MaineHealth has joined the National Institutes of Health (NIH) Researching COVID to Enhance Recovery (RECOVER) Initiative to investigate potential treatments for long-term symptoms following COVID-19 infection. The healthcare system will participate in mid-stage clinical trials specifically targeting exercise intolerance and post-exertional malaise (PEM), two of the most debilitating symptoms experienced by long COVID patients.
The MaineHealth Institute for Research (MHIR) is now enrolling participants in two RECOVER-ENERGIZE clinical trials at its Scarborough research site, with recruitment continuing through July 2025. These trials represent a significant step forward in addressing the growing public health challenge of long COVID, which affects millions of Americans with symptoms persisting months after initial infection.
Two Targeted Intervention Approaches
The first trial focuses on personalized cardiopulmonary rehabilitation, combining exercise training, strength and flexibility training, education, and social support. This comprehensive program targets individuals experiencing exercise intolerance, characterized by symptoms such as shortness of breath and fatigue during physical activity following COVID-19 infection.
Importantly, patients identified as having PEM through validated screening questionnaires will be excluded from this trial to prevent potential symptom exacerbation. Participants will be randomized to receive either the full rehabilitation program or basic exercise education for a three-month period.
The second trial evaluates structured pacing, currently the only intervention used to treat PEM—a condition where symptoms worsen following physical or mental exertion. This approach helps participants identify, control, and minimize symptoms by carefully regulating daily activities. The trial deliberately excludes exercise training or physical movement components to protect participants from worsening PEM symptoms. Participants will be randomized to either structured pacing with a trained coach or basic PEM education for three months.
Dr. Clifford Rosen, principal investigator of both the RECOVER observational study and the ENERGIZE interventional study at MaineHealth, emphasized the significance of these trials: "This NIH-sponsored intervention trial is a unique opportunity for individuals with Long COVID to participate in a program that may improve their exercise capacity. We hope that these studies will lead to treatments that can significantly improve these patients' quality of life."
Patient-Centered Research Design
Both trials were developed with extensive community feedback and in close partnership with patient representatives. The PEM trial specifically addresses concerns raised by patient advocacy groups regarding safety and aims to better understand how structured pacing may help improve symptoms.
This patient-centered approach reflects growing recognition within the medical community that long COVID research must incorporate the lived experiences of those affected by the condition.
Part of Broader RECOVER Initiative
With these two studies, MaineHealth joins 50 RECOVER study sites nationwide investigating treatments for the most common and burdensome long COVID symptoms. The RECOVER Initiative is currently testing 13 treatments across eight clinical trials, addressing various aspects of long COVID including viral persistence, neurological symptoms like brain fog, and autonomic nervous system dysfunction.
MHIR has previously participated in RECOVER's PROMIS study examining potential causes of long COVID and in early research characterizing common symptoms among affected individuals.
Dr. Doug Sawyer, MaineHealth's chief academic officer, highlighted the alignment between this research and the organization's mission: "MHIR's participation in this important NIH-supported research is a clear example of how our care team lives the MaineHealth vision of working together so our communities are the healthiest in America. The results of these studies into long COVID could have a tangible impact on the lives of our neighbors and those suffering from long COVID worldwide."
Long COVID's Significant Health Burden
Long COVID, also known as Post-Acute Sequelae of SARS-CoV-2 infection (PASC), represents a significant and growing health challenge. Symptoms can persist for months or even years after initial infection, substantially impacting quality of life and ability to work. Exercise intolerance and PEM are among the most frequently reported and debilitating symptoms, with limited treatment options currently available.
The condition affects an estimated 7-23% of individuals who have had COVID-19, according to various studies, translating to millions of Americans living with persistent symptoms. The economic impact is substantial, with many patients unable to return to pre-infection levels of activity and employment.
Enrollment Information
Those interested in participating in these trials at MaineHealth can contact Kathryn Stevens, RN, FNP at ENERGIZE@mainehealth.org. Additional information about RECOVER clinical trials nationwide is available at trials.recovercovid.org.
The trials represent a crucial step toward developing evidence-based treatments for long COVID, potentially benefiting millions suffering from persistent symptoms worldwide.
