Self-medication and off-label prescribing in post COVID-19 syndrome: Baseline data of a randomized acupressure and qigong trial.

Background: Post COVID-19 syndrome (PCS), characterized by persistent fatigue and multi-systemic symptoms following SARS-CoV-2 infection, emerged as a clinical challenge with limited treatment options and high patient burden. This paper presents the medication history and clinical baseline characteristics of PCS patients recruited in a randomized controlled trial (RCT). Methods: Patients who reported PCS symptoms of ≥12 weeks after SARS-CoV-2 infection and who met defined fatigue criteria were included in this study. At baseline we assessed among others demographic data, symptom burden, medication history including off-label drug use, dietary supplements, and complementary self-help strategies. Results: Altogether 235 adult PCS-patients were recruited between June 2022 and June 2023. The study population (mean age 42.1 years, 85.1 % female) reported a mean PCS duration of 56.4 weeks, with 74 % on sick leave. Patients frequently used off-label medications (e.g. antihistamines 9.4 %), supplements (vitamin D 53.6 %, minerals 50.2 %), and herbal medicine products (32.3 %). Most PCS patients had prior experience with complementary medicine. Correlations between fatigue and depressive symptoms (PHQ-9) were modest but notable. No strong associations were found between fatigue and age, sex, PCS duration, or vaccination status. Conclusion: PCS-patients suffered from long-term complaints that led to a long period of sick leave and resorted to diverse, largely unproven therapeutic strategies amid clinical uncertainty. This baseline analysis highlights the unmet needs of PCS patients. Understanding these baseline patterns is essential for optimizing care pathways and patient-centered management strategies in PCS. Trial registration: Clinicaltrial.gov (NCT05289154).