Intervening in microbiome and inflammatory processes to reduce Long COVID

A P4O2 partnership between UMCG, Amsterdam UMC, TNO, Vitakruid and Novartis started the 2-year LIMIT project in December 2024. The Long COVID microbiome and inflammation trial (LIMIT) tests the effect of a 6-month intervention with a synbiotic supplement of Vitakruid on Long COVID complaints. The supplement is provided to 75 of the 150 patients in the study,  75 receive a placebo. Also, the effect of a therapeutic product of Novartis on inflammation is tested in vitro in nose cells.

A proportion of individuals recovering from COVID-19 (estimated at 12.7% at 90-150 days after SARS-CoV-2 infection, PMID: 35934007) experiences persistent, debilitating symptoms that significantly impair their quality of life and ability to function. Despite significant efforts, clear treatment or diagnosis guidelines for Long COVID remain elusive.

Participants will receive the synbiotic intervention or  placebo for six months, with pre- and post-intervention fecal sample collection for microbial analysis. The effect of the Vitakruid product on the microbiome will also be tested in vitro using the i-screen technique (TNO). Lung function testing and monthly questionnaires will assess symptomatology. SMURF-1 expression and the effects of the inhibitor will be tested ex vivo in nasal cells obtained at baseline and after the intervention.

The trial will yield clinical and microbiome datasets. Nasal specimens enable ex vivo SMURF-1 analysis, gene modulation, and patient stratification. Results from both work packages will be analyzed and disseminated, with integrated data providing insights into inflammation and intervention efficacy. This might lead to optimizing care for patients with Long COVID.

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