Interventions for the management of long covid (post-covid condition): living systematic review Article Swipe
Dena Zeraatkar
,
King‐Hwa Ling
,
Sarah Kirsh
,
Tanvir Jassal
,
Mahnoor Shahab
,
Hamed Movahed
,
Jhalok Ronjan Talukdar
,
A. Walch
,
Samantha Chakraborty
,
Tari Turner
,
Lyn S. Turkstra
,
Roger S McIntyre
,
Ariel Izcovich
,
Lawrence Mbuagbaw
,
Thomas Agoritsas
,
Signe Flottorp
,
Paul Garner
,
Tyler Pitre
,
Rachel Couban
,
Jason W. Busse
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1136/bmj-2024-081318
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1136/bmj-2024-081318
Objective To compare the effectiveness of interventions for the management of long covid (post-covid condition). Design Living systematic review. Data sources Medline, Embase, CINAHL, PsycInfo, Allied and Complementary Medicine Database, and Cochrane Central Register of Controlled Trials from inception to December 2023. Eligibility criteria Trials that randomised adults (≥18 years) with long covid to drug or non-drug interventions, placebo or sham, or usual care. Results 24 trials with 3695 patients were eligible. Four trials (n=708 patients) investigated drug interventions, eight (n=985) physical activity or rehabilitation, three (n=314) behavioural, four (n=794) dietary, four (n=309) medical devices and technologies, and one (n=585) a combination of physical exercise and mental health rehabilitation. Moderate certainty evidence suggested that, compared with usual care, an online programme of cognitive behavioural therapy (CBT) probably reduces fatigue (mean difference −8.4, 95% confidence interval (CI) −13.11 to −3.69; Checklist for Individual Strength fatigue subscale; range 8-56, higher scores indicate greater impairment) and probably improves concentration (mean difference −5.2, −7.97 to −2.43; Checklist for Individual Strength concentration problems subscale; range 4-28; higher scores indicate greater impairment). Moderate certainty evidence suggested that, compared with usual care, an online, supervised, combined physical and mental health rehabilitation programme probably leads to improvement in overall health, with an estimated 161 more patients per 1000 (95% CI 61 more to 292 more) experiencing meaningful improvement or recovery, probably reduces symptoms of depression (mean difference −1.50, −2.41 to −0.59; Hospital Anxiety and Depression Scale depression subscale; range 0-21; higher scores indicate greater impairment), and probably improves quality of life (0.04, 95% CI 0.00 to 0.08; Patient-Reported Outcomes Measurement Information System 29+2 Profile; range −0.022-1; higher scores indicate less impairment). Moderate certainty evidence suggested that intermittent aerobic exercise 3-5 times weekly for 4-6 weeks probably improves physical function compared with continuous exercise (mean difference 3.8, 1.12 to 6.48; SF-36 physical component summary score; range 0-100; higher scores indicate less impairment). No compelling evidence was found to support the effectiveness of other interventions, including, among others, vortioxetine, leronlimab, combined probiotics-prebiotics, coenzyme Q10, amygdala and insula retraining, combined L-arginine and vitamin C, inspiratory muscle training, transcranial direct current stimulation, hyperbaric oxygen, a mobile application providing education on long covid. Conclusion Moderate certainty evidence suggests that CBT and physical and mental health rehabilitation probably improve symptoms of long covid. Systematic review registration Open Science Framework https://osf.io/9h7zm/ . Readers’ note This article is a living systematic review that will be updated to reflect emerging evidence. Updates may occur for up to two years from the date of original publication.
