Nikhil Prasad Fact checked by:Thailand Medical News Team Jul 23, 2025 7 hours, 53 minutes ago
Thailand Medical News: A new randomized clinical trial has revealed that oxaloacetate, a naturally occurring metabolic compound, may help improve cognitive function and ease fatigue in people suffering from long COVID. The study, called REGAIN, was conducted by researchers from the Bateman Horne Center in Salt Lake City, Utah; the Department of Mechanical Engineering at the University of Utah; the Center for Complex Diseases in Seattle, Washington; and Terra Biological LLC in San Diego, California.
Oxaloacetate Trial Offers Hope for Long COVID Brain Fog and Fatigue Relief
Long COVID, a condition where symptoms persist for months or even years after initial COVID-19 infection, has baffled both patients and doctors with its wide range of debilitating effects—especially fatigue and “brain fog.” This
Thailand Medical News report focuses on the potential of oxaloacetate (OAA) to offer relief.
A Rigorous Clinical Trial on Oxaloacetate
In the REGAIN study, 69 participants aged between 18 and 65 were randomly assigned to receive either 2,000 mg of oxaloacetate or a placebo daily for 42 days. While the primary goal—reducing fatigue as measured by the Chalder Fatigue Questionnaire—did not show a significant difference between the treatment and control groups, the researchers uncovered other promising results.
Participants in the oxaloacetate group experienced earlier and more noticeable improvements in overall symptoms and cognitive function. The DePaul Symptom Questionnaire showed significant reductions in fatigue and total symptom burden by day 21. More impressively, those on oxaloacetate demonstrated greater improvements in cognitive performance, including reaction time and attention, when assessed using the FDA-cleared DANA Brain Vital app.
Brain Fog Sees Noticeable Improvement
The trial showed that those receiving oxaloacetate had a 10.7% improvement in total cognitive efficiency by the end of the study, compared to virtually no change in the control group. Participants in the treatment arm also had significant gains in tasks like procedural reaction time and go/no-go decision-making.
Additionally, symptom improvements and cognitive function were strongly linked in the oxaloacetate group—those with reduced symptom burden were more likely to show better brain function. This association was not found in the placebo group.
Safe and Well Tolerated
Oxaloacetate was generally well tolerated. Adverse events were mild or moderate in most cases and included a few cases of upper respiratory infections, gastrointestinal discomfort, and minor aches. No serious health issues directly tied to the supplement were reported.
Conclusion
While the primary fatigue measure didn’t yield a clear victory, the results from secondary tools and cognitive testing paint a hopeful picture. Oxaloacetate appears to help alleviate the cognitive fog and s
ymptom load that plague many long COVID patients. Its safety profile and the speed at which improvements occurred make it a promising candidate for further study. The trial’s findings support future larger-scale research to confirm the benefits and understand how oxaloacetate works on a biological level.
The study findings were published in the peer reviewed journal: Frontiers in Neuroscience
https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2025.1627462/full
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https://www.thailandmedical.news/news/creatine-shows-promise-in-treating-post-viral-fatigue-syndrome-especially-in-long-covid-patients
https://www.thailandmedical.news/news/german-study-finds-that-nicotinamide-supplement-found-to-help-speed-up-covid-19-recovery-and-restore-gut-health
https://www.thailandmedical.news/articles/long-covid
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