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Long COVIDPhase 2NCT06305780

RECOVER-AUTONOMIC Platform Protocol

A Phase 2 study testing IVIG + Coordinated Care and Ivabradine + Coordinated Care in people with Long COVID and Long Covid19, run by Kanecia Obie Zimmerman at 50 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study is a platform protocol designed to be flexible so that it is suitable for a wide range of settings within health care systems and in community settings where it can be integrated into COVID-19 programs and subsequent treatment plans. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Long COVID, Long Covid19, Long Covid-19
What is being tested?
IVIG + Coordinated Care and Ivabradine + Coordinated Care
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
381 participants
Where
50 sitesUnited States
Study dates
11 Mar 2024to 9 Jul 2025
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • ≥ 18 years of age at the time of enrollment
  • Previous suspected, probable, or confirmed SARS-CoV-2 infection, as defined by the Pan American Health Organization12ɸ ɸ Enrollment of participants with suspected or probable SARS-CoV-2 infection will only be allowed if they occurred before May 1, 2021 and be limited to no more than 10% of the total sample size per Study Drug Appendix. Refer to the Manual of Procedures (MOP) for details.
  • Suspected case of SARS-CoV-2 infection - Three options, A through C:
  • Meets the clinical OR epidemiological criteria.
  • Clinical criteria: Acute onset of fever AND cough (influenza-like illness) OR Acute onset of ANY THREE OR MORE of the following signs or symptoms: fever, cough, general, weakness/fatigue, headache, myalgia, sore throat, coryza, dyspnea, nausea, diarrhea, anorexia.
  • Epidemiological criteria: Contact of a probable or confirmed case or linked to a COVID-19 cluster; or B. Presents with acute respiratory infection with history of fever or measured fever of ≥ 38°C; and cough; with onset within the last 10 days; and who requires hospitalization); or C. Presents with no clinical signs or symptoms, NOR meeting epidemiologic criteria with a positive professional use or self-test SARS-CoV-2 antigen-Rapid Diagnostic Test.
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  • Probable case of SARS-CoV-2 infection, defined as meets clinical criteria above AND is a contact of a probable or confirmed case or is linked to a COVID-19 cluster.
  • Confirmed case of SARS-CoV-2 infection - Two options, A through B:
  • A person with a positive nucleic acid amplification test, regardless of clinical criteria OR epidemiological criteria; or B. Meeting clinical criteria AND/OR epidemiological criteria (See suspect case A). With a positive professional use or self-test SARS-CoV-2 Antigen-Rapid Diagnostic Test.
  • Moderate, self-identified autonomic symptoms (defined as COMPASS-31 >20) following a SARS-CoV-2 infection that has persisted for at least 12 weeks and is still present at the time of consent
  • OHQ/OIQ, question 1 score >2

Who cannot join

  • Known pregnancy, breast-feeding, or contemplating pregnancy during the study period
  • Known active acute SARS-CoV-2 infection ≤ 4 weeks from enrollment
  • Known renal failure (eGFR <20ml/1.73 m²)
  • Known atrial fibrillation or significant cardiac arrhythmia
  • Known cardiovascular conditions such as heart failure (Class 3-4), severe valvular disease
  • Clinically significant atherosclerotic disease, defined as history of stroke or myocardial infarction or revascularization 6 months prior to enrollment and/or current symptomatic angina
Show all 11Show fewer
  • Existing uncontrolled hypertension
  • Inability to comply with the protocol
  • Any condition that the investigator believes makes it inappropriate to treat with study intervention, including severe debility.
  • History of POTS or significant dysautonomia before COVID-19 index infection
  • Enrolled in another clinical trial or another study intervention appendix in this platform protocol * Patients who are a part of observational studies (e.g. imaging) may be included in this trial. Participants may enroll in another interventional trial or re-enroll in this trial for a different study intervention appendix 30 days after end of study (Follow-up visit).

Trial locations and contacts

50 sites in 1 country.