Related Topics
Concepts
Medicine
Psychological intervention
Checklist
PsycINFO
MEDLINE
CINAHL
Placebo
Physical therapy
Strictly standardized mean difference
Confidence interval
Randomized controlled trial
Anxiety
Systematic review
Psychiatry
Internal medicine
Alternative medicine
Psychology
Political science
Cognitive psychology
Pathology
Law
Metadata
- Type
- review
- Language
- en
- Landing Page
- https://doi.org/10.1136/bmj-2024-081318
- https://www.bmj.com/content/bmj/387/bmj-2024-081318.full.pdf
- OA Status
- hybrid
- Cited By
- 48
- References
- 128
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4404754258
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4404754258Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1136/bmj-2024-081318Digital Object Identifier
- Title
-
Interventions for the management of long covid (post-covid condition): living systematic reviewWork title
- Type
-
reviewOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2024Year of publication
- Publication date
-
2024-11-27Full publication date if available
- Authors
-
Dena Zeraatkar, King‐Hwa Ling, Sarah Kirsh, Tanvir Jassal, Mahnoor Shahab, Hamed Movahed, Jhalok Ronjan Talukdar, A. Walch, Samantha Chakraborty, Tari Turner, Lyn S. Turkstra, Roger S McIntyre, Ariel Izcovich, Lawrence Mbuagbaw, Thomas Agoritsas, Signe Flottorp, Paul Garner, Tyler Pitre, Rachel Couban, Jason W. BusseList of authors in order
- Landing page
-
https://doi.org/10.1136/bmj-2024-081318Publisher landing page
- PDF URL
-
https://www.bmj.com/content/bmj/387/bmj-2024-081318.full.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
hybridOpen access status per OpenAlex
- OA URL
-
https://www.bmj.com/content/bmj/387/bmj-2024-081318.full.pdfDirect OA link when available
- Concepts
-
Medicine, Psychological intervention, Checklist, PsycINFO, MEDLINE, CINAHL, Placebo, Physical therapy, Strictly standardized mean difference, Confidence interval, Randomized controlled trial, Anxiety, Systematic review, Psychiatry, Internal medicine, Alternative medicine, Psychology, Political science, Cognitive psychology, Pathology, LawTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
48Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 48Per-year citation counts (last 5 years)
- References (count)
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128Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.Database, | 30 |
| abstract_inverted_index.Framework | 385 |
| abstract_inverted_index.Objective | 1 |
| abstract_inverted_index.PsycInfo, | 25 |
| abstract_inverted_index.certainty | 111, 178, 275, 363 |
| abstract_inverted_index.cognitive | 123 |
| abstract_inverted_index.component | 304 |
| abstract_inverted_index.education | 357 |
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| abstract_inverted_index.estimated | 205 |
| abstract_inverted_index.evidence. | 404 |
| abstract_inverted_index.inception | 39 |
| abstract_inverted_index.patients) | 76 |
| abstract_inverted_index.programme | 121, 195 |
| abstract_inverted_index.providing | 356 |
| abstract_inverted_index.recovery, | 222 |
| abstract_inverted_index.subscale; | 145, 169, 240 |
| abstract_inverted_index.suggested | 113, 180, 277 |
| abstract_inverted_index.training, | 346 |
| abstract_inverted_index.Conclusion | 361 |
| abstract_inverted_index.Controlled | 36 |
| abstract_inverted_index.Depression | 237 |
| abstract_inverted_index.Individual | 142, 165 |
| abstract_inverted_index.L-arginine | 340 |
| abstract_inverted_index.Readers’ | 388 |
| abstract_inverted_index.Systematic | 380 |
| abstract_inverted_index.compelling | 315 |
| abstract_inverted_index.confidence | 134 |
| abstract_inverted_index.continuous | 294 |
| abstract_inverted_index.depression | 227, 239 |
| abstract_inverted_index.difference | 131, 158, 229, 297 |
| abstract_inverted_index.hyperbaric | 351 |
| abstract_inverted_index.including, | 326 |
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| abstract_inverted_index.meaningful | 219 |
| abstract_inverted_index.randomised | 47 |
| abstract_inverted_index.systematic | 18, 395 |
| abstract_inverted_index.(post-covid | 14 |
| abstract_inverted_index.Eligibility | 43 |
| abstract_inverted_index.Information | 263 |
| abstract_inverted_index.Measurement | 262 |
| abstract_inverted_index.application | 355 |
| abstract_inverted_index.behavioural | 124 |
| abstract_inverted_index.combination | 102 |
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| abstract_inverted_index.−0.022-1; | 268 |
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| abstract_inverted_index.experiencing | 218 |
| abstract_inverted_index.impairment), | 247 |
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| abstract_inverted_index.rehabilitation. | 109 |
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| abstract_inverted_index.probiotics-prebiotics, | 332 |
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| countries_distinct_count | 6 |
| institutions_distinct_count | 20 |
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