RECOVER-AUTONOMIC Platform Protocol

Inclusion Criteria:

1. ≥ 18 years of age at the time of enrollment

2. Previous suspected, probable, or confirmed SARS-CoV-2 infection, as defined by thePan American Health Organization12ɸ ɸ Enrollment of participants with suspected orprobable SARS-CoV-2 infection will only be allowed if they occurred before May 1, 2021 and be limited to no more than 10% of the total sample size per Study DrugAppendix. Refer to the Manual of Procedures (MOP) for details. Suspected case of SARS-CoV-2 infection - Three options, A through C: A. Meets the clinical OR epidemiological criteria.

3. Clinical criteria: Acute onset of fever AND cough (influenza-like illness) ORAcute onset of ANY THREE OR MORE of the following signs or symptoms: fever,cough, general, weakness/fatigue, headache, myalgia, sore throat, coryza,dyspnea, nausea, diarrhea, anorexia.

4. Epidemiological criteria: Contact of a probable or confirmed case or linked toa COVID-19 cluster; or B. Presents with acute respiratory infection withhistory of fever or measured fever of ≥ 38°C; and cough; with onset within thelast 10 days; and who requires hospitalization); or C. Presents with noclinical signs or symptoms, NOR meeting epidemiologic criteria with a positiveprofessional use or self-test SARS-CoV-2 antigen-Rapid Diagnostic Test. Probable case of SARS-CoV-2 infection, defined as meets clinical criteria above ANDis a contact of a probable or confirmed case or is linked to a COVID-19 cluster. Confirmed case of SARS-CoV-2 infection - Two options, A through B: A. A person with a positive nucleic acid amplification test, regardless of clinicalcriteria OR epidemiological criteria; or B. Meeting clinical criteria AND/ORepidemiological criteria (See suspect case A). With a positive professional use orself-test SARS-CoV-2 Antigen-Rapid Diagnostic Test.

5. Moderate, self-identified autonomic symptoms (defined as COMPASS-31 >25) following aSARS-CoV-2 infection that has persisted for at least 12 weeks and is still presentat the time of consent

6. OHQ/OIQ, question 1 score >2

Exclusion Criteria:

1. Known pregnancy, breast-feeding, or contemplating pregnancy during the study period

2. Known active acute SARS-CoV-2 infection ≤ 4 weeks from enrollment

3. Known renal failure (eGFR <20ml/1.73 m²)

4. Known atrial fibrillation or significant cardiac arrhythmia

5. Known cardiovascular conditions such as heart failure (Class 3-4), severe valvulardisease, symptomatic ischemic coronary artery disease, revascularization for PAD/CADwithin the past 6 months

6. Clinically significant atherosclerotic disease, defined as history of stroke ormyocardial infarction or revascularization 6 months prior to enrollment and/orcurrent symptomatic angina

7. Existing uncontrolled hypertension

8. History of significant hypercoagulability disorders

9. Active or recent thrombosis