What interventions or best practice are there to support people with Long COVID, or similar post-viral conditions or conditions characterised by fatigue, to return to normal activities: a rapid review

Abstract

Previous research has categorised symptoms of COVID-19 / Long COVID into 12 thematic areas including: fever, myalgia, fatigue, impaired cognitive function, and that COVID-19 survivors had reduced levels of physical function, activities of daily living, and health-related quality of life. Our aim was to review the evidence for interventions or best practice to support people with Long COVID, or similar post-viral conditions characterised by fatigue, to return to normal activities. Evidence was included from guidelines, systematic reviews (SR), and primary studies. The primary studies focussed on Long COVID (LC) indicated that there should be a needs-based focus to care for those with LC. Consideration should be given to individuals living with LC in the same way as people with disabilities are accommodated in terms of workplace adjustment. Two SRs indicated that non-pharmaceutical interventions (NPIs) for patients with LC or chronic fatigue syndrome could help improve function for activities of daily life. However, the third, most recent SR, concluded that there is a lack of robust evidence for NPIs. LC fatigue management methods may be beneficial under certain conditions. One SR reported work capability as an outcome however they did not find any studies which evaluated the impact of interventions on return to work/ normal life. One primary study, on individuals with CFS, described a written self-management programme. Following this intervention there was an 18% increase in the number of patients in employment. Policy and practice implications: Long COVID is still being established as a post-viral condition with many symptoms. Patient-centred treatment options such as occupational therapy, self-management therapy and talking therapy may be considered in the same way as for other debilitating conditions. Return-to-work accommodations are needed for all workers unable to return to full-time employment. Due to the nature of the studies included, there was little reported evidence of effectiveness of getting individuals back into their normal activities.

Coordination of Care for long COVID-19 Patients: A Scoping Review

“…It suggests that their needs should be taken into account to adapt their professional activity, as can be done for people with disabilities [42]. This attention should include care and treatment options such as occupational therapy, self-management therapy, and speech therapy [20] to enable them to continue working.…”

“…Lastly, coordination geared towards the rehabilitation and readaptation of patients means taking into account the return to work by adapting workstations or retraining for workers who have to change jobs or who are unable to return to full-time employment [20].…”

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

“…Several trials testing interventions for the management of long COVID have been published to date (30)(31)(32)(33) and hundreds more are planned or ongoing (34)(35)(36). These trials, however, will be published faster than evidence users, such as clinicians and patients, can read them or make sense of them and will come with strengths and limitations that may not be immediately apparent.…”