Post-COVID syndrome: Prednisolone shows modest, short-lived lift in treatment trial

by University Hospital Würzburg

edited by Gaby Clark, reviewed by Robert Egan

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Persistent fatigue, shortness of breath, difficulty concentrating, anxiety or low mood: Many people continue to suffer from symptoms months after a COVID-19 infection, significantly restricting their daily lives. However, reliable data on which treatments are effective remain scarce.

"People with post-COVID first come to us at the primary care doctor's office. That's why it was important to us to test a treatment right where those affected are being cared for—using medicines that have been known for decades, are affordable and readily available," says professor Ildikó Gágyor from the Institute of General Practice at Würzburg University Hospital (UKW).

The professor heads PreVitaCOV, one of the first studies into drug-based treatments for post-COVID syndrome in Germany—involving a large sample size of 323 patients for this condition. The study was conducted in Würzburg, Tübingen and Kiel. Its findings have now been published in the journal eClinicalMedicine.

Prednisolone and vitamins versus placebo

The study included adults who had had a confirmed SARS-CoV-2 infection at least 12 weeks previously and who were still suffering from typical post-COVID symptoms. The majority were women.

Participants were randomly assigned to one of four groups and received either low-dose prednisolone (a corticosteroid), a combination of vitamins B1, B6 and B12, both together or a placebo for 28 days.

As an anti-inflammatory agent, prednisolone could help to reduce persistent inflammatory processes, which are thought to be a possible cause of post-COVID syndrome. B vitamins are considered to have a neuroprotective effect.

Measurable effect on fatigue

The study measured the extent to which symptoms in five typical areas—fatigue, shortness of breath, cognitive function and concentration, anxiety and depression—changed over a 28-day period.

Result: After four weeks, participants who received prednisolone reported significantly greater relief from their symptoms than those who did not receive prednisolone. The difference was most pronounced in relation to fatigue—that is, the pathological exhaustion which many sufferers find particularly distressing.

No significant benefit could be demonstrated for the B vitamins. The medicines tested were equally well tolerated across all groups.

A significant difference—but is that enough?

The researchers are cautious in their interpretation of the results. Although the difference is statistically significant, it is small, and it remains unclear whether those affected would experience it as a noticeable improvement in their daily lives. The predefined threshold for a clinically relevant improvement was not reached.

"Our study does not support a recommendation for the widespread use of prednisolone—the effect is too small for that, and it disappeared again after treatment was stopped," explains professor Hanna Kaduszkiewicz from Kiel. Further studies are needed, for example, with a longer duration of treatment or with specifically selected patient groups who might benefit particularly.

"We need to understand even better for which patients prednisolone might ultimately be helpful. We hope to gain insights into this as soon as the results of the blood sample analyses are available," says professor Stefanie Joos from Tübingen University Hospital.

General practice research in a collaborative network

Nevertheless, those involved in PreVitaCOV see this as an important step: "We have shown that high-quality therapeutic trials on post-COVID are possible within general practice. Almost all participants stayed with the study until the end. That is a great demonstration of trust on the part of the patients," says Andreas Klug from the Würzburg team.

Publication details

Ildikó Gágyor et al., Low-dose prednisolone and B vitamins for post-COVID-19 syndrome in Germany: the PreVitaCOV randomised clinical trial, eClinicalMedicine (2026). DOI: 10.1016/j.eclinm.2026.104264

Journal information: EClinicalMedicine

Key medical concepts

Fatigue

Clinical categories

Family medicineCommon illnesses & PreventionInfectious diseases Provided by University Hospital Würzburg Who's behind this story?

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Citation: Post-COVID syndrome: Prednisolone shows modest, short-lived lift in treatment trial (2026, October 30) retrieved 30 October 2026 from https://medicalxpress.com/news/2026-10-covid-syndrome-prednisolone-modest-short.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.