%20Long%20COVID

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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