A safe and effective micro-choice based rehabilitation for patients with long COVID: results from a quasi-experimental study

Abstract

At least 65 million people suffer from long COVID. Treatment guidelines are unclear, especially pertaining to recommendations of increased activity. This longitudinal study evaluated safety, changes in functional level and sick leave following a concentrated rehabilitation program for patients with long COVID. Seventy-eight patients (19–67 years) participated in a 3-day micro-choice based rehabilitation program with 7-day and 3-month follow-up. Fatigue, functional levels, sick leave, dyspnea and exercise capacity were assessed. No adverse events were reported and 97.4% completed the rehabilitation. Fatigue measured with Chalder Fatigue Questionnaire decreased at 7-days [mean difference (MD = − 4.5, 95% CI − 5.5 to − 3.4) and 3-month (MD = − 5.5, 95% CI − 6.7 to − 4.3). Sick leave rates and dyspnea were reduced (p < 0.001) and exercise capacity and functional level increased (p < 0.001) at 3-month follow-up regardless of severity of fatigue at baseline. Micro-choice based concentrated rehabilitation for patients with long COVID was safe, highly acceptable and showed rapid improvements in fatigue and functional levels, sustaining over time. Even though this is a quasi-experimental study, the findings are of importance addressing the tremendous challenges of disability due to long COVID. Our results are also highly relevant for patients, as they provide the base for an optimistic outlook and evidence supported reason for hope.

Concentrated transdiagnostic and cross-disciplinary micro-choice based group treatment for patients with depression and with anxiety leads to lasting improvements after 12 months: a pilot study

“…Compared to pre-treatment, clinically meaningful improvements in level of functioning were seen with correspondingly increased perceived understanding of the health challenges. In our view, the swiftness of symptom reduction (measured first at 7 days) was noteworthy, although in line with earlier experiences with the concentrated treatment format [ 6 , 7 ]. As expected based on previous experience with concentrated treatment for OCD [ 8 ], the improvements did not deteriorate between post-treatment (7 days) and follow-up (3, 6 and 12 months).…”

Psychological burden associated with incident persistent symptoms and their evolution during the COVID-19 pandemic: a prospective population-based study

“…Although no causal conclusions could be drawn from this observational study, further studies should test whether reducing the psychological burden associated with persistent symptoms could be effective in improving the course of these symptoms. 26 For instance, cognitive–behavioral therapy may be useful in reducing fatigue in patients with post-COVID-19 condition, as suggested by one randomised controlled trial 27 and two quasi-experimental studies. 26 28 Should these results be confirmed, further analyses would be needed to determine whether alleviating the psychological burden associated with persistent symptoms may mediate their improvement over time.…”

“… 26 For instance, cognitive–behavioral therapy may be useful in reducing fatigue in patients with post-COVID-19 condition, as suggested by one randomised controlled trial 27 and two quasi-experimental studies. 26 28 Should these results be confirmed, further analyses would be needed to determine whether alleviating the psychological burden associated with persistent symptoms may mediate their improvement over time. Ongoing studies will also provide answers about the effectiveness of targeting negative expectations, which were not associated with persistent symptoms at follow-up in our study.…”

Cognitive-behavioral therapy for patients with post-COVID-19 condition (CBT-PCC): a feasibility trial

“…stress management, cognitive restructuring, behavioral activation; Witthöft & Hiller, 2010), yielding small to medium-sized effects on the reduction of somatic symptom severity including fatigue (Ingman, Smakowski, Goldsmith, & Chalder, 2022;Kleinstäuber, Witthöft, & Hiller, 2011;Price, Mitchell, Tidy, & Hunot, 2008;Van Dessel et al, 2014). Despite promising first results (Frisk et al, 2023;Kuut et al, 2023), the application of CBT principles for the treatment of PCC is still under research.…”