Positives

• Three case reports describe favorable responses to upadacitinib in Long COVID patients with severe encephalopathy-like neuropsychiatric symptoms, with noticeable improvement in cognition after the JAK1 inhibitor was added PMC.
  
  
• Two patients with post-COVID inflammatory arthritis had clinically meaningful responses to upadacitinib, supporting JAK1 inhibition for connective tissue overlap presentations PMC.
  
  

Negatives

• In a patient-coordinated case series shared on Health Rising, two of three Long COVID patients felt significantly worse on Rinvoq and reported lowered baselines for at least six weeks after stopping the drug Health Rising.
  
  

Hurdles & Side Effects

• Upadacitinib (Rinvoq) lists at roughly $6,000 per month and requires prior authorization tied to approved autoimmune indications, leaving Long COVID patients to fight insurers or pay cash The Sick Times.