The coronavirus disease 2019 (COVID-19) pandemic has been one of the most severe medical crises in recent decades. While acute respiratory symptoms have been the primary focus, an increasing number of patients now report persistent symptoms, collectively referred to as long COVID. The pathogenesis of long COVID is believed to be multifactorial, involving viral and host factors as well as downstream effects of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Currently, there is no effective treatment for long COVID, and the prolonged and often severe course poses a substantial burden on healthcare systems. Recent research has highlighted similarities between long COVID and chronic fatigue syndrome (CFS), which may provide a framework for developing treatments for long COVID. One such candidate is low-dose naltrexone (LDN), an opioid antagonist that has shown promise in the management of CFS. The following case describes a patient with long COVID that developed after COVID-19 vaccination and whose symptoms were fully alleviated with LDN therapy.
