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Non-Pharmacological Therapies for Post-Viral Syndromes, Including Long COVID: A Systematic Review

Author

Listed:
  • Joht Singh Chandan

    (Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK)

  • Kirsty R. Brown

    (Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
    School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK)

  • Nikita Simms-Williams

    (Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK)

  • Nasir Z. Bashir

    (School of Oral and Dental Sciences, University of Bristol, Bristol BS8 1TH, UK)

  • Jenny Camaradou

    (School of Health Sciences, University of East Anglia, Norwich NR4 7TJ, UK)

  • Dominic Heining

    (Department of Microbiology, Royal Wolverhampton NHS Trust, Wolverhampton WV10 0QP, UK)

  • Grace M. Turner

    (Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
    Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK)

  • Samantha Cruz Rivera

    (Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
    Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
    Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham B15 2TT, UK)

  • Richard Hotham

    (Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK)

  • Sonica Minhas

    (Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK)

  • Krishnarajah Nirantharakumar

    (Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
    Midlands Health Data Research UK, Birmingham B15 2TT, UK)

  • Manoj Sivan

    (School of Medicine, University of Leeds, Leeds LS2 9JT, UK)

  • Kamlesh Khunti

    (Diabetes Research Centre, University of Leicester, Leicester LE1 7RH, UK)

  • Devan Raindi

    (School of Dentistry, Institute of Clinical Sciences, University of Birmingham, Birmingham B5 7EG, UK)

  • Steven Marwaha

    (Institute for Mental Health, University of Birmingham, Birmingham B15 2TT, UK
    Birmingham and Solihull Mental Health NHS Foundation Trust, Unit 1, B1, 50 Summer Hill Road, Birmingham B1 3RB, UK)

  • Sarah E. Hughes

    (Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
    Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
    Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham B15 2TT, UK
    National Institute for Health Research (NIHR), Applied Research Collaboration, Birmingham B15 2TT, UK)

  • Christel McMullan

    (Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
    Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK)

  • Tom Marshall

    (Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK)

  • Melanie J. Calvert

    (Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
    Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
    Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham B15 2TT, UK
    National Institute for Health Research (NIHR), Applied Research Collaboration, Birmingham B15 2TT, UK)

  • Shamil Haroon

    (Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
    Joint senior author.)

  • Olalekan Lee Aiyegbusi

    (Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
    Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
    Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham B15 2TT, UK
    National Institute for Health Research (NIHR), Applied Research Collaboration, Birmingham B15 2TT, UK)

Abstract

Background: Post-viral syndromes (PVS), including Long COVID, are symptoms sustained from weeks to years following an acute viral infection. Non-pharmacological treatments for these symptoms are poorly understood. This review summarises the evidence for the effectiveness of non-pharmacological treatments for PVS. Methods: We conducted a systematic review to evaluate the effectiveness of non-pharmacological interventions for PVS, as compared to either standard care, alternative non-pharmacological therapy, or placebo. The outcomes of interest were changes in symptoms, exercise capacity, quality of life (including mental health and wellbeing), and work capability. We searched five databases (Embase, MEDLINE, PsycINFO, CINAHL, MedRxiv) for randomised controlled trials (RCTs) published between 1 January 2001 to 29 October 2021. The relevant outcome data were extracted, the study quality was appraised using the Cochrane risk-of-bias tool, and the findings were synthesised narratively. Findings: Overall, five studies of five different interventions (Pilates, music therapy, telerehabilitation, resistance exercise, neuromodulation) met the inclusion criteria. Aside from music-based intervention, all other selected interventions demonstrated some support in the management of PVS in some patients. Interpretation: In this study, we observed a lack of robust evidence evaluating the non-pharmacological treatments for PVS, including Long COVID. Considering the prevalence of prolonged symptoms following acute viral infections, there is an urgent need for clinical trials evaluating the effectiveness and cost-effectiveness of non-pharmacological treatments for patients with PVS. Registration: The study protocol was registered with PROSPERO [CRD42021282074] in October 2021 and published in BMJ Open in 2022.

Suggested Citation

  • Joht Singh Chandan & Kirsty R. Brown & Nikita Simms-Williams & Nasir Z. Bashir & Jenny Camaradou & Dominic Heining & Grace M. Turner & Samantha Cruz Rivera & Richard Hotham & Sonica Minhas & Krishnara, 2023. "Non-Pharmacological Therapies for Post-Viral Syndromes, Including Long COVID: A Systematic Review," IJERPH, MDPI, vol. 20(4), pages 1-21, February.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:4:p:3477-:d:1070419
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    References listed on IDEAS

    as
    1. Markus C. Hayden & Matthias Limbach & Michael Schuler & Steffen Merkl & Gabriele Schwarzl & Katalin Jakab & Dennis Nowak & Konrad Schultz, 2021. "Effectiveness of a Three-Week Inpatient Pulmonary Rehabilitation Program for Patients after COVID-19: A Prospective Observational Study," IJERPH, MDPI, vol. 18(17), pages 1-22, August.
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    Cited by:

    1. Valeska Gatica-Rojas & Ricardo Cartes-Velásquez, 2023. "Telerehabilitation in Low-Resource Settings to Improve Postural Balance in Older Adults: A Non-Inferiority Randomised Controlled Clinical Trial Protocol," IJERPH, MDPI, vol. 20(18), pages 1-13, September.

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