Motilal Shastri, Rampersad Rebecca, Adams Mercédes, Goon Lun Sarah, Ramdhanie Adesh, Ruiz Tricia, Shah Amresh, Wilkinson Arien, Lewis Jadon
Paraclinical Sciences Department, The University of the West Indies, St. Augustine Campus, Faculty of Medical Sciences, St. Augustine, TTO.
Cureus. 2024 Aug 23;16(8):e67603. doi: 10.7759/cureus.67603. eCollection 2024 Aug.
Post-coronavirus disease 2019 (COVID-19) syndrome or condition (PCS) is defined as new onset symptoms for at least three months following COVID-19 infection that has persisted for at least two months. Given the global sequelae of COVID-19, there is an urgent need for effective PCS interventions. The aim of this study was to systematically review all interventions for PCS tested in randomized controlled trials. In this International Prospective Register of Systematic Reviews (PROSPERO) registered (CRD42023415835) systematic review, PubMed, Google Scholar, and ClinicalTrials.gov databases were searched between 1st January 2020 and 30th April 2023. Inclusion criteria were (1) randomized controlled trials that tested interventions for (2) PCS as defined above. Studies were independently reviewed, and final decisions regarding extracted data and risk of bias were made by consensus. Trial findings were summarized qualitatively. The review included 23 trials with 1,916 subjects (mean age 44.9, 25.8% males) from 10 countries. The predominant symptom or function targeted by the interventions were general long COVID-19 symptoms (35%), fatigue (30%), breathlessness (17%), olfactory (17%), and brain function (9%). Overall, the majority of trials (74%) were at high risk of bias. A range of interventions were identified, including physical therapies, dietary and regenerative treatments, electrical stimulation, and digital wellness programs with variable effects. While a diverse range of interventions for PCS have been tested, their effectiveness varies, with threats to validity in most studies. Trials focusing on PCS mental health disorders, musculoskeletal complaints, and children are needed. Well-designed RCTs are needed to establish definitive interventions for PCS.
2019冠状病毒病（COVID-19）后综合征或状况（PCS）被定义为COVID-19感染持续至少两个月后至少持续三个月出现的新发症状。鉴于COVID-19的全球后遗症，迫切需要有效的PCS干预措施。本研究的目的是系统评价在随机对照试验中测试的所有PCS干预措施。在这项国际前瞻性系统评价注册库（PROSPERO）注册（CRD42023415835）的系统评价中，于2020年1月1日至2023年4月30日期间检索了PubMed、谷歌学术和ClinicalTrials.gov数据库。纳入标准为：（1）测试上述（2）PCS干预措施的随机对照试验。研究由独立评审，并通过共识对提取的数据和偏倚风险做出最终决定。对试验结果进行定性总结。该评价纳入了来自10个国家的23项试验，共1916名受试者（平均年龄44.9岁，男性占25.8%）。干预措施针对的主要症状或功能为一般的长期COVID-19症状（35%）、疲劳（30%）、呼吸困难（17%）、嗅觉（17%）和脑功能（9%）。总体而言，大多数试验（74%）存在高偏倚风险。确定了一系列干预措施，包括物理治疗、饮食和再生治疗、电刺激以及效果各异的数字健康计划。虽然已经测试了多种针对PCS的干预措施，但其有效性各不相同，大多数研究存在有效性威胁。需要针对PCS心理健康障碍、肌肉骨骼问题和儿童的试验。需要设计良好的随机对照试验来确定PCS的确定性干预措施。
