Oral minocycline therapy as first-line treatment in patients with Myalgic encephalomyelitis and long COVID: A pilot study.

Background: Myalgic encephalomyelitis (ME) is associated with long COVID and also untoward sequelae after anti-coronavirus vaccination. Recently, oral minocycline therapy has been reported to ameliorate symptoms in patients with ME, particularly at the initial stage of the disease. Methods: Oral minocycline (100 mg × 2 on the first day, followed by 100 mg/day for 41 days) was administered to 55 patients with ME that emerged during the "Corona era," including 19 patients with long COVID and 5 patients diagnosed with untoward sequalae following coronavirus vaccination. Results: Acute adverse effects including nausea and/or dizziness caused four (7 %) patients to discontinue treatment in the first few days. Among the other 51 patients who completed therapy, favorable effects were observed, including a decrease in performance status score or index for restricted activities of daily living ≥2 points in 41 (80 %) patients. Disease duration was inversely associated with the favorable therapeutic effects ( Conclusions: Oral minocycline was effective at ameliorating symptoms in patients with ME including long COVID and post-coronavirus vaccination sequalae. It represents an effective first-line therapeutic option for these patients in the initial stage.