This paper https://www.nature.com/articles/s42255-025-01290-1 is interesting. They tested Vitamin B3 in a pill that is
designed to release nicotinamide [a form of Vitamin B3] in the lower small intestine and colon
And found:
Acute COVID-19 might be safely and easily reduced in severity and duration
In general, no improvement in Long COVID rates (here termed Post-COVID syndrome, PCS)
BUT, for people with recovery-like trajectories, they found superior outcomes. This takes a few quotes:
The subgroup was
participants at risk who had shown improvement in the primary endpoint or one of the three key secondary endpoints in the acute phase of the disease
In [this] subgroup, a significant benefit of nicotinamide was also observed in participants with PCS (nicotinamide: n = 48, PCS score 8.33 ± 0.84; placebo: n = 57, PCS score 11.82 ± 1.03; absolute difference: −3.49; 95% confidence interval, −6.1 to −0.86; P = 0.010
Now we all know how Long COVID isn't one single disease. Let's assume for a second that other results that suggest at least one subset has a microbiome component are correct.
As they say "life finds a way" so it would make sense that remnant gut populations could rebound over time and that this subset of LC sufferers might be more likely to have recovery trajectories. (This while we have no treatments for any subset.)
This obviously won't stop the pandemic nor its consequences, but still, here's hoping that there's no patent encumbrance on coating B3 for lower-gut delivery.
Of course here in BC we'll get access the same time we get access to Metformin.
h/t https://zeroes.ca/explore I think?