What the Trial Entailed

In a study published last month titled "Efficacy of Adaptogens in Patients with Long COVID-19: A Randomized, Quadruple-Blind, Placebo-Controlled Trial," researchers led by Karosanidze et al. enrolled 100 survivors of Covid-19 (average age 48.9 years; 86% female) into either the ADAPT-232/Chisan group or a placebo group. Participants included individuals who had tested positive for SARS-CoV-2 and had experienced at least three long-Covid symptoms for at least 30 days before enrollment. However, those who had severe Covid-19 complications requiring mechanical ventilation were excluded, as were individuals with serious pre-existing health conditions such as renal failure, uncontrolled diabetes, autoimmune disorders, and pregnant or nursing women.

The trial took place in Georgia, while the ADAPT-232/Chisan product was manufactured in accordance with the International Council for Harmonisation (ICH) standards at the Swedish Herbal Institute. Each daily oral dose consisted of 60 mL containing:

• 180 mg of Rhodiola rosea L. extract
• 600 mg of Schisandra chinensis extract
• 156 mg of Eleutherococcus senticosus extract

Additionally, the inactive ingredients included dark syrup, anhydrous ethanol, glycerol, caramel aroma, polysorbate 80, and water. Patients consumed the treatment twice daily for 14 days. The placebo was designed to mimic the appearance, smell, and taste of the active treatment while containing only the inactive components.

Participants were assessed over a span of 21 days, which included 14 days of treatment and a 7-day follow-up.

Findings from the Trial

1. ADAPT-232/Chisan notably enhanced walking duration—a common indicator of physical endurance and fatigue—by 18 minutes compared to the placebo group at the 21-day mark. Specifically, the average walking time for participants increased from 18 minutes to 36 minutes.
2. The treatment also resulted in a fivefold decrease in creatinine levels, a biomarker for kidney health, compared to the placebo. However, there was no significant effect on other inflammatory markers such as interleukin-6, C-reactive protein, or D-dimer.
3. Unfortunately, ADAPT-232/Chisan did not significantly impact the duration of long-Covid symptoms over the 21-day period. The average duration of symptoms such as fatigue, headache, and respiratory issues did not show meaningful differences between the two groups.
4. Adverse events were minimal, with no incidents reported in the ADAPT-232/Chisan group and only one case of allergic conjunctivitis in the placebo group.

In summary, while ADAPT-232/Chisan shows potential by increasing physical capacity and improving kidney function, its overall effectiveness in treating long-Covid symptoms remains limited.

Insights on ADAPT-232/Chisan

Prior studies have also explored ADAPT-232/Chisan, with three randomized placebo-controlled trials yielding positive results. For instance, a 2005 trial found that the treatment, combined with antibiotics, improved recovery times in pneumonia patients. A 2010 trial demonstrated cognitive benefits in fatigued women, while a 2015 study highlighted reduced fatigue and emotional stress in elite athletes.

Preclinical studies have suggested that ADAPT-232/Chisan may enhance cellular pathways related to energy metabolism and neurological function, thereby providing a broad spectrum of health benefits.

Nonetheless, the variability in individual responses to ADAPT-232/Chisan makes its effects less predictable than those of more targeted medications. Given the diverse nature of long-Covid, a multifaceted approach like that offered by ADAPT-232/Chisan may be more effective.

Further Research and Considerations

ADAPT-232/Chisan is not the sole treatment under investigation for long-Covid; other therapies include prednisolone and various herbal formulations. However, many of these studies lack the rigor of randomized placebo-controlled trials, which are considered the gold standard.

While the Georgian/Swedish trial was well-structured, it did have limitations, including a relatively small sample size and a short study duration. Additionally, the trial's funding source raises potential conflict of interest concerns.

Ultimately, this trial represents a step forward in understanding long-Covid treatments, but it is only one piece of a larger puzzle. Ongoing research continues to explore various therapeutic options, underscoring the scientific community's commitment to addressing long-Covid.

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