Table 1.

Summary of clinical trials conducted on mitochondria dysfunction-targeted CoQ10 supplementation in post-viral fatigue syndrome.

Population	Case Criteria	CoQ10 Daily Dose and Duration	Sample Size	Study Design	Outcomes	Refs.
FM	1990 ACR	300 mg for 40 days	20	RCT	Reduced chronic pain and fatigue, improved mitochondrial bioenergetic function, and reduced oxidative stress and inflammation	Cordero et al., 2013 [75]
FM	2010 ACR	300 mg for 40 days	20	RCT	Regulated serotonin levels in platelets and improved depression symptoms	Alcocer-Gómez et al., 2014 and 2017 [76,77]
FM	1990 ACR	300 mg for 40 days	20 cases 15 controls	Case-control study	Significant negative correlations between CoQ10 or catalase levels in PBMCs and headache parameters, restored biochemical parameters, and improved clinical symptoms	Cordero et al., 2012 [78]
FM	1990 ACR	2 × 200 mg for 6 months	22	Open-label crossover study	Significantly improved most pain-related outcomes by 24–37%, including fatigue (by ~22%) and sleep disturbance (by ~33%)	Di Pierro et al., 2017 [79]
FM	2010 ACR	Pregabalin with CoQ10 or pregabalin with placebo for 40 days	11	RCT crossover study	Reduced greater pain, anxiety, inflammation, and mitochondrial oxidative stress, along with increased GSH levels and superoxide dismutase levels	Sawaddiruk et al., 2019 [80]
FM	Not given	200 mg CoQ10 and 200 mg Ginkgo biloba extract for 84 days	25	Open-label pilot study	Improved quality of life and improved self-rating with 64% claiming to be better and only 9% claiming to feel worse	Lister et al., 2002 [81]
FM	2016 ACR	150 mg CoQ10 combined with vitamin D, alpha-lipoic acid, magnesium, and tryptophan or acupuncture treatment, both for 3 months	55	RCT	Reduced pain at 1 month after the start of therapy, strengthened after 3 months with the maintenance of treatment	Schweiger et al., 2020 [82]
Long COVID	eHRs from Israel Clalit Health Services provider	Not given	6953 cases 6530 controls	Retrospective case-control study	Case studies showing ubiquinone associated with significantly reduced odds for COVID-19 hospitalization (OR = 0.185, 95% CI (0.058–0.458), p < 0.001)	Israel et al., 2021 [83]
Long COVID	2015 IOM/NIH criteria for ME/CFS	100 mg CoQ10 and 100 mg alpha-lipoic acid (n = 116) or placebo (n = 58) for 60 days	174	Prospective observational study	Complete Fatigue Severity Scale response was reached more frequently in treatment group (53.5%) than in placebo (3.5%)	Barletta et al., 2023 [73]
Long COVID	2021 WHO clinical case definition	500 mg or placebo for 6 weeks, with crossover treatment after a 4-week washout period	119	RCT crossover trial	No significant benefit on chronic COVID-19 symptoms	Hansen et al., 2023 [74]
ME/CFS	1994 CDC/Fukuda	200 mg CoQ10 and 20 mg of NADH (n = 104) or placebo (n = 103) for 12 weeks	207	RCT	Reduced cognitive fatigue perception and overall FIS-40 score and improved quality of life; improved sleep duration at 4 weeks and improved habitual sleep efficiency at 8 weeks	Castro-Marrero et al., 2021 [63]
ME/CFS	1994 CDC/Fukuda	400 mg CoQ10 and 200 mcg selenium for 8 weeks	27	Open-label exploratory study	Improved overall fatigue severity and global quality of life but no significant effect on sleep disturbances; increased total antioxidant capacity, reduced lipoperoxide levels, and decreased circulating cytokine levels	Castro-Marrero et al., 2022 [64]
ME/CFS	1994 CDC/Fukuda	150 mg ubiquinol or placebo for 3 months	20	RCT	Improved autonomic function and cognitive function	Fukuda et al., 2016 [84]