Post-COVID (long COVID / PASC)
Persistent symptoms ≥12 weeks after acute COVID-19 — fatigue, brain fog, GI disruption, exercise intolerance, autonomic dysregulation. Affects ~10% of infected adults.
What changes during this transition
Long COVID (PASC) has no FDA-approved treatment as of 2026 — the field is actively researching mitochondrial dysfunction, immune dysregulation, gut-barrier disruption, and microvascular damage as candidate mechanisms. Peptides relevant here mirror those mechanisms: thymosin alpha-1 addresses immune dysregulation (registered abroad for hepatitis/sepsis — strongest non-US clinical-use case in the library); SS-31 and MOTS-c target the mitochondrial-dysfunction theory of PASC fatigue (no PASC-specific trials yet); KPV addresses GI-dominant PASC presentations (the actual evidence base is IBD/inflammatory skin — extrapolation is honest); BPC-157 has community use for GI-dominant PASC and post-acute deconditioning, frequently stacked with low-dose naltrexone (LDN). Metformin (PASC prevention) and LDN (symptom management) currently have stronger evidence than any library peptide for this population.
Important caveat
Post-COVID myocarditis is a meaningful concern — if active or recent myocarditis is in your history, defer BPC-157 and other angiogenic peptides until cardiac workup clears them. Standard PASC workup first: orthostatic vitals (for POTS), TSH, CBC, ferritin, B12, vitamin D, basic metabolic panel. If exercise intolerance is prominent, pacing protocols (post-exertional malaise avoidance) outrank any peptide. Long-COVID clinics exist — they're the right starting point, not vendor peptides.
Peptides editorially relevant to post-covid (long covid / pasc)
5 peptides from the library — each evidence-tiered honestly.
- Thymosin Alpha-1Tier 2
Immunomodulatory peptide
Approved in 30+ countries for chronic hepatitis B and C and as a sepsis adjunct in critically ill patients — but not in the US. Evidence quality varies sharply by indication, and the popular 'general immune support' framing has no clinical backing.
- SS-31 (Elamipretide)Tier 2
Mitochondrial-targeted peptide
Mitochondrial-targeted peptide. FDA-approved for Barth syndrome (2024); explored in other mitochondrial conditions and as a longevity compound.
- MOTS-cTier 3
Mitochondrial-derived peptide
Mitochondrial-encoded peptide with strong rodent data on insulin sensitivity, endurance, and metabolic health.
- KPVTier 3
α-MSH C-terminal tripeptide
Short tripeptide fragment of a natural hormone (alpha-MSH). Appears to carry the anti-inflammatory signaling of the parent hormone without its pigmentation effects. Growing animal and early-human work, especially for inflammatory bowel disease.
- BPC-157Tier 3
Gastric pentadecapeptide
Extensively studied in rodents for tissue healing across tendon, gut, vascular, and CNS injury models. Human evidence is essentially absent — community framing far outpaces the data.
Want this list to grow? The library is editorial — if there’s a peptide you think belongs on this page with documented or mechanistically-clear evidence, send us a note with the citation and we’ll review it under the same evidence-tier discipline as every other entry.