From the Guidelines
Treatment for Long COVID should involve a multifaceted approach, including pulmonary rehabilitation training, Traditional Chinese Medicine (TCM) decoctions, and non-drug treatments such as Baduanjin, Tai-chi, and breathing exercises, as recommended by the most recent guidelines 1.
Key Components of Treatment
- Pulmonary rehabilitation training to improve pulmonary function and exercise capacity
- TCM decoctions based on syndrome differentiation to address impaired pulmonary function and pulmonary fibrosis
- Non-drug treatments such as Baduanjin, Tai-chi, and breathing exercises to improve symptoms and quality of life
Symptom-Specific Management
- For fatigue, pacing activities and energy conservation techniques are recommended, while physical therapy and gradually increasing exercise can help with deconditioning
- For cognitive issues or "brain fog," cognitive rehabilitation exercises can be helpful
- Medications may include over-the-counter pain relievers, antihistamines, and low-dose naltrexone for inflammation and pain
- Mental health support is crucial, as depression and anxiety often accompany Long COVID
Importance of Personalized Treatment Plans
Recovery timelines vary significantly between individuals, and patients should work closely with healthcare providers to develop personalized treatment plans, taking into account their specific symptoms, medical history, and lifestyle 1.
From the Research
Treatment Strategies for Long Covid
- Treatment strategies for Long Covid are symptom-focused, encompassing multidisciplinary care, rehabilitation, and tailored exercise programmes 2, 3, 4.
- Pulmonary rehabilitation is an effective and critical component of Long Covid management, particularly for patients with respiratory symptoms such as dyspnoea 2, 5, 6.
- Innovative technologies, such as telemedicine, wearable devices, and telerehabilitation, are transforming Long Covid management by facilitating consultations, remote monitoring, and rehabilitation 2.
Components of Pulmonary Rehabilitation
- Pulmonary rehabilitation programmes combine exercise, breathing techniques, education, and psychological support to improve symptoms, quality of life, and overall recovery 2, 5, 6.
- Aerobic and strength training have shown benefit for adults living with Long Covid, although individualization of exercise programs is necessary to avoid postexertional malaise 5.
- Breathing pattern disorder is common in adults with Long Covid, and considerations on treatment before or alongside rehabilitation are necessary 5.
Effectiveness of Pulmonary Rehabilitation
- Outpatient pulmonary rehabilitation has been shown to improve exercise capacity, functional status, dyspnea, fatigue, and quality of life in patients with Long Covid 6.
- A 6-week interdisciplinary individualized pulmonary rehabilitation program resulted in significant improvements in 6-min walk distance, post-COVID-19 functional status, Borg dyspnea scale, Fatigue Assessment Scale, and quality of life 6.
- Pulmonary function parameters, such as forced expiratory volume in 1 s, lung diffusion capacity, and inspiratory muscle pressure, also significantly increased during rehabilitation 6.
Multidisciplinary Approach
- A multidisciplinary approach is essential for the diagnosis and treatment of Long Covid, involving physiatrists, primary care physicians, pulmonologists, cardiologists, psychiatrists, neuropsychologists, neurologists, occupational therapists, physical therapists, speech and language pathologists, patients, and government representatives 4.
- Guidance on assessment and management of Long Covid should be delivered in a holistic manner, acknowledging challenges faced by the patient and uncertainties in the field 4.