What Is the Role of Palmitoylethanolamide Co-Ultramicronized with Luteolin on the Symptomatology Reported by Patients Suffering from Long COVID? A Retrospective Analysis Performed by a Group of General Practitioners in a Real-Life Setting

Abstract

Long COVID is a recognized post-viral syndrome characterized by neurological, somatic and neuropsychiatric symptoms that might last for long time after SARS-CoV-2 infection. An ever-growing number of patients come to the observation of General Practitioners complaining of mild or moderate symptoms after the resolution of the acute infection. Nine General Practitioners from the Rome area (Italy) performed a retrospective analysis in order to evaluate the role of the supplementation with Palmitoylethanolamide co-ultramicronized with Luteolin (PEALUT) on neurologic and clinical symptoms reported by their patients after COVID-19 resolution. Supplementation with PEALUT helped to improve all patient-reported symptoms, especially pain, anxiety and depression, fatigue, brain fog, anosmia and dysgeusia, leading to an overall improvement in patients' health status. To our knowledge these are the first data presented on Long COVID patients collected in a territorial setting. Despite their preliminary nature, these results highlight the pathogenetic role of "non-resolving" neuroinflammation in Long COVID development and consequently the importance of its control in the resolution of the pathology and put the focus on the General Practitioner as the primary figure for early detection and management of Long COVID syndrome in a real-life setting. Future randomized, controlled, perspective clinical trials are needed to confirm this preliminary observation.

Keywords: PEALUT; anosmia; brain fog; dysgeusia; fatigue; long COVID; neuroinflammation; pain; real-life setting.

Figure 1

Pain intensity over time (PD-Q NRS scores). (a) Current pain intensity at each time-point; (b) strongest pain intensity during the previous month at each time-point; (c) average pain intensity during the previous month at each time-point. * Significant change over time (GLMM); ** Significant change compared to previous assessment (post hoc analysis). PD-Q: Pain Detect Questionnaire; NRS: Numerical Rating Scale; T0: examination prior to start treatment with PEALUT; T60: examination after 60 days of treatment with PEALUT; T90: examination after 90 days of treatment with PEALUT.

Figure 2

Depression and anxiety symptoms over time. (a) HAM-D score; (b) HAM-A score. * Significant change over time (GLMM); ** Significant change compared to previous assessment (post hoc analysis). HAM-D: Hamilton Depression Questionnaire; HAM-A: Hamilton Anxiety Questionnaire; T0: examination prior to start treatment with PEALUT; T60: examination after 60 days of treatment with PEALUT; T90: examination after 90 days of treatment with PEALUT.

Figure 3

Number of symptoms presented by patients at each time-point. * Significant change over time (GLMM); ** Significant change compared to previous assessment (post hoc analysis). T0: examination prior to start treatment with PEALUT; T60: examination after 60 days of treatment with PEALUT; T90: examination after 90 days of treatment with PEALUT.

Figure 4

Symptom distribution among patients over time. * Significant change over time (GLMM). T0: examination prior to start treatment with PEALUT; T60: examination after 60 days of treatment with PEALUT; T90: examination after 90 days of treatment with PEALUT.

Figure 5

Change in the health status perceived by patients according to the PGIC scale at the end of treatment.