Assessment and Management of Long COVID, 2022, Rivas-Vazquez et al

Abstract

Almost two years into the pandemic, the scientific and healthcare communities continue to learn a great deal regarding COVID-19, the disease produced by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Broad variability during acute COVID-19 infection is seen, ranging from asymptomatic presentation to death. The vast majority of individuals who develop COVID-19 return to their pre-COVID-19 baseline within several weeks. However, a portion of patients will develop a post-COVID-19 syndrome of persistent cognitive, somatic, and behavioral symptoms. This syndrome, designated as post-acute sequelae of SARS-CoV-2 infection, is more commonly known as long COVID. The objectives of this paper are to inform psychologists regarding our current understanding of the underlying pathophysiology of COVID-19, review criteria for range of severity during acute illness, present clinical manifestations of long haul phenomena, and discuss the emerging literature base of evidence-based treatment and management approaches.

Open access, https://link.springer.com/article/10.1007/s42843-022-00055-8

 

"Those individuals who were COVID-19 positive and who are now demonstrating long haul CSBS are a distinct group who stand to benefit from psychological support. Systematic data from studies of psychotherapeutic modalities specifically for long COVID are not yet available. There is some data regarding the efficacy of cognitive behavioral therapy to other post-infectious fatigue states (e.g., ME/CFS and Q-fever fatigue syndrome), providing impetus for application and assessment of CBT to long COVID-19 fatigue (Vink & Vink-Niese, 2020)."

@Mark Vink ?

 

it’s always interesting when people refer to our article but then come up with something we didn’t say. We wrote the following for example about long Covid and CBT:

“Our reanalysis found that the Qure study [of CBT for Q-fever fatigue syndrome] suffered from many serious methodological problems, which included relying on one subjective primary outcome in a study without a control group for the non-blinded CBT treatment group, using a post hoc definition of improvement, waiting 2 years before publishing their objective actometer results and ignoring the null effect of said results. Moreover, only 10% of participants achieved a clinically meaningful subjective improvement in fatigue as a result of CBT according to the study's own figures. Consequently, CBT has no subjective clinically meaningful effect in nine out of every ten patients that are treated with it. Additionally, the subjective improvement in fatigue was not matched by an improvement in disability, even though the disability was fatigue related according to the researchers. On top of this, CBT did not lead to an objective improvement in physical performance. Therefore, it cannot be said that CBT is an effective treatment for Q-fever fatigue syndrome either. It seems therefore unlikely that CBT will reduce disability or lead to objective improvement in long COVID or in post-COVID-19 fatigue syndrome.”
https://www.researchgate.net/public...m_the_Qure_Study_for_Q-Fever_Fatigue_Syndrome

 

Wow, even by the usual standards, this is awful. Zero clue. I got curious WTH could this CSBS be and wow is this just terrible:

The most urgent and immediate focus has been placed on identifying and developing effective therapeutic interventions during the acute phase of the illness; however, recent attention has increasingly been drawn to residual symptoms manifested by those who are post-COVID-19. While the majority of individuals infected with SARS-CoV-2 will return to their premorbid baseline within several weeks, it is now known that some individuals will have persistent cognitive, somatic, and behavioral symptoms (CSBS) that may last up to several months, possibly a year. This protracted syndrome is being referred to as “long COVID,” and individuals manifesting this persistent state have been designated as “long haulers” (Collins, 2021).

Psychologists will increasingly be called upon to assess individuals presenting with these complaints following COVID-19. The objectives of this paper are to discuss pathophysiological mechanisms suspected to mediate CNS dysfunction, to review current criteria to determine acute COVID-19 disease severity, and to present what is currently known regarding the phenomena of long COVID and potential management approaches.​

I regularly see medical professionals angrily saying Long Covid should not be used, that better terms need to be developed. It's easy to see why LC hasn't been replaced yet, the alternatives offered are literally worse in every regard. Amazing.

And yet another paper that seems to suggest the problem as the solution to the problem, either unaware this is already the case, or not bothered to check. Possibly a year. It's literally been 2 years, how does "possibly a year" even make any sense here when it's already above 2? It's not hard to keep track of such low numbers.

Again, in hindsight, building academia on the need to publish as many papers as possible, regardless of quality, is terrible.

 

Yes, that's very sad don’t you think?

 

We’ve contacted the journal and submitted a response, so let’s see what happens…

 

@Trish and @Andy,

The sentence has now been changed by the journal into:
“To date, some data indicate that cognitive behavioral therapy (CBT) may not be efficacious as a stand-alone treatment for long COVID-19 fatigue (Vink & Vink-Neise, 2020).”