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Interventions for Long COVID: A Narrative Review

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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.

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References

  1. Centers for Disease Control and Prevention. COVID-19 data modernization. April 21, 2023, Accessed April 21, 2023, https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/past-reports/033123.html

  2. Perlis RH, Lunz Trujillo K, Safarpour A et al. Association of Post-COVID-19 Condition Symptoms and Employment Status. JAMA Netw Open. 2023;6(2):e2256152. https://doi.org/10.1001/jamanetworkopen.2022.56152

    Article  PubMed  PubMed Central  Google Scholar 

  3. Swank Z, Senussi Y, Manickas-Hill Z et al. Persistent Circulating Severe Acute Respiratory Syndrome Coronavirus 2 Spike Is Associated With Post-acute Coronavirus Disease 2019 Sequelae. Clin Infect Dis. 2023;76(3):e487-e490. https://doi.org/10.1093/cid/ciac722

    Article  PubMed  Google Scholar 

  4. Peluso MJ, Deveau TM, Munter SE et al. Chronic viral coinfections differentially affect the likelihood of developing long COVID. J Clin Invest. 2023;133(3):e163669. https://doi.org/10.1172/JCI163669

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Su Y, Yuan D, Chen DG, et al. Multiple early factors anticipate post-acute COVID-19 sequelae. Cell. 2022;185(5):881-895 e20. https://doi.org/10.1016/j.cell.2022.01.014

  6. Wallukat G, Hohberger B, Wenzel K et al. Functional autoantibodies against G-protein coupled receptors in patients with persistent Long-COVID-19 symptoms. J Transl Autoimmun. 2021;4:100100. https://doi.org/10.1016/j.jtauto.2021.100100

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Xu SW, Ilyas I, Weng JP. Endothelial dysfunction in COVID-19: an overview of evidence, biomarkers, mechanisms and potential therapies. Acta Pharmacol Sin. 2023;44(4):695-709. https://doi.org/10.1038/s41401-022-00998-0

    Article  CAS  PubMed  Google Scholar 

  8. Gavriilaki E, Eftychidis I, Papassotiriou I. Update on endothelial dysfunction in COVID-19: severe disease, long COVID-19 and pediatric characteristics. J Lab Med. 2021;45(6):293-302. https://doi.org/10.1515/labmed-2021-0134

    Article  CAS  Google Scholar 

  9. Liu Q, Mak JWY, Su Q et al. Gut microbiota dynamics in a prospective cohort of patients with post-acute COVID-19 syndrome. Gut. 2022;71(3):544-552. https://doi.org/10.1136/gutjnl-2021-325989

    Article  CAS  PubMed  Google Scholar 

  10. Alenazy MF, Aljohar HI, Alruwaili AR et al. Gut Microbiota Dynamics in Relation to Long-COVID-19 Syndrome: Role of Probiotics to Combat Psychiatric Complications. Metabolites. 2022;12(10):912. https://doi.org/10.3390/metabo12100912

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Yong SJ. Persistent Brainstem Dysfunction in Long-COVID: A Hypothesis. ACS Chem Neurosci. 2021;12(4):573-580. https://doi.org/10.1021/acschemneuro.0c00793

    Article  CAS  PubMed  Google Scholar 

  12. Castanares-Zapatero D, Chalon P, Kohn L et al. Pathophysiology and mechanism of long COVID: a comprehensive review. Ann Med. 2022;54(1):1473-1487. https://doi.org/10.1080/07853890.2022.2076901

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Chou R, Herman E, Ahmed A et al. Long COVID Definitions and Models of Care : A Scoping Review. Ann Intern Med. 2024;https://doi.org/10.7326/m24-0677

    Article  PubMed  Google Scholar 

  14. Wisk LE, Nichol G, Elmore JG. Toward Unbiased Evaluation of Postacute Sequelae of SARS-CoV-2 Infection: Challenges and Solutions for the Long Haul Ahead. Ann Intern Med. 2022;175(5):740-743. https://doi.org/10.7326/M21-4664

    Article  PubMed  Google Scholar 

  15. Wong TL, Weitzer DJ. Long COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)-A Systemic Review and Comparison of Clinical Presentation and Symptomatology. Medicina (Kaunas). 2021;57(5):418. https://doi.org/10.3390/medicina57050418

    Article  PubMed  PubMed Central  Google Scholar 

  16. Chadda KR, Blakey EE, Huang CLH, Jeevaratnam K. Long COVID-19 and postural orthostatic tachycardia syndrome - is dysautonomia to be blamed? Front Cardiovasc Med. 2022;9:1290883. https://doi.org/10.3389/fcvm.2022.860198

    Article  CAS  Google Scholar 

  17. Yelin D, Moschopoulos CD, Margalit I et al. ESCMID rapid guidelines for assessment and management of long COVID. Clin Microbiol Infect. 2022;28(7):955-972. https://doi.org/10.1016/j.cmi.2022.02.018

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. American Academy of Pediatrics. Post-COVID-19 conditions in children and adolescents. May 1, 2023, Accessed May 1, 2023, https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/post-covid-19-conditions-in-children-and-adolescents/

  19. National Institute for Health and Care Excellence. COVID-19 rapid guideline: managing the long term effects of COVID-19 [NG188]. Updated November 11, 2021. Accessed May 1, 2023, https://www.nice.org.uk/guidance/ng188

