Wonder drugs against obesity Wegovy and Zepbound already demonstrate that they can reduce the risk of cardiovascular and chronic kidney diseases in addition to helping people lose weight. Now, a U.S.-wide trial will test whether tirzepatide, the active ingredient in Zepbound, can be an effective treatment for people with long Covid.
Part of a class of drugs called GLP-1, tirzepatide acts on receptors in the gut and brain to regulate appetite. As a result, people lose weight by eating less. But the reduction in body weight does not fully explain the positive effects on the heart and kidneys. Growing evidence suggests that the drugs have a broad anti-inflammatory effect on the body – an interesting mechanism for treating long Covid.
In the United States, up to 20 million people have suffered from long Covid, a chronic illness that lasts at least three months after an initial infection. While more than 200 symptoms of long Covid have been documented, some of the most common include cough, shortness of breath, brain fog, fatigue, mood changes, trouble sleeping and body aches.
Scientists still don’t fully understand how and why long Covid occurs, but they have found persistent inflammation in many patients. This chronic inflammation can be caused by lingering traces of viruses in the body or by misdirected antibodies, called autoantibodies, that attack a person’s cells and tissues. The hope is that tirzepatide can alleviate this inflammation and improve patients’ symptoms.
“The rationale for a GLP-1 drug is its powerful body- and brain-wide anti-inflammatory properties,” says Eric Topol, a cardiologist and director of the La Jolla, Calif.-based Scripps Research Translational Institute, which is sponsoring the trial.
Scripps researchers are recruiting 1,000 people across the country who are 18 or older and have long-term Covid medical documentation. Unlike most medical studies, which typically require multiple in-person visits, the Scripps trial is conducted entirely remotely. Participants will be randomized to receive either tirzepatide or a placebo by mail and take it for a year. They will receive a fitness tracker so researchers can measure their step counts, an important indicator of fatigue. Participants will also receive a smart scale and weigh themselves regularly. Since GLP-1s are used for weight management, study investigators want to make sure participants don’t lose too much weight during the trial.
Julia Moore Vogel, a co-principal investigator of the trial who herself has had long-term Covid, says the remote design of the trial was intentional. “For the long-Covid population, this is so crucial, because if you force people to come to a clinic, you systematically exclude the most severely affected people who are housebound or bedbound. It was really important for us to make sure those people were included.”
