What is your preferred first-line treatment for chronic fatigue in patients with long COVID-19?  

Assuming that a thorough workup for other causes of fatigue (anemia, thyroid dysfunction, sleep apnea, etc.) has been performed and is negative, no single medication has been proven by a randomized placebo-controlled trial to help chronic fatigue in PASC. Anecdotally, my colleagues who treat PASC ha...

Vitamin D, if the level is below 35 Vitamin C Attention to circadian rhythms (exposure to sunlight in the morning) Minimizing artificial light at night (blue light-blocking glasses) Minimize exposure to non-native EMF

Note that there is a multi-center clinical trial (RECOVER trials) starting with this question in mind. One protocol looks at exercise intolerance/fatigue. Another protocol trial looks at sleep disturbances (either hypersomnia or disrupted sleep). Hypersomnia patients will be randomized to modafini...

Treat insomnia if present (Melatonin, etc.) and attention to sleep patterns. Consider supplementation with vitamin D, fish oil, magnesium, and CoQ10. Rule out myalgia, myopathic syndromes, EDS, and other collagen connective tissue disorders, spondylosis, Lyme, other tick-borne disorders, EBV, et...