Psychological interventions for individuals with long COVID: a systematic review and meta-analysis, 2026, Garriga-Salvó et al

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Psychological interventions for individuals with long COVID: a systematic review and meta-analysis

Garriga-Salvó, Cristina; Navarro, Emiliano; Lidón-Moyano, Cristina; Arévalo, Antonio; Roca, Ramon; Morera, Mireia; Llistosella, Maria

Introduction
Long COVID involves a variety of persistent symptoms after initial SARS-CoV-2 infection, affects multiple functional areas and requires multidisciplinary treatment.

Objective
This study aimed to explore the available evidence about psychological interventions for individuals with long COVID and their effectiveness in reducing some prevalent symptoms, such as fatigue, anxiety or depression, among others, and improving patient quality of life.

Methodology
A systematic review and meta-analysis were conducted following the PRISMA 2020 guidelines. Two independent reviewers performed study selection and data extraction using Web of Science, Scopus, and PubMed databases prior to March 2024. Data synthesis was performed via random-effects meta-analysis, with heterogeneity assessed using the I2 statistic.

Results
Of the 1041 articles obtained, 19 were included in the systematic review and 14 in the meta-analysis. Results showed significant reductions in symptoms of anxiety [SMD =  −0.64 (95% CI: −1.18 to −0.10)], depression [SMD =  −0.41 (95% CI: −0.73 to −0.10)] and fatigue [SMD =  −1.37 (95% CI: −2.48 to −0.26)]. Significant improvements were only registered in self-perceived health-related quality of life [SMD =  7.59 (95% CI: 3.70–11.48)].

Conclusion
Results showed improvements in anxiety, depression or fatigue, highlighting the potential role of psychological interventions in patient recovery.

Web | DOI | Health Psychology Review | Paywall
 
Anyone got access? I would love to see the quality assessment and risk of bias, because they only mention subjective outcomes for a treatment that can’t be blinded.

Leaving out any info like that from the abstract does not give me much confidence in the work..
 
Utsikt said:
I would love to see the quality assessment and risk of bias, because they only mention subjective outcomes for a treatment that can’t be blinded.
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The risk of bias was assessed by two independent researchers (CGS and MLL). The risk of bias assessments in the studies analysed in this Systematic Review were carried out following the guidelines of the National Heart, Lung, and Blood Institute (NHLBI). To be more specific, the guidelines of the ‘Quality Assessment of Controlled Intervention Studies’ were used to assess studies that contained at least two groups (intervention and control). For studies with single-group pre- and post-evaluation, the guidelines of the ‘Quality Assessment Tool for Before-After (Pre–Post) Studies with No Control Group’ were used (Study Quality Assessment Tools | NHLBI, NIH, n.d.)
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This study has several limitations that should be considered. […] Thirdly, two different instruments were used to assess the risk of bias in the studies, rather than only one. This depended on the type of study. Even so, the instruments used were always validated and standardised.
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Of 19 studies analysed, 73.7% (n = 14) had a quality that we considered ‘Poor’ (Barnhill et al., 2023; Braga et al., 2023; Cahalan et al., 2022; Compagno et al., 2022; Deodato et al., 2024; Frisk et al., 2023; García-Molina et al., 2022; Harenwall et al., 2021; Hasting et al., 2023; Hausswirth et al., 2023; McEwan et al., 2022; Nikrah et al., 2023; Ostrowska et al., 2023; Shatri et al., 2023), 5.3% (n = 1) were considered ‘Borderline’ (Orendáčová et al., 2022) and only 21.1% (n = 4) were considered to be ‘low risk’ (Kuut et al., 2023; McGregor et al., 2024; Samper-Pardo et al., 2023; Wright et al., 2022). For more detail, see Supplementary material 2.
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The areas in which controlled intervention studies failed most were those related to the blinding of participants and professionals, patient adherence to the intervention, control of confounding variables in terms of preventing parallel interventions, and sample size. However, most of the deficiencies were due to a lack of information on these aspects in the study. In pre–post studies, the deficiencies were also diverse. The representativeness of the participants could not be determined by reading most of the studies, nor could the adequacy of the sample size. The blinding of the professionals who processed the data was not reported in any of the studies. Finally, the studies showed deficiencies in the analysis of follow-up results, as well as in the evaluation of variables, since they were not evaluated more than once before and after.
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Thank you, @SNT Gatchaman

5.3% (n = 1) were considered ‘Borderline’ (Orendáčová et al., 2022) and only 21.1% (n = 4) were considered to be ‘low risk’ (Kuut et al., 2023; McGregor et al., 2024; Samper-Pardo et al., 2023; Wright et al., 2022). For more detail, see Supplementary material 2.
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Orendáčová was uncontrolled, subjective outcomes and 10 participants:
pubmed.ncbi.nlm.nih.gov

Effect of neurofeedback therapy on neurological post-COVID-19 complications (A pilot study) - PubMed

These findings showed effectiveness neurofeedback for reducing anxiety and depression after COVID-19 and for studying correlations between neurological complications after COVID-19. However, since our pilot clinical trial was open-label, it is hard to differentiate between neurofeedback-specific...
pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov

Kuut is this attrocity:

McGregor is this unblinded trial:

We don’t have a thread on Samper-Pardo, but it was unblinded and got a null result:

Wright was uncontrolled:

How anyone can read those an conclude that there is any evidence in favour of psychological interventions is beyond me.
 
From The Simpsons "Lisa the vegetarian" episode, when Lisa is mad at Homer for liking eating meat too much, and steals the pig he was roasting during a BBQ:
[The pig falls into a ravine]
Homer: "It's just a little dirty! It's still good, it's still good!"

[The pig gets stuck in a drainage pipe]
Homer: "It's just a little slimy! It's still good, it's still good!"

[The pig gets launched into the air]
Homer: "It's just a little airborne! It's still good, it's still good!"

Bart: "It's gone"

Homer: "I know."
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And it's all made even more relevant by the next scene:
Mr. Burns: "You know, Smithers, I think I'll donate a million dollars to the local orphanage. When pigs fly!"

[Both Burns and Smithers start laughing, but then a pig flies by their window]

Smithers: "Will you be donating that million dollars now, sir?"

Mr. Burns: "Hmm, no I'd still prefer not."
Click to expand...
 
This is the product of decades of "work". It's not something they started doing just recently. This is the most over-tested, over-funded nothing in history, applied onto millions, asserted to be effective, a fact that was always contradicted, by their own studies! And, this, they call evidence-based medicine. Compassionate, holistic. Words and their meaning, why bother?

This is what makes it so absurd. There was nothing to begin with. There wasn't even anything before it began. It was entirely made-up from nothing, based on nothing, with no real aim other than altering reality on the basis of fantasies. There is still nothing after decades of mangling everything, and it's still, somehow, promising.

Basically like an 80 year-old special boy who can't do no wrong, should always be treated with infinite kindness and rescued from every blunder he commits, but somehow also happens to be the person in charge of everything, with dictatorial powers and is beyond any accountability. In itself this is enough to cast doubt on how sane our species really is, and it's really not, ironically, promising.
 
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