Interventions for mental health, cognition, and psychological wellbeing in long COVID: a systematic review of registered trials

Abstract

Background. Among patients diagnosed with COVID-19, a substantial proportion are experiencing ongoing symptoms for months after infection, known as "long COVID". Long COVID is associated with a wide range of physical and neuropsychological symptoms, including impacts on mental health, cognition, and psychological wellbeing. However, intervention research is only beginning to emerge. This systematic review synthesizes currently registered trials examining interventions for mental health, cognition, and psychological wellbeing in patients with long COVID. Methods. Standard systematic review guidelines were followed. Trials registered in two large trial registries in 2020 to May 2022 were reviewed. Included studies were narratively synthesized by type of intervention and a risk-of-bias assessment was conducted. Results. 42 registered trials were included, with a total target sample size of 5814 participants. These include 11 psychological interventions, five pharmacological and other medical interventions, and five evaluating herbal, nutritional, or natural supplement interventions. An additional nine trials are examining cognitive and neurorehabilitation interventions and twelve are examining physiotherapy or physical rehabilitation. Most trials are randomized, but many are feasibility trials; trials are evaluating a wide spectrum of outcomes. Conclusions. While there is a newly emerging body of research testing interventions for mental health, cognition, and psychological wellbeing in long COVID, the breadth and scope of the research remains limited. Building upon the trials currently under way, it is urgently incumbent on researchers to expand upon the intervention research currently under way, in order to generate high-quality evidence on a wide range of candidate interventions for diverse long COVID patient populations.

The Feasibility and Impact of Practising Online Forest Bathing to Improve Anxiety, Rumination, Social Connection and Long-COVID Symptoms: A Pilot Study

“…There is currently little published research on interventions for patients with Long-COVID. A review of registered trials underway [ 10 ] found 12 physical rehabilitation, 11 psychological, nine cognitive and neurorehabilitation, five pharmacological, and five natural supplement interventions for the treatment of Long-COVID. Whilst published intervention research for Long-COVID patients is emerging, Hawke [ 10 ] suggests that a wider range of intervention choices is needed for diverse Long-COVID populations.…”

Protocol for a systematic review of interventions targeting mental health, cognition or psychological well-being among individuals with long COVID

“…This review will include articles reporting the results of clinical trials of any intervention aiming to promote mental health, cognition or psychological well-being among people who have long COVID, as described in table 1 . Based on our existing review of registered trials on this topic, 21 the literature is expected to report on psychological interventions, pharmacological interventions, nutritional or natural supplement interventions, cognitive and neurorehabilitation interventions and physiotherapy or physical rehabilitation. Applying the inclusion criteria, we will include these types of interventions in the review, as well as any other types of interventions that may emerge.…”

“…The English search strategy will be translated to Chinese for use in Chinese searches and the Chinese search strategy will be optimised to each relevant database by qualified Chinese-speaking team members. In addition, specific title and author searches will be conducted for all studies identified in our existing systematic review of registered trials; 21 if unpublished, lead researchers for each previously identified trial will be contacted to request any results that might be eligible for inclusion. On completion of the article selection process, the search will be rerun to update the findings.…”

“…To capture the broadest range of studies, the article's definition of long COVID will be accepted, provided that it Open access reports on symptoms experienced at least 4 weeks after acute infection, consistent with the observed lower limit of duration observed in currently registered trials. 21 Articles can be published in print, online ahead of print or in unreviewed preprint format; unpublished summaries of findings will also be accepted. For articles published in a language other than English or French, we will contact authors for English-language summaries; if unavailable, we will have the abstracts translated and will include the English-language abstracts in the review.…”

“…Our team’s systematic review of registered trials of interventions for mental health, cognition or psychological well-being in long COVID revealed that the research on such interventions is only just beginning to emerge. 21 Given that COVID-19 research has been emerging at an extremely rapid pace, 22 the associated long COVID treatment literature is expected to follow suit. Timely reviews of the literature on this topic will therefore be key to the process of developing and optimising the recommended complex, integrated interventions for individuals with long COVID.…”