Since the early days of COVID-19 and even up to the present day, some people still struggle with its long-term symptoms. While infection rates have decreased, traditional treatment plans from health providers are unfortunately still not enough for those who suffer. However, surprising results from pre-clinical and early clinical studies show possible efficacy by a maybe not-so-surprising source–cannabis.
The hard-to-shake illness known as long COVID or “post-COVID conditions” (PCC) includes a vast spectrum of ongoing, relapsing, or new symptoms and is defined by the Centers for Disease Control as “a chronic condition that occurs after SARS-CoV-2 infection and is present for at least 3 months”. Evidence from a sample size of 17,418 adults published in June 2024 estimates that around 7% in the U.S. have had long COVID.
Just like its original variation, long COVID affects breathing, heart, and brain functions, but also adds the unfortunate dynamic of long-term physical and mental disabilities. According to a comprehensive meta-analysis by researchers, the five most common symptoms long COVID patients face are:
There is also widespread physical evidence of organ damage (e.g., brain, lungs, etc.) and impaired gaseous exchange.
Many people have unofficially accepted cannabis as having therapeutic potential, despite the lack of robust research on how cannabinoids interact with SARS-CoV-2, acute vs. long COVID, and the body’s endocannabinoid system.
However, its acceptance in similar inflammatory conditions is why so many medical patients and recreational consumers alike use cannabis as their preferred choice of how to get potential relief from chronic pain, muscle spasms, nausea, insomnia, and anxiety. In addition, gastrointestinal, neurological, and oxidative stress are common among medical marijuana patients and people who must deal with the destructive, multipronged horns of long COVID.
Emerging clinical research conducted in a small sample (n=28), with more currently underway, suggests that cannabis, specifically “cannabis-based medicinal products” (CBMPs), may effectively relieve many symptoms experienced by long COVID sufferers. CBMPs, along with their active ingredients, can interact with the endocannabinoid system as prescription medicines like Sativex (1:1 THC:CBD isolate) or as full-spectrum, plant-based oils and tinctures with varying cannabinoid, terpene, and flavonoid content.
Note that this new clinical research is highly limited and actively being investigated further to determine any efficacy. It is quite small and only single-blinded so far, meaning it is not robust enough to recommend cannabis as a treatment yet. Cannabinoid-based prescriptions like Sativex and Epidiolex are not FDA-approved to treat COVID or PCC and aren’t being studied for this yet, but full-spectrum CBMs and high-CBD extracts are in early, experimental phases. Nevertheless, these early studies are promising.
In vitro (lab-based) and in silico (computer-based) studies show that CBMPs are able to neutralize and prevent SARS-CoV-2 entry in cellular and organ tissues by attaching themselves to the infamous spike proteins that give COVID its other infamous name–coronavirus.
Researchers also determined that the possibility of multiple cannabinoid concentrations and ratios could have a more increased effect on preventing COVID as compared to acting individually. For many folks already in the know, this phenomenon is known as the entourage effect, a result of synergy between ratios of whole-plant compounds like cannabinoids, terpenes, and more.
The lab studies here largely emphasize cannabinoid acids CBGA, THCA, and CBDA as being the most promising antivirals against COVID, with neutral cannabinoids having some but less binding activity. These acidic compounds appear to be more reactive and antiviral than their neutral forms we are more familiar with, which we speculate below.
Further research into synergies with other, neutral cannabinoids like CBG, THCV, and CBDV could also prove useful to help create an even more potentially medicinal entourage effect for long COVID patients.
The anti-inflammatory benefits that CBD reportedly provides pose great potential for long COVID patients. Although researchers are still conducting more group-based clinical studies, one placebo-controlled, single-blind crossover study has already found correlations suggesting that CBD-rich CBMPs may improve symptoms of long COVID. Other studies also highlight CBD’s antioxidant potential and name it a leading candidate for providing antiviral protection against long COVID.
Meanwhile, a preclinical study from 2022 finds that prolonged inflammation present in mice infected with COVID also leads to anxiety. CBD is long known for its potential to provide relief from inflammation and anxiety in multiple other settings. Similar studies also suggest CBD’s efficacy in reducing respiratory inflammation and lung scarring. Such chronic conditions reflect the same types of difficulties that long COVID sufferers must deal with regularly, and how CBD can lend some possible relief.
READ: What Is THCA and What Are the Benefits of This Cannabinoid?
CBG is another cannabinoid that has great potential for helping long COVID patients as well. This particular cannabinoid is fast becoming more popular not only for its anti-inflammatory potential but also for its antioxidant, neuroprotective, and gastrointestinal capacities. CBG already has a solid reputation for reducing neuroinflammation caused by Parkinson’s and Alzheimer’s diseases in animal models, so it could prove useful for those suffering from similar neurological and psychiatric issues from long COVID.
Antiviral capabilities in combination with CBD and THC are also demonstrated by the precursor to all cannabinoids, specifically CBGA, which is also the precursor to CBG. CBG may also be more effective at relieving anxiety than CBD, using smaller doses and without the intoxication of THC. The fact remains that researchers need to conduct more clinical studies on the many possibilities of relief that CBG could unlock in the future.
CBMP compounds rich in THC also show some potential in being able to help with symptoms of long COVID. Formulas rich in THC were shown in vitro to attach to the spike proteins of COVID and neutralize them as an antiviral, but in several orders less than its raw form, THCA.
As far as clinical studies go, there aren’t any that examine THC for COVID. Still, THC in combination with other cannabinoids like CBD and CBG shows an ability to alleviate chronic inflammation and could be used for long COVID therapy as well. These findings all cement the important status that THC and THCA have as main members of the “entourage”.
It’s also important to note THC’s psychoactive nature compared to its non-psychoactive cannabinoid counterparts—THCA (acidic THC), CBD, and CBG—as this can be a key psychological factor for patients who may be more sensitive. As we all know, everybody handles THC differently, and patients dealing with long COVID are no exception.
Cannabinoids like CBDA, CBGA, and THCA can directly target coronavirus 2 proteins, showing antiviral effects. Preclinical and clinical studies also suggest these cannabinoids may help long COVID patients more effectively than other experimental treatments have so far.
CBDA, CBGA, and THCA–plus their neutral forms individually and cooperatively–already lend a helping hand to a variety of medical patients who suffer from many of the same symptoms as long COVID patients. It is natural to assume that they could similarly help people with long COVID by extension, but the clinical data needs to catch up before making any treatment conclusions.
Further research is necessary on the synergy of other less-known cannabinoids, even just in general. Clinical trials currently underway regarding the ability of cannabinoids to fight long COVID can hopefully be the key to getting patients the right care they still desperately seek.
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