Three institutes specialising in general practice, under the leadership of the University of Würzburg, have carried out trials to investigate the effectiveness of prednisolone and B vitamins in treating post-COVID syndrome.
Persistent fatigue, shortness of breath, difficulty concentrating, anxiety or low mood: many people continue to suffer from symptoms months after a COVID-19 infection, which significantly restrict their daily lives. However, reliable data on which treatments are actually effective remains scarce.
"People with post-COVID first come to us at the GP surgery. That's why it was important to us to test a treatment right where those affected are being cared for - using medicines that have been known for decades, are affordable and readily available," says Professor Ildikó Gágyor from the Institute of General Practice at Würzburg University Hospital (UKW).
The professor heads PreVitaCOV, one of the first studies into drug-based treatments for post-COVID syndrome in Germany - involving a large sample size of 323 patients for this condition. The study was conducted in Würzburg, Tübingen and Kiel. Its findings have now been published in the specialist journal eClinicalMedicine.
Prednisolone and vitamins versus placebo
The study included adults who had had a confirmed SARS-CoV-2 infection at least twelve weeks previously and who were still suffering from typical post-COVID symptoms. The majority were women.
Participants were randomly assigned to one of four groups and received either low-dose prednisolone (a corticosteroid), a combination of vitamins B1, B6 and B12, both together, or a placebo for 28 days.
As an anti-inflammatory agent,prednisolone could help to reduce persistent inflammatory processes, which are thought to be a possible cause of post-COVID syndrome. B vitamins are considered to have a neuroprotective effect.
Measurable effect on fatigue
The study measured the extent to which symptoms in five typical areas - fatigue, shortness of breath, cognitive function and concentration, anxiety and depression - changed over a 28-day period.
Result: After four weeks, participants who received prednisolone reported significantly greater relief from their symptoms than those who did not receive prednisolone. The difference was most pronounced in relation to fatigue - that is, the pathological exhaustion which many sufferers find particularly distressing.
No significant benefit could be demonstrated for the B vitamins. The medicines tested were equally well tolerated across all groups.
A significant difference - but is that enough?
The researchers are cautious in their interpretation of the results. Whilst the difference is statistically significant, as it is small, it remains unclear whether those affected would experience it as a noticeable improvement in their daily lives. The pre-defined threshold for a clinically relevant improvement was not reached.
"Our study does not support a recommendation for the widespread use of prednisolone - the effect is too small for that, and it disappeared again after treatment was stopped," explains Professor Hanna Kaduszkiewicz from Kiel. Further studies are needed, for example with a longer duration of treatment or with specifically selected patient groups who might benefit particularly.
"We need to understand even better for which patients prednisolone might ultimately be helpful. We hope to gain insights into this as soon as the results of the blood sample analyses are available," says Professor Stefanie Joos from Tübingen University Hospital.
General practice research in a collaborative network
Nevertheless, those involved in PreVitaCOV see this as an important step: "We have shown that high-quality therapeutic trials on post-COVID are possible within general practice. Almost all participants stayed with the study until the end. That is a great demonstration of trust on the part of the patients," says Andreas Klug from the Würzburg team.
The PreVitaCOV study was coordinated by the Institute of General Practice at Würzburg University Hospital; the Institutes of General Practice at the University Hospitals of Tübingen and Schleswig-Holstein (Kiel Campus) were also involved.
Other partners included the Centre for Clinical Trials at the University Hospital of Würzburg (UKW), the Institute of Clinical Pharmacology at the Brandenburg Medical School, and the pharmacies at the Charité and the University Medical Centre Hamburg-Eppendorf. The study was funded by the Federal Ministry of Research, Technology and Space (BMFTR).
Publication
Low-dose prednisolone and B vitamins for post-COVID-19 syndrome in Germany: the PreVitaCOV randomised clinical trial. eClinicalMedicine, 24 October 2026, DOI: 10.1016/j.eclinm.2026.104264
