{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:56:26Z","timestamp":1790751386508,"version":"4.1.0"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p>Long COVID is an emerging chronic condition that results in substantial impairments in quality of life, physical function, and ability to maintain gainful employment. There are no FDA-approved treatments for Long COVID, and recent institution-based clinical trials have not yielded effective treatments. Current standard of care involves trial-and-error drug repurposing that warrants evaluation in rigorous clinical trials. Here we describe potential advantages of decentralized repurposing drug trials as an alternative or complementary approach to institution-based trials. Additionally, we describe lessons learned when launching a local feasibility pilot trial that may inform the design of future decentralized trials in the Long COVID field.<\/jats:p>","DOI":"10.3389\/fpubh.2026.1822376","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:05:50Z","timestamp":1790748350000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Facilitators and barriers to decentralized Long COVID platform clinical trials using repurposed drugs"],"prefix":"10.3389","volume":"14","author":[{"given":"Marco","family":"Schito","sequence":"first","affiliation":[{"name":"CURE Drug Repurposing Collaboratory, Critical Path Institute","place":["Tucson, AZ, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey","family":"Coe","sequence":"additional","affiliation":[{"name":"CURE Drug Repurposing Collaboratory, Critical Path 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of mild-to-moderate Covid-19 in the outpatient setting: a decentralized, placebo-controlled, randomized, platform clinical trial","author":"Naggie","year":"2022","journal-title":"medRxiv"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1007\/s40258-023-00816-6","article-title":"Drug repurposing of generic drugs: challenges and the potential role for government","volume":"21","author":"Van Der Pol","year":"2023","journal-title":"Appl Health Econ Health Policy"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"82","DOI":"10.3390\/medsci6040082","article-title":"Low-dose naltrexone (LdN)-review of therapeutic utilization","volume":"6","author":"Toljan","year":"2018","journal-title":"Med Sci (Basel)"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"110966","DOI":"10.1016\/j.intimp.2023.110966","article-title":"Low-dose naltrexone use for the management of post-acute sequelae of Covid-19","volume":"124","author":"Bonilla","year":"2023","journal-title":"Int Immunopharmacol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1136\/jim-2021-002051","article-title":"Long Covid following mild Sars-CoV-2 infection: characteristic T cell alterations and response to antihistamines","volume":"70","author":"Glynne","year":"2022","journal-title":"J Investig Med"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1202696","DOI":"10.3389\/fcvm.2023.1202696","article-title":"Antihistamines improve cardiovascular manifestations and other symptoms of long-Covid attributed to mast cell activation","volume":"10","author":"Salvucci","year":"2023","journal-title":"Front Cardiovasc Med"}],"container-title":["Frontiers in Public 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