50 sites in 1 country

United States50 sites
  • Grady Memorial Hospital - Woodruff Memorial Research - Appendix A & B

    Atlanta, Georgia, 30303

  • Morehouse School of Medicine - Appendix A & B

    Atlanta, Georgia, 30310

  • University of Colorado Anschutz Medical Campus Clinical and Translational Research Center (CTRC) - Appendix A & B

    Aurora, Colorado, 80045

  • National Neuromuscular Research Institute - Appendix A & B

    Austin, Texas, 78759

  • Johns Hopkins Hospital - Appendix A Only

    Baltimore, Maryland, 21287

  • Brigham and Women's Hospital - Appendix A Only

    Boston, Massachusetts, 02115

  • University at Buffalo - Appendix A & B

    Buffalo, New York, 14203

  • Vermont Lung Center, University of Vermont - Appendix B Only

    Burlington, Vermont, 05405

  • St. Lawrence Health Medical Campus - Appendix A & B

    Canton, New York, 13617

  • University of Virginia Health System, University Hospital - Appendix A & B

    Charlottesville, Virginia, 22908

  • Rush University Medical Center - Appendix B Only

    Chicago, Illinois, 60612

  • University of Illinois at Chicago - Appendix A & B

    Chicago, Illinois, 60612

  • Cleveland Clinic - Appendix A & B

    Cleveland, Ohio, 44195

  • Southwest Family Medicine Associates - Appendix A & B

    Dallas, Texas, 75235

  • Henry Ford Hospital - Appendix A & B

    Detroit, Michigan, 48202

  • Duke University Hospital - Appendix A & B

    Durham, North Carolina, 27710

  • NorthShore University HealthSystem - Evanston Hospital - Appendix B Only

    Evanston, Illinois, 60201

  • University of Kansas Medical Center CTSU Fairway - Appendix A & B

    Fairway, Kansas, 66205

  • University of Florida Health - Appendix A & B

    Gainesville, Florida, 32610

  • East Carolina University - Appendix B Only

    Greenville, North Carolina, 27834

  • Queens Medical Center - Appendix B Only

    Honolulu, Hawaii, 96813

  • University of Texas Health Science Center at Houston

    Houston, Texas, 78701

  • Marshall Health - University Physicians and Surgeons - Appendix A & B

    Huntington, West Virginia, 25701

  • University of Iowa - Appendix A & B

    Iowa City, Iowa, 52242

  • University of Mississippi Medical Center - Appendix A & B

    Jackson, Mississippi, 39216

  • Evergreen Hospital Medical Center - Appendix A & B

    Kirkland, Washington, 98034

  • University of California San Diego - Appendix B Only

    La Jolla, California, 92307

  • Lakeland Regional Medical Center - Appendix A & B

    Lakeland, Florida, 33805

  • University of Kentucky Medical Center - Appendix A & B

    Lexington, Kentucky, 40536

  • University of Arkansas for Medical Sciences - Appendix A & B

    Little Rock, Arkansas, 72205

  • Cedars Sinai Medical Center - Appendix A & B

    Los Angeles, California, 90048

  • Vanderbilt University Medical Center

    Nashville, Tennessee, 37232

  • University Medical Center New Orleans - Appendix A & B

    New Orleans, Louisiana, 70112

  • Columbia University Irving Medical Center - Appendix A & B

    New York, New York, 10032

  • Sentara Norfolk General Hospital - Appendix A & B

    Norfolk, Virginia, 23507

  • University of Oklahoma Health Science Center - Oklahoma Clinical and Translational Science Institute - Appendix A & B