  20. National Clinical Evidence Taskforce. Caring for people with COVID-19. Supporting Australia's healthcare professionals with continually updated evidence-based clinical guidelines. National Clinical Evidence Taskforce. April 20, 2023, Accessed April 20, 2023, https://clinicalevidence.net.au/covid-19/

  21. U.S. Department of Veterans Affairs. Whole health system approach to long COVID. Patient-aligned care team (PACT) guide. Accessed May 1, 2023, https://www.publichealth.va.gov/n-coronavirus/docs/Whole-Health-System-Approach-to-Long-COVID_080122_FINAL.pdf

  22. Davies M. Long covid patients travel abroad for expensive and experimental "blood washing". BMJ. 2022;378:o1671. https://doi.org/10.1136/bmj.o1671

    Article  PubMed  Google Scholar 

  23. Garritty C, Gartlehner G, Nussbaumer-Streit B et al. Cochrane Rapid Reviews Methods Group offers evidence-informed guidance to conduct rapid reviews. J Clin Epidemiol. 2021;130:13-22. https://doi.org/10.1016/j.jclinepi.2020.10.007

    Article  PubMed  Google Scholar 

  24. McIntyre RS, Phan L, Kwan ATH et al. Vortioxetine for the treatment of post-COVID-19 condition: a randomized controlled trial. Brain. 2024;147(3):849-857. https://doi.org/10.1093/brain/awad377

    Article  PubMed  Google Scholar 

  25. Khaibullina DK, Maksimov YN. Post-Covid Asthenia Syndrome. Neurosci Behav Physiol. 2023;53(8):1347-1354. https://doi.org/10.1007/s11055-023-01524-3

    Article  CAS  Google Scholar 

  26. Tejerina F, Catalan P, Rodriguez-Grande C, et al. Post-COVID-19 syndrome. SARS-CoV-2 RNA detection in plasma, stool, and urine in patients with persistent symptoms after COVID-19. BMC Infect Dis. 2022;22(1):211. https://doi.org/10.1186/s12879-022-07153-4

  27. Tamariz L, Bast E, Klimas N, Palacio A. Low-dose Naltrexone Improves post-COVID-19 condition Symptoms. Clin Ther. 2024;46(3):e101-e106. https://doi.org/10.1016/j.clinthera.2023.12.009

    Article  CAS  PubMed  Google Scholar 

  28. Lau RI, Su Q, Lau ISF et al. A synbiotic preparation (SIM01) for post-acute COVID-19 syndrome in Hong Kong (RECOVERY): a randomised, double-blind, placebo-controlled trial. Lancet Infect Dis. 2024;24(3):256-265. https://doi.org/10.1016/S1473-3099(23)00685-0

    Article  CAS  PubMed  Google Scholar 

  29. Finnigan LEM, Cassar MP, Koziel MJ et al. Efficacy and tolerability of an endogenous metabolic modulator (AXA1125) in fatigue-predominant long COVID: a single-centre, double-blind, randomised controlled phase 2a pilot study. EClinicalMedicine. 2023;59:101946. https://doi.org/10.1016/j.eclinm.2023.101946

    Article  PubMed  PubMed Central  Google Scholar 

  30. Tanashyan M, Morozova S, Raskurazhev A, Kuznetsova P. A prospective randomized, double-blind placebo-controlled study to evaluate the effectiveness of neuroprotective therapy using functional brain MRI in patients with post-covid chronic fatigue syndrome. Biomed Pharmacother. 2023;168:115723. https://doi.org/10.1016/j.biopha.2023.115723

    Article  CAS  PubMed  Google Scholar 

  31. Samper-Pardo M, Leon-Herrera S, Olivan-Blazquez B, Mendez-Lopez F, Dominguez-Garcia M, Sanchez-Recio R. Effectiveness of a telerehabilitation intervention using ReCOVery APP of long COVID patients: a randomized, 3-month follow-up clinical trial. Sci Rep. 2023;13(1):7943. https://doi.org/10.1038/s41598-023-35058-y

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Lobanov AA, Irina AG, Andronov SV et al. Can aquatic exercises contribute to the improvement of the gait stereotype function in patients with Long COVID outcomes? Eur J Transl Myol. 2022;32(3):10698. https://doi.org/10.4081/ejtm.2022.10698

    Article  PubMed  PubMed Central  Google Scholar 

  33. Reis N, Costa Dias MJ, Sousa L et al. Telerehabilitation Intervention in Transitional Care for People with COVID-19: Pre-Post Study with a Non-Equivalent Control Group. Healthcare (Basel). 2023;11(18):2561. https://doi.org/10.3390/healthcare11182561

    Article  PubMed  PubMed Central  Google Scholar 

  34. Philip KEJ, Owles H, McVey S et al. An online breathing and wellbeing programme (ENO Breathe) for people with persistent symptoms following COVID-19: a parallel-group, single-blind, randomised controlled trial. Lancet Respir Med. 2022;10(9):851-862. https://doi.org/10.1016/S2213-2600(22)00125-4

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Del Corral T, Fabero-Garrido R, Plaza-Manzano G, Fernandez-de-Las-Penas C, Navarro-Santana M, Lopez-de-Uralde-Villanueva I. Home-based respiratory muscle training on quality of life and exercise tolerance in long-term post-COVID-19: Randomized controlