Lidocaine Treatment for Long COVID Faces Scrutiny Amidst Ethical Concerns and Commercialization

A Dutch clinic, Excellent Care Clinics, has been offering a lidocaine-based treatment for Long COVID, claiming significant improvements in patient symptoms. However, the approach has drawn criticism from medical experts due to concerns about research methodology, ethical standards, and the clinic’s simultaneous pursuit of patents and financial gain. The story highlights the desperation of Long COVID sufferers and the challenges of rapidly evaluating potential treatments for this complex condition.

What is Long COVID?

Long COVID, also known as post-COVID or PASC (Post-Acute Sequelae of SARS-CoV-2 infection), is a chronic condition characterized by a wide range of persistent symptoms, including severe fatigue, post-exertional malaise (PEM), reduced exercise tolerance, pain, breathlessness, and cognitive dysfunction such as brain fog. These symptoms can significantly impair daily functioning, leading to work absence, social isolation, and diminished quality of life. Excellent Care Clinics estimates that approximately 450 million people worldwide have been affected by prolonged post-COVID symptoms.

The Lidocaine Treatment at Excellent Care Clinics

Excellent Care Clinics developed a treatment involving a new formulation and method of administering lidocaine, a well-known local anesthetic. In an observational study of 103 patients with severe Long COVID symptoms lasting an average of 2.5 years, 78% reported clear and clinically relevant improvements in symptoms and quality of life. The study was published in eClinicalMedicine, part of The Lancet Group.

The treatment involves patients self-administering lidocaine at home, following a phased protocol: 500 mg every other day for the first 7 weeks, 500 mg daily for weeks 7-14, and up to 1000 mg/day thereafter for non-responders. Researchers at Vrije Universiteit Amsterdam and Amsterdam UMC analyzed the data, monitoring patients remotely through an app and other measurement tools.

Ethical and Methodological Concerns

Despite the reported improvements, the study has faced significant criticism. Experts have raised concerns about the lack of a control group (placebo), which is considered a gold standard in medical research. Without a control group, it’s challenging to determine whether the observed improvements are due to the lidocaine treatment or other factors, such as the natural fluctuation of symptoms or the placebo effect. Researchers at Erasmus MC have described the approach as “very harmful” due to the false hope it may create.

the study design was criticized before it began by ZonMw, a Dutch institute that distributes subsidies for medical research, which declined to fund the research due to concerns about the research design. The clinic proceeded with the study independently.

The study also reported adverse events, including 73 incorrect injections resulting in side effects like tinnitus, dizziness, or fainting. One patient required emergency room treatment after administering a toxic dose of lidocaine.

Commercialization and Lobbying Efforts

Concurrent with the treatment and research, Excellent Care Clinics applied for patents on the new formulation and administration method of lidocaine. The clinic also established a BV structure to prepare for international commercial exploitation. The clinic has been actively lobbying health insurers to reimburse the treatment, which costs patients approximately €3,000 per month. Excellent Care Clinics initially covered the cost for the first 100 patients, but now patients are responsible for the full expense.

Current Status and Future Outlook

As of February 2026, health insurers have not yet agreed to reimburse the lidocaine treatment, citing the lack of robust scientific evidence. The Central Committee on Human Research is currently investigating whether the clinic conducted a prohibited drug experiment. The future of the treatment remains uncertain, with experts emphasizing the need for rigorous, controlled studies to determine its true efficacy and safety.