A Study of Amantadine for Cognitive Dysfunction in Patients With Long-Covid

Feasibility Study of Amantadine for Cognitive Dysfunction in Patients With Long-Covid: A Pilot Randomized Control Trial

Purpose: To decrease symptom burden, improve cognitive function, improve endurance, and decrease fatigue in subjects with post-acute sequelae of COVID-19 (PASC) or "long-hauler" COVID using amantadine. If amantadine use is determined to be efficacious in this population, the findings of this study will be used towards a subsequent randomized control trial.

This study is a prospective, open-label, single-blind, randomized control study. Study duration is approximately 6 weeks starting at the baseline visit. We will recruit 30 participants (15 per arm) for this pilot study.

Inclusion Criteria:

• Age 20-65
• Can provide informed consent
• Confirmed COVID+ test (either rapid antigen or PCR) between 8 weeks and one year prior to initial visit.
• Able to consent in English
• Endorse symptoms during their initial evaluation and history with the provider that began around the time of the acute COVID19 infection (subjective) including cognitive changes such as cognitive fatigue, brain fog, memory issues,attention issues AND have symptoms in at least 1 out of the 2 following symptom categories:
• Category 1: Decreased endurance, physical fatigue, weakness
• Category 2: Depression, anxiety

Exclusion Criteria:

• Known hypersensitivity to amantadine
• Clinically significant psychiatric, neurologic, renal, hepatic, opthalmologic, cardiac impairment in the opinion of the investigators, including but not limited to:
• Psychiatric:
• Acute or chronic unstable Axis I psychiatric illness
• History of psychosis
• Severe depression Patient Health Questionnaire-9 (PHQ-9) score >= 20
• Suicidality
• Neurologic:
• Epilepsy
• Cognitive dysfunction predating COVID infection
• History of delirium
• Neurologic conditions with agitation or confusion