    Oklahoma City, Oklahoma, 73104

  • East Alabama Medical Center - Appendix B Only

    Opelika, Alabama, 36801

  • Innovation Clinical Trials Inc.- Appendix A & B

    Palmetto Bay, Florida, 33157

  • Kent Hospital - Appendix A & B

    Pawtucket, Rhode Island, 02860

  • Center for Complex Neurology - Appendix A & B

    Phoenix, Arizona, 85006

  • Oregon Health and Science University - Appendix A & B

    Portland, Oregon, 97239

  • Mayo Clinic - Appendix A & B

    Rochester, Minnesota, 55905

  • Bateman Horne Center - Appendix B Only

    Salt Lake City, Utah, 84102

  • University of Texas Health Science Center at San Antonio - Appendix A & B

    San Antonio, Texas, 78229

  • Providence Medical Research Center - Appendix A & B

    Spokane, Washington, 99204

  • Washington University School of Medicine - Appendix B Only

    St Louis, Missouri, 63110

  • Stanford University - Appendix B Only

    Stanford, California, 94305

  • Stony Brook University Hospital - Appendix A & B

    Stony Brook, New York, 11794

  • Montefiore Medical Center - Moses Campus - Appendix B

    The Bronx, New York, 10467

  • MedStar National Rehabilitation Hospital - Appendix B only

    Washington D.C., District of Columbia, 20010

Other trials in United States

About this study

Official title: RECOVER-AUTONOMIC: A Platform Protocol for Evaluation of Interventions for Autonomic Dysfunction in Post-Acute Sequelae of SARS-CoV-2 Infection (PASC)

This study is a platform protocol designed to be flexible so that it is suitable for a wide range of settings within health care systems and in community settings where it can be integrated into COVID-19 programs and subsequent treatment plans.

This protocol is a prospective, multi-center, multi-arm, randomized, controlled platform trial evaluating various interventions for use in the treatment of autonomic dysfunction symptoms, including cardiovascular complications and postural orthostatic tachycardia syndrome (POTS), in PASC participants. The interventions tested will include non-pharmacologic care and pharmacologic therapies with study drugs.

Read the detailed description

The hypothesis is that some of the autonomic dysfunction symptoms are immune-mediated, so immunotherapy and other applicable therapies will result in improvement in autonomic symptoms.

Interventions will be added to the platform protocol as appendices. Each appendix will leverage all elements of the platform protocol, with additional elements described in the individual appendix.

Being tested
IVIG + Coordinated Care, IVIG Placebo + Coordinated Care, Ivabradine + Coordinated Care, Ivabradine Placebo + Coordinated Care, IVIG + Usual Care
Keywords
PASC, POTS
Medical subject headings
Post-Acute COVID-19 Syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • IVIG + Coordinated CareDrug

    Participants will receive IVIG for a duration of 9 months and coordinated non-pharmacologic care for a duration of 3 months, concurrent with IVIG administration. Coordinated non-pharmacologic care involves volume expansion through high salt diet, water intake, abdominal binder, exercise/rehabilitation, motivation, education, and assisted care through a care coordinator.

  • IVIG Placebo + Coordinated CareDrug

    Normal saline given intravenously will be the control (placebo) product. Blinding IV bag and tubing covers will be used for both IVIG and Placebo administration.

    Participants will receive IVIG placebo for a duration of 9 months and coordinated non-pharmacologic care for a duration of 3 months, concurrent with IVIG placebo administration. Coordinated non-pharmacologic care involves volume expansion through high salt diet, water intake, abdominal binder, exercise/rehabilitation, motivation, education, and assisted care through a care coordinator.

  • Ivabradine + Coordinated CareDrug

    Participants will receive Ivabradine for a duration of 3 months and coordinated non-pharmacologic care for a duration of 3 months, concurrent with ivabradine administration. Coordinated non-pharmacologic care involves volume expansion through high salt diet, water intake, abdominal binder, exercise/rehabilitation, motivation, education, and assisted care through care coordinator.

  • Ivabradine Placebo + Coordinated CareDrug

    The control (placebo) oral tablets will be similar to the study drug, ivabradine.

    The control packaging matches the packaging.

    Participants will receive Ivabradine placebo for a duration of 3 months and coordinated non-pharmacologic care for a duration of 3 months, concurrent with ivabradine placebo administration. Coordinated non-pharmacologic care involves volume expansion through high salt diet, water intake, abdominal binder, exercise/rehabilitation, feedback, nutrition counseling, motivation, education, and assisted care through care coordinator.

