Clinical Classification and Interventions for Post–COVID-19 Condition: A Scoping Review

Chao, Yi-Sheng; Vu, Thyna; McGill, Sarah C.; Gates, Michelle

doi:10.51731/cjht.2022.337

Cited by 4 publications

(16 citation statements)

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“…In May 2022, CADTH published a scoping review that mapped the available evidence and gaps up to February 2022 regarding post-COVID-19 condition across the following concepts: risk factors and prevention, classification, diagnostic tests, treatment and management, and health system issues (e.g., increased health care services use and policy impact). 7 A relatively small proportion (n = 74 of 637; 11.6%) of the published reports evaluated the treatment or management of post-COVID-19 condition. 7 Most of the evidence-based guidelines did not provide recommendations specific to post-COVID-19 condition according to the WHO definition (i.e., patients with symptoms at least 3 months after initial infection).…”

Section: Introduction and Rationalementioning

confidence: 99%

“…7 A relatively small proportion (n = 74 of 637; 11.6%) of the published reports evaluated the treatment or management of post-COVID-19 condition. 7 Most of the evidence-based guidelines did not provide recommendations specific to post-COVID-19 condition according to the WHO definition (i.e., patients with symptoms at least 3 months after initial infection). 7 However, there were 67 registrations or protocols of clinical trials that aimed to investigate interventions for the treatment of post-COVID-19 condition.…”

Section: Introduction and Rationalementioning

confidence: 99%

“…7 Most of the evidence-based guidelines did not provide recommendations specific to post-COVID-19 condition according to the WHO definition (i.e., patients with symptoms at least 3 months after initial infection). 7 However, there were 67 registrations or protocols of clinical trials that aimed to investigate interventions for the treatment of post-COVID-19 condition. 7 Similarly, a recent systematic review identified 6 published clinical trials and 54 trial registrations on the drugs of post-COVID-19 condition.…”

Section: Introduction and Rationalementioning

confidence: 99%

“…7 However, there were 67 registrations or protocols of clinical trials that aimed to investigate interventions for the treatment of post-COVID-19 condition. 7 Similarly, a recent systematic review identified 6 published clinical trials and 54 trial registrations on the drugs of post-COVID-19 condition. 8 Other author groups have identified at least 26 ongoing clinical trials in which interventions for post-COVID-19 condition were evaluated.…”

Section: Introduction and Rationalementioning

confidence: 99%

“…Herein, we have updated (with modification) the treatment and management concept within CADTH's scoping review in response to stakeholder requests and to understand the direction of research about the treatment and management of post-COVID-19 condition. 7 The rapidly changing evidence base warrants continuous efforts to characterize the literature and identify research gaps; therefore, we transitioned the scoping review into living mode.…”

Section: Introduction and Rationalementioning

confidence: 99%

See 4 more Smart Citations

Post‒COVID-19 Condition Treatment and Management Rapid Scoping Review

Chao¹,

McGill²,

Gates³

et al. 2022

cjht

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This rapid living scoping review provides an up-to-date map of the latest published evidence, and identifies research gaps regarding the treatment and management for post–COVID-19 condition. Most of the included studies were from a few countries, particularly the US, the UK, and Canada. Also, most of the studies were case reports or series, meaning they included few participants. Most of the identified published research on treatments for post‒COVID-19 condition focused on: vaccines administered 3 months after initial infection pharmacological interventions for cardiovascular, neurological, and pulmonary symptoms and diagnoses non-pharmacological interventions for pulmonary symptoms. There were fewer studies related to other types of symptoms and organ systems. There were notable evidence gaps across all treatments for post–COVID-19 condition, as noted by most of the evidence being from case reports, in which physicians may more often report patients with uncommon symptoms or diagnoses.

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Section: Introduction and Rationalementioning

confidence: 99%

Section: Introduction and Rationalementioning

confidence: 99%

Section: Introduction and Rationalementioning

confidence: 99%

Section: Introduction and Rationalementioning

confidence: 99%

Section: Introduction and Rationalementioning

confidence: 99%

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Post‒COVID-19 Condition Treatment and Management Rapid Scoping Review

Chao¹,

McGill²,

Gates³

et al. 2022

cjht

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Interventions for the management of post COVID-19 condition (long COVID): Protocol for a living systematic review & network meta-analysis

Zeraatkar,

Ling,

Kirsh

et al. 2024

Preprint

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Background Up to 15% of survivors of COVID-19 infection experience long-term health effects, including fatigue, myalgia, and impaired cognitive function, termed post COVID-19 condition or long COVID. Several trials that study the benefits and harms of various interventions to manage long COVID have been published and hundreds more are planned or are ongoing. Trustworthy systematic reviews that clarify the benefits and harms of interventions are critical to promote evidence-based practice. Objective To create and maintain a living systematic review and network meta-analysis addressing the benefits and harms of pharmacologic and non-pharmacologic interventions for the treatment and management of long COVID. Methods Eligible trials will randomize adults with long COVID, to pharmacologic or non-pharmacologic interventions, placebo, sham, or usual care. We will identify eligible studies by searches of MEDLINE, EMBASE, CINAHL, PsycInfo, AMED, and CENTRAL, from inception, without language restrictions. Reviewers will work independently and in duplicate to screen search records, collect data from eligible trials, including trial and patient characteristics and outcomes of interest, and assess risk of bias. Our outcomes of interest will include fatigue, pain, post-exertional malaise, changes in education or employment status, cognitive function, mental health, dyspnea, quality of life, patient-reported physical function, recovery, and serious adverse events. For each outcome, when possible, we will perform a frequentist random-effects network meta-analysis. When there are compelling reasons to suspect that certain interventions are only applicable or effective for a subtype of long COVID, we will perform separate network meta-analyses. The GRADE approach will guide our assessment of the certainty of evidence. We will update our living review biannually, upon the publication of a seminal trial, or when new evidence emerges that may change clinical practice. Conclusion This living systematic review and network meta-analysis will provide comprehensive, trustworthy, and up-to-date summaries of the evidence addressing the benefits and harms of interventions for the treatment and management of long COVID. We will make our findings available publicly and work with guideline producing organizations to inform their recommendations.

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Interventions for the management of long covid (post-covid condition): living systematic review

Zeraatkar,

Ling,

Kirsh

et al. 2024

BMJ

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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.

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Clinical Classification and Interventions for Post–COVID-19 Condition: A Scoping Review

Cited by 4 publications

References 0 publications

Post‒COVID-19 Condition Treatment and Management Rapid Scoping Review

Post‒COVID-19 Condition Treatment and Management Rapid Scoping Review

Interventions for the management of post COVID-19 condition (long COVID): Protocol for a living systematic review & network meta-analysis

Interventions for the management of long covid (post-covid condition): living systematic review

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