Treatment of Neuropsychiatric Manifestations of Long-COVID with Empiric Acyclovir
Treatment of Neuropsychiatric Manifestations of Long-COVID with Empiric Acyclovir
Oral Antiviral Associated with Clinical Improvement and Reductions in Antibody Titers
By Peter A. McCullough, MD, MPH
The US HHS Biden Administration Long-COVID research program has spent $1B tax payer dollars and yielded zero new drugs, protocols, or ideas of how the clinical community can manage the plethora of patients with post acute sequelae after SARS-CoV-2 infection.
This report from German et al caught my attention. Four cases were seen in a psychiatry office all with well documented neuropsychiatric manifestations of long-COVID syndrome including delirium, seizures, dissociative and encephalopathic symptoms. Each case was treated with oral acyclovir, presumptively for either persistent SARS-CoV-2 replication or systemic reactivation of an endogenous virus. Acyclovir is active against Herpes simplex virus type 1 (HSV-1), HSV-2, Varicella zoster virus (VZV), Herpesvirus simiae (B-virus), and to a lesser degree Epstein-Barr virus (EBV). The rationale is given by the authors:
Acyclovir acts by competitively inhibiting DNA polymerase through phosphorylation of the drug compound [14,15]. Acyclovir is now also being proposed to act by preventing the binding of IL-12 to the IL-12 receptor. This is promising for the treatment of COVID-19 by treating the high levels of serum cytokines, inhibiting the cytokine storm inflammatory response [16]. The use of acyclovir is FDA-indicated for the treatment of herpes zoster infections, genital herpes, varicella, and herpes simplex virus encephalitis [17,18]. Acyclovir has been used to treat COVID-19, with proven efficacy, safety, and low cost in small-scale studies [15].
In each case after several months of therapy, there was clinical and serologic evidence of viral clearing. Large prospective, double-blind, placebo-controlled trials are required to make therapeutic claims and strong treatment recommendations. However, the next time I see a patient who falls into this syndromic category, I am going to consider this safe and widely available generic medication for an empiric trial of acyclovir 400 mg three times daily.
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Peter A. McCullough, MD, MPH
President, McCullough Foundation
Will the use of acyclovir now be prohibited for the treatment of long-COVID, even if not outright banned, because it is a generic drug? Will the FDA warn people not to take it because it is used to treat Pacheco's disease, a virus in birds, because we are not birds! Even though it has been frequently used for many years to treat herpes infections in humans. Let’s see what happens.
My son is a 17 year sufferer of PANS which has included post encephalytic neuro psychiatric symptoms reactive to many viruses. High doses of both antibiotics, usually Clarithromycin, and the antiviral Valcyclovir over the course of a few months was the go to treatment for the last 12 years. It was an inefficient and slow treatment protocol and he had to go on disability because of many months long recoveries. He was not vaccinated for Covid, he had it in April of 2021 (Omicron) and just had his second bout in Dec 2023. Both times he had Covid he was taking a prophylactic dose of IVM previous to the infection and took both supplemental and IVM protocols during the illness. I had researched and gleaned information from AFDLS, Dr Zalenko, FLOCC, and your protocols. He did have a post viral episode occurring six weeks post Covid and we decided to treat using IVM instead of Valcyclovir. He had a sinus infection and also treated with a normal course of antibiotic along with a titrated course of steroids. He had the quickest return to health and elimination of all symptoms of post viral encephalytic symptoms that he had ever had. He was well in 3 weeks! At this time he is five weeks post Covid 2023 and he is taking a prophylactic dose of IVM and your new supplemental treatment Natto/Brom/Curcumin with no symptoms of post viral.
A future study comparing Valcyclovir, Ivermectin and your new protocol for all post viral syndromes would be interesting. Thank you Dr M for your courage and research to help so many people who have been struggling and without treatment for post viral issues!