Evidence map›Paper›PMID 39603702›Full record

SynthesisBMJ (Clinical research ed.)2024

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

Dena Zeraatkar, Michael Ling, Sarah Kirsh, Tanvir Jassal, Mahnoor Shahab, Hamed Movahed, Jhalok Ronjan Talukdar, Alicia Walch, Samantha Chakraborty, Tari Turner and 10 more

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 72 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
72citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

72 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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  9. VSL#3British journal of biomedical science · 2026
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12 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Dena ZeraatkarDepartment of Anesthesia, McMaster University, Hamilton, ON, Canada zeraatd@mcmaster.ca.ORCID 0000-0003-4287-0541
Michael LingDepartment of Anesthesia, McMaster University, Hamilton, ON, Canada.
Sarah KirshDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Tanvir JassalDepartment of Anesthesia, McMaster University, Hamilton, ON, Canada.
Mahnoor ShahabFaculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
Hamed MovahedDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Jhalok Ronjan TalukdarDepartment of Anesthesia, McMaster University, Hamilton, ON, Canada.
Alicia WalchDepartment of Anesthesia, McMaster University, Hamilton, ON, Canada.
Samantha ChakrabortySchool of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Tari TurnerSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Lyn TurkstraSchool of Rehabilitation Science and Program in Neuroscience, McMaster University, ON, Canada.
Roger S McIntyreDepartment of Psychiatry and Pharmacology, University of Toronto, Toronto, ON, Canada.
Ariel IzcovichDepartment of Medicine, Universidad del Salvador, Buenos Aires, Argentina.
Lawrence MbuagbawDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Thomas AgoritsasDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Signe A FlottorpCentre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway.
Paul GarnerDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
Tyler PitreDivision of Respirology, Department of Medicine, University of Toronto, Toronto, ON, Canada.
Rachel J CoubanDepartment of Anesthesia, McMaster University, Hamilton, ON, Canada.
Jason W BusseDepartment of Anesthesia, McMaster University, Hamilton, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare the effectiveness of interventions for the management of long covid (post-covid condition).

designLiving 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.

results24 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.

conclusionModerate 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.

Indexed as

COVID-19SARS-CoV-2Cognitive Behavioral TherapyExerciseHumansPost-Acute COVID-19 SyndromeRandomized Controlled Trials as Topic

Identifiers

PMID39603702
PMCPMC11600537

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.