Interventions for Long COVID: A Narrative Review, 2025, Ivlev et al

Interventions for Long COVID: A Narrative Review

Ilya Ivlev, Jesse Wagner, Taylor Phillips, Jonathan R. Treadwell

Abstract
Long COVID continues to impose a significant burden on COVID-19 survivors, presenting with diverse symptoms and clinical uncertainty. This review synthesized evidence from 97 studies, including 26 randomized controlled trials and 15 non-randomized comparative studies, which explored the effectiveness, comparative effectiveness, and potential risks of proposed interventions for managing common long COVID symptoms: fatigue, neurocognitive symptoms, anxiety, depression, and sleep issues.

Our comprehensive analysis, encompassing English-language articles, gray literature, and feedback from 14 Key Informants (i.e., patients, caregivers, clinicians, payors, and researchers), reveals a persistently weak body of evidence, characterized by high imprecision and considerable uncertainty regarding the benefits and harms of the interventions. The studies examined a wide array of treatment categories, including multi-component rehabilitation, supplements, complementary treatments, prescription medications, and the COVID-19 vaccine.

Key informants emphasized the critical need for establishing robust diagnostic criteria and utilizing functional outcomes while also highlighting significant barriers to care, including dismissive attitudes from healthcare providers, inadequate insurance coverage, and restricted access to specialty care.

Given the evolving definitions of long COVID and the variable mechanisms of its management, our findings underscore the pressing need for further rigorous research to refine and validate effective treatment protocols. Until more definitive evidence is available, both clinicians and patients face substantial uncertainty in treatment decisions, with many resorting to self-treatment using costly and potentially ineffective options.

Link (Journal of General Internal Medicine) [Paywall]

 

Kids just call it evidence-based medicine these days. It's literally mainly what they do: weak, pathetic nonsense.

I don't know what it will take for medicine to stop clowning around with this. Without a plausible pathological target, they simply are not able to come up with anything. Which makes sense, as a programmer, there is simply no way to fix a complex bug in a large system if I have no way to evaluate it, no access to the source code, or even the systems, no possible way to trace the conditions of the program as it runs. It's a firm requirement and they've been building this completely useless industry entirely around not bothering with that. Medicine is a biomedical profession and it can only ever have biomedical solutions to problems that have failed to be prevented.

I've never seen any group of professionals so utterly lost about the most basic aspects of their job and perform so poorly as this. They seem almost completely dependent on chance, and when they don't have that they just devolve into delusional fantasies, where they remain stuck indefinitely until chance buries the whole thing.

None of this is inevitable. It's awful decisions made by cowards who'd rather waste their entire careers cheating than face reality. We need health care to be connected to reality, and it just isn't. The only connections to reality they make is when they understand the biology. This is where they shine, literally 100% of their achievements are dependent on it. If not on knowing it beforehand, every single achievement has lead to a better understanding of the biology involved. Everything else is useless nonsense.