  • IVIG + Usual CareDrug

    Participants will receive IVIG for a duration of 9 months and usual non-pharmacologic care (control) for a duration of 3 months. This will be concurrent with scheduled IVIG administration.

  • IVIG Placebo + Usual CareDrug

    Normal saline given intravenously will be the control (placebo) product. The normal saline will be of similar formulation and appearance to IVIG.

    Participants will receive IVIG placebo for a duration of 9 months and usual non-pharmacologic care (control) for a duration of 3 months. This will be concurrent with scheduled IVIG placebo administration.

  • Ivabradine + Usual CareDrug

    Participants will receive Ivabradine for a duration of 3 months and usual non-pharmacologic care (control) for a duration of 3 months, concurrent with ivabradine administration.

  • Ivabradine Placebo + Usual CareDrug

    The control (placebo) oral tablets will be similar to the study drug, ivabradine.

    The control packaging matches the packaging.

    Participants will receive Ivabradine placebo for a duration of 3 months and usual non-pharmacologic care (control) for a duration of 3 months, concurrent with ivabradine placebo administration.

Study groups in NCT06305780
Study groupRoleWhat they receive
Intravenous immunoglobulin (IVIG)ExperimentalIn the IVIG study, randomization will be implemented with 1:1:1:1 allocation among the combination of IVIG/placebo and coordinated/ usual non-pharmacologic care. All participants will receive IVIG or placebo for 9 months (36 weeks) with a follow-up period for an additional 3 months (total study duration for 12 months). See NCT06305793 for additional details.
Receives: Drug: IVIG + Coordinated Care; Drug: IVIG Placebo + Coordinated Care; Drug: IVIG + Usual Care; Drug: IVIG Placebo + Usual Care
IvabradineExperimentalIn the ivabradine study, randomization will be implemented with 1:1:1:1 allocation among the combinations of ivabradine/placebo and coordinated/usual care. All participants receive either ivabradine or placebo for 3 months (12 weeks) with a follow-up period for an additional 3 months (total study duration of 6 months). See NCT06305806 for additional details.
Receives: Drug: Ivabradine + Coordinated Care; Drug: Ivabradine Placebo + Coordinated Care; Drug: Ivabradine + Usual Care; Drug: Ivabradine Placebo + Usual Care

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Total Number of Participants Enrolled in Each Appendix

    Measured: During the enrollment period, approximately 16 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted12 Mar 2024
  2. Study start11 Mar 2024
  3. Primary completion9 Jul 2025
  4. Study completion9 Jul 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
In each Appendix trial, each participant will be assigned with equal probability to one of the factorial combinations based on two factors: (1) a study intervention/control and (2) non-pharmacologic intervention/control if the participant is eligible for the study intervention.
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
381 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06305780
Sponsor's protocol ID
Pro00112597
Other IDs
OTA-21-015G
Status last verified
Jul 2026
First submitted
4 Mar 2024
Last updated
3 Aug 2026
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No: The summary of results will be shared on the study website: https://recovercovid.org/

Publications

  • Fudim M, Novak P, Taub PR, Chung T, Zimmerman KO, Moy OV, Fissler HZ, Wen J, Freeman NLB, O'Brien S, Marti H, Cook D, Low P, Kim DY, Rosenberg Y, Granger CB, Shibao CA. Design and rationale of RECOVER-AUTONOMIC: A randomized platform trial evaluating interventions for Long COVID postural orthostatic tachycardia syndrome. Am Heart J. 2026 Jun;296:107384. doi: 10.1016/j.ahj.2026.107384. Epub 2026 Feb 18.

    PubMed 41720282

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing IVIG + Coordinated Care and Ivabradine + Coordinated Care in people with Long COVID and Long Covid19, run by Kanecia Obie Zimmerman at 50 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 11 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 3 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 50 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 3 Aug 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Total Number of Participants Enrolled in Each Appendix (time frame: During the enrollment period, approximately 16 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06305780, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Aug 2026.

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RECOVER-AUTONOMIC Platform Protocol (NCT06305780) | AzTrials