COVID-19 is highly transmissive and contagious disease with a wide spectrum of clinicopathological issues, including respiratory, vasculo-coagulative, and
immune disorders. In some cases of
COVID-19, patients can be characterized by clinical sequelae with mild-to-moderate symptoms that persist long after the resolution of the acute
infection, known as
long-COVID, potentially affecting their quality of life. The main symptoms of
long-COVID include persistent
dyspnea,
fatigue and weakness (that are typically out of proportion, to the degree of ongoing lung damage and gas exchange impairment), persistence of
anosmia and
dysgeusia, neuropsychiatric symptoms, and
cognitive dysfunctions (such as
brain fog or memory lapses). The appropriate management and prevention of potential
long-COVID sequelae is still lacking. It is also believed that long-term symptoms of
COVID-19 are related to an immunity over-response, namely a
cytokine storm, involving the release of pro-inflammatory
interleukins,
monocyte chemoattractant proteins, and tissue
necrosis factors.
Palmitoylethanolamide (PEA) shows affinity for
vanilloid receptor 1 and for
cannabinoid-like
G protein-coupled receptors, enhancing
anandamide activity by means of an entourage effect. Due to its anti-inflammatory properties, PEA has been recently used as an early add-on
therapy for respiratory problems in patients with
COVID-19. It is believed that PEA mitigates the
cytokine storm modulating cell-mediated immunity, as well as counteracts
pain and oxidative stress. In this article, we theorize that PEA could be a potentially effective nutraceutical to treat
long-COVID, with regard to
fatigue and
myalgia, where a mythocondrial dysfunction is hypothesizable.