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.
Int J Environ Res Public Health. 2023 Feb 16;20(4):3477. doi: 10.3390/ijerph20043477.
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.
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.
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.
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.
The study protocol was registered with PROSPERO [CRD42021282074] in October 2021 and published in BMJ Open in 2022.
病毒性疾病后综合征（PVS），包括长新冠，是指在急性病毒感染后持续数周到数年的症状。这些症状的非药物治疗方法知之甚少。本综述总结了非药物治疗 PVS 的有效性证据。
我们进行了一项系统综述，以评估非药物干预措施治疗 PVS 的有效性，与标准护理、替代非药物治疗或安慰剂相比。我们关注的结局是症状、运动能力、生活质量（包括心理健康和幸福感）和工作能力的变化。我们在五个数据库（Embase、MEDLINE、PsycINFO、CINAHL、MedRxiv）中检索了 2001 年 1 月 1 日至 2021 年 10 月 29 日发表的随机对照试验（RCT）。提取了相关结局数据，使用 Cochrane 偏倚风险工具评估了研究质量，并进行了叙述性综合。
总体而言，五项不同干预措施（普拉提、音乐治疗、远程康复、抗阻运动、神经调节）的五项研究符合纳入标准。除了基于音乐的干预措施外，所有其他选定的干预措施在某些患者中都对 PVS 的管理提供了一些支持。
在这项研究中，我们观察到缺乏评估 PVS 包括长新冠非药物治疗的有力证据。考虑到急性病毒感染后持续存在症状的普遍性，迫切需要评估非药物治疗对 PVS 患者的有效性和成本效益的临床试验。
研究方案于 2021 年 10 月在 PROSPERO（CRD42021282074）中注册，并于 2022 年在《英国医学杂志开放》上发表。
