Although most patients recover from COVID-19, up to 15% (an estimated 65 million people globally) might experience long term health effects, including fatigue, muscle pain (myalgia), and impaired cognitive function.
Medical Xpress
Medical Xpress reports on the new research review, ‘Interventions for the management of long covid (post-covid condition): living systematic review,' published by The BMJ on November 27th.
Extracts from Medical Xpress
Evidence of moderate certainty suggests that compared with usual care, an online program of CBT probably reduces fatigue and improves concentration, and an online, supervised combined physical and mental health rehabilitation program probably increases the proportion of patients that experience meaningful improvement or recovery, reduces symptoms of depression and improves quality of life.
Moderate certainty evidence also suggests that intermittent aerobic exercise 3-5 times a week for 4-6 weeks probably improves physical function compared with continuous aerobic exercise.
However, no compelling evidence was found to support the effectiveness of other interventions, including the antidepressant vortioxetine, the antibody leronlimab, a combination of probiotics and prebiotics, the antioxidant coenzyme Q10, brain retraining, transcranial direct current stimulation, inspiratory muscle training, hyperbaric oxygen, and a mobile education app on long COVID.
Dr Charles Shepherd Comments
A new research report in the BMJ is receiving wide coverage in the press and media today.
I would agree that the huge amount of money that has been poured into trying to find a treatment for Long Covid has failed to identify any drugs, supplements, alternative treatments or brain retraining programmes that are safe and effective.
I would also agree that Long Covid has a lot of symptom and management overlaps with ME/CFS – as we have been pointing out since May 2020!
However, there is no evidence, as with ME/CFS, that CBT or rehabilitation exercise programmes are an effective form of treatment for Long Covid and may cause harm.
I fear that clinicians and health service managers are losing interest in developing proper multidisciplinary referral services that provide medical management for people with all types of Long Covid.
Consequently, these Long Covid referral services may soon be offered little more than CBT (which can help some people with the mental and emotional consequences of having a long term illness) and a rehabilitation activity plan that is more in line with graded exercise therapy than pacing.
This is clearly going to create problems in places where service providers are now looking at joining up ME/CFS and Long Covid services.
Dr Charles Shepherd,
Trustee and Hon. Medical Adviser to the ME Association,
Member of the 2018-2021 NICE guideline on ME/CFS committee,
Member of the 2002 Chief Medical Officer's Working Group on ME/CFS
Further media coverage
- Telegraph: Long Covid can only be treated with therapy, study suggests | 28/11/2024
- Daily Mail: Scientists discover the only treatment that could cure long Covid | 28/11/2024
- DailyRecord: Doctors say treatment ‘cures' Long Covid better than drugs or diet | 28/11/2024
- Science Media Centre: Expert reaction to systematic review looking at interventions (including talking therapy and rehabilitation) for the management of long Covid | 27/11/2024
- EurekaAlert! Talking therapy and rehabilitation probably improve long covid symptoms, but effects modest | 27/11/2024
- The Science Bit: That BMJ review of Long Covid therapies does not show what it says it does | 28/11/2024