Cannabidiol (CBD) for long COVID
Last updated on August 13, 2024, 09:38 am
CANNABIDIOL (CBD)
What is cannabidiol?
CBD is an active ingredient found in the cannabis plant that does not contain THC (the component of marijuana that produces a high). According to the 2018 Farm Bill, hemp-derived products that are less than 0.3% THC are federally legal; therefore, CBD is considered legal at the federal level, but individual states may have different regulations. The FDA has currently approved one CBD product (Epidiolex), which is an oral solution that can be prescribed for certain types of epilepsy, such as Lennox-Gastaut syndrome and Dravet syndrome. CBD products can come in many forms and strengths, such as capsules, oil solutions, sublingual formulations, and sprays.
How can cannabidiol help alleviate certain long COVID symptoms?
In vitro, cannabidiol is a potent inhibitor of the SARS-CoV-2 virus. It has been suggested that CBD activates the interferon pathway, an antiviral component of the immune response that prevents viral replication, which leads to the degradation of viral RNA and subsequently prevents the release of cytokines (small proteins released by the body that can promote an inflammatory response).1
An analysis done by the University of Chicago on 1,212 patients showed that patients taking a prescribed oral solution of CBD for the treatment of epilepsy tested positive for COVID at significantly lower rates than matched patients who did not take CBD.2 This is believed to be due to the antiviral and anti-inflammatory effects of CBD.
Long COVID is believed to result from a prolonged hyperinflammatory state caused by dysregulation in the immune system. CBD can also cross the blood-brain barrier, downregulating the immune system and lowering neuroinflammation. By reducing the production of pro-inflammatory cytokines and increasing the levels of anti-inflammatory cytokines, CBD is hypothesized to improve long COVID symptoms.3 In addition, CBD improves symptoms common in many long COVID patients, such as anxiety, insomnia, cognitive impairment, and neuropathic pain.
What evidence supports the use of cannabidiol for long COVID?
Cannabidiol has been previously studied as a potential treatment for COVID symptoms in mild to moderate-severity infections. In a randomized placebo-controlled study of 105 patients, participants were randomized to receive 300 mg of CBD or placebo added to standard care for 14 days.4 The study found no differences between CBD and placebo in reducing or preventing worsening of clinical status for a COVID infection. Thus, CBD should not be used in the treatment or prevention of an active COVID infection.
There is currently a lack of studies investigating the use of cannabidiol for long COVID. A randomized controlled trial of 24 participants studied the use of a cannabidiol formulation in post-acute COVID-19 syndrome and found subjectively reported improvement in overall symptoms.5 A study conducted in the UK is currently under peer review in which 30 participants were prescribed CBD-dominant medical cannabis daily for five months. Breathlessness, fatigue, mood, cognition, and pain were assessed to determine the safety and efficacy of CBD for long COVID.6
What are some things to watch out for with cannabidiol?
No serious adverse events have been reported from trials. CBD is often well-tolerated but can cause side effects such as dry mouth, nausea, diarrhea, fever, drowsiness, fatigue, and changes in appetite.4,7 It is important to remember that the FDA does not approve nonprescription CBD products, and the quality and purity of these products may vary. CBD can also have drug interactions with many medications, including blood thinners (such as warfarin), anti-epileptic drugs, antidepressants, opioids, statins, and more. It is important to tell your doctor or pharmacist if you are taking CBD regularly to see if there are any potential drug interactions with your other medications.
References:
2) Reyer M. Researchers recommend clinical trials for CBD to prevent COVID-19 based on promising animal data. UChicagoMedicine. January 20, 2022. Accessed November 10, 2023. https://www.uchicagomedicine.org/forefront/research-and-discoveries-articles/researchers-recommend-clinical-trials-for-cbd
6) Thurgur H, Lynskey M, Schlag A, et al. Feasibility of a cannabidiol (CBD)-dominant cannabis based medicinal product (CBMP) for the treatment of Long COVID symptoms: A single arm open label feasibility trial. Authorea. July 4, 2023. Accessed November 10, 2023. https://www.authorea.com/users/635694/articles/652949-feasibility-of-a-cannabidiol-cbd-dominant-cannabis-based-medicinal-product-cbmp-for-the-treatment-of-long-covid-symptoms-a-single-arm-open-label-feasibility-trial
7) Bauer BA. What are the benefits of CBD – and is it safe to use? Health Lifestyle Consumer Health. Mayo Clinic. December 6, 2022. Accessed November 10, 2023. https://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/is-cbd-safe-and-effective/faq-20446700#:~:text=Though%20it%27s%20often%20well%2Dtolerated,dosage%20of%20CBD%20in%20products
Active Clinical Trials: Long COVID, cannabidiol | Card Results | ClinicalTrials.gov
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