Dapagliflozin for Long COVID Syndrome

An estimated 30 million Canadians have been infected by the virus causing COVID-19 since the start of the pandemic. A recent Canadian survey found that 10-30% of COVID survivors describe long-term symptoms, with daily activities often limited by fatigue and shortness of breath. This condition is referred to as long COVID syndrome. Other studies have also shown that patients have a 50-70% higher risk for diabetes and heart disease in the first 12 months following COVID-19 infection. We recently evaluated 215 patients at 3-6 months post-COVID-19 infection and compared them to 133 patients without prior COVID-19. We performed whole body MRI and found significant abdominal fat accumulation in patients with prior COVID-19. Abdominal fat has been linked to a number of health issues including an increased risk for diabetes and heart disease. We also found that fat accumulation in the leg muscles was associated with long COVID symptom severity. We are the first group to identify these abnormalities in patients with prior COVID-19 infection. Dapagliflozin is a drug therapy that reduces the risk of heart disease in patients with diabetes and it has also been shown to reduce fat volumes in the abdomen. This medication has been studied in patients with acute COVID and was shown to be safe. However, dapagliflozin has not been evaluated in patients with long COVID syndrome. For this study, we will recruit 706 patients with long COVID syndrome and randomly assign them to 12 months of dapagliflozin or a placebo pill. All patients will undergo MRI to assess fat content in their abdomen and leg muscles. We expect to find that patients taking dapagliflozin will have lower abdominal fat and a lower risk for developing diabetes and heart disease. If dapagliflozin is found to be effective then it would be the first proven treatment of long COVID syndrome. It could immediately be used to help patients with this poorly understood condition.