NIH's RECOVER-TLC Long COVID Trials Face Delays, Won't Begin Enrollment Until Summer 2026
核心洞察
The NIH's RECOVER-TLC initiative will begin enrolling participants in new Long COVID (搜索) clinical trials this summer, marking nearly two years since the program launched with promises of urgency for treating this chronic condition.
Three new trials will test low-dose naltrexone in children and young adults, semaglutide (Ozempic/Wegovy) for inflammation, and stellate ganglion block procedures, while a baricitinib study is already enrolling participants.
Patient advocates express disappointment with the timeline delays, noting that despite $1.8 billion in total RECOVER funding, the program has been slow to deliver treatment trials for the tens of millions of Americans affected by Long COVID (搜索).
The National Institutes of Health's RECOVER-Treating Long COVID (搜索) (RECOVER-TLC) initiative will not begin enrolling participants in new clinical trials until summer 2026, nearly two years after the program launched with promises to deliver greater urgency for Long COVID research affecting tens of millions of Americans.
RECOVER-TLC leaders and staff from the National Institute for Allergy and Infectious Diseases (NIAID (搜索)) and Foundation for the National Institutes of Health (FNIH) shared this timeline during a webinar on January 23, 2026. The webinar itself was delayed from its original October 2025 schedule due to a government shutdown.
Four Trials Target Different Treatment Approaches
The initiative plans to launch three new trials alongside one existing study. The baricitinib trial, called REVERSE-LC, is furthest along and already enrolling participants. RECOVER-TLC provided additional funding to expand this immunomodulating drug study from four to 17 sites across the United States.
Two new trials are scheduled to begin enrollment in summer 2026. The first will test low-dose naltrexone (LDN) specifically in children and young adults, marking a unique focus on pediatric populations. LDN involves small amounts of an opioid addiction drug that some people with Long COVID (搜索) and myalgic encephalomyelitis (搜索) have used off-label.
"I wish I had a date for you but I do not," said NIAID (搜索) medical officer Kay Tomashek when asked about the LDN trial's enrollment start date, adding that enrollment may begin in the summer.
The second summer trial will test semaglutide (known commercially as Ozempic and Wegovy), a GLP-1 receptor (搜索) agonist that researchers hypothesize could address inflammation in Long COVID (搜索). NIAID (搜索) medical officer Agam Rao described this trial as "complementary" to another GLP-1 clinical trial at Scripps Research (搜索) testing tirzepatide (Zepbound).
"Semaglutide is only a GLP-1 agonist, while tirzepatide is a dual agonist with a glucose-dependent insulinotropic polypeptide component as well as GLP-1 component," Rao explained. "Comparing results from both trials will give us a sense of whether the GLP component alone is beneficial."
The Scripps trial has already completed enrollment, recruiting 1,000 participants in less than two months through a fully remote design.
Stellate Ganglion Block Trial in Development
A fourth trial will test the stellate ganglion block procedure, which NIAID (搜索) program officer Joseph Breen described as a "Phase 2, randomized, blinded, sham-controlled trial" comparing the procedure against a similar "sham" procedure. While patients will be blinded, healthcare providers administering treatments will not be, as the nature of this procedure makes double-blinding difficult. NIAID staff did not provide a timeline for this trial.
Community Input Shapes Trial Selection
RECOVER-TLC has received nearly 600 potential treatment submissions from people with Long COVID (搜索), researchers, and community members. These submissions undergo review by working groups that include community members who submitted treatments or applied to serve the initiative.
"Our output is better because of the community input," said Breen, who helps lead RECOVER-TLC.
The initiative's portal for prospective treatments remains open, with staff reviewing submissions on a rolling basis, according to FNIH project manager Lizzie Geerling. While RECOVER-TLC has selected four treatments for its initial round, the initiative may support additional studies in the future.
Funding and Timeline Concerns
RECOVER-TLC emerged as an offshoot of the larger RECOVER program, which received $1.1 billion in initial Congressional funding in late 2020, followed by additional NIH funds totaling approximately $1.8 billion. Much of that funding supported observational studies rather than treatment trials.
The delays have frustrated patient advocates who pushed for the creation of RECOVER-TLC specifically to accelerate treatment research. "RECOVER-TLC was supposed to correct the mistakes of RECOVER 1.0 — at this point it really feels like more of the same," said Ezra Spier, a Long COVID (搜索) patient-advocate and creator of Long COVID Studies, which tracks clinical trials.
Spier acknowledged the complexity of clinical trial development but expressed disappointment given the program's significant budget and initial promises of urgency.
RECOVER-TLC has not yet shared specific budget details for individual trials, despite questions from advocates. Breen indicated that budgets will become clearer once trial sites are determined.
Next Steps
The GLP-1 protocol working group is currently meeting twice weekly to discuss trial design. Rao stated that "our goal is for the synopsis to be available for public comment sometime in the spring, and then for the study to actually be ready for enrollment, perhaps late summer."
The LDN trial recently completed a public comment period where community members reviewed and provided feedback on the protocol draft. The protocol working group is now incorporating that feedback while reviewing potential trial sites.
RECOVER-TLC staff plan to provide further updates at their next webinar, scheduled for March 2026.