Alleviation of Post-COVID-19 Cognitive Deficits by Treatment with EGb 761 (R): A Case Series

Objective: Unusual or unexpected effect of treatmentBackground: Cognitive symptoms persisting longer than 3 months after infection, such as memory loss, or difficulties con-centrating, have been reported in up to one-third of patients after COVID-19. Evidence-based therapeutic in-terventions to treat post-COVID-19 symptoms (also called "Long-COVID symptoms") have not yet been estab-lished, and the treating physicians must rely on conjecture to help patients. Based on its mechanism of action and its efficacy in treating cognitive impairment, as well as its good tolerability, the Ginkgo biloba special ex-tract EGb 761 (R) has been suggested as a remedy to alleviate cognitive post-COVID-19 symptoms. In many stud-ies, EGb 761 (R) has been demonstrated to protect endothelial cells, to have potent anti-inflammatory effects, and to enhance neuroplasticity. Case Reports: Here, we report for the first time the application of EGb 761 (R) in the therapy of post-COVID-19-related cogni-tive deficits. Three women and 2 men, aged 26 to 59 years (average age 34.6 years), presented with concen-tration and attention deficits, cognitive deficiencies, and/or fatigue 9-35 weeks after infection. A daily dose of 2x80 mg of EGb 761 (R) did not cause any detectable adverse effects, and it substantially improved or complete -ly restored cognitive deficits and, when initially present, also other symptoms, such as fatigue and hyposmia, within an observation period of up to 6 months. Conclusions: Our observations support the hypothesis that EGb 761 (R) might be a low-risk treatment option for post-COV-ID-19 patients with cognitive symptoms. Moreover, we derive recommendations for randomized controlled clin-ical trials to confirm efficacy in that indication.