Summary
- A German study protocol outlines a randomised controlled trial to compare exercise therapy, psychotherapy, and their combination for treating Long Covid.
- Dr. Charles Shepherd warns the study risks repeating past mistakes by promoting behavioral therapies that may be ineffective or harmful for some patients.
The following study protocol, ‘Comparison of telemedicine-assisted psychotherapy, exercise therapy, or a combination of both in patients with post-COVID-19 syndrome (TelPoCo): study protocol for a randomized controlled trial', was published on BioMed Central on the 20th July, 2025. As a study protocol, it lays out plans from a German research team to compare the effectiveness of exercise therapy and psychotherapy, and their combined use in the treatment of Long Covid.
Dr Charles Shepherd, MEA Hon Medical Adviser, expresses his concerns below.
Extracts
Post-COVID-19 syndrome (PCS) presents in a multitude of ways, with fatigue, physical constraints, and diminished quality of life being common symptoms. It is becoming increasingly clear that unimodal behavioral interventions do benefit all PCS patients. Adherence to and response to isolated psychotherapy or physical activity interventions vary greatly, with certain patients benefit more from one form of therapy, or even a combination, than others do. The study aims to compare the effects of a single exercise therapy, psychotherapy, and a combination of both therapies.
MEA Comment
It is very concerning to read that this German research group do not appear to have learnt any lessons from the disastrous way in which a disease model for ME/CFS involving abnormal illness beliefs and behaviours coupled with inactivity and deconditioning resulted in huge numbers of people being prescribed two forms of behaviour therapy – CBT and GET – that either had no effect or made them worse.
It looks as though the same mistakes are about to be made for Long Covid in Germany.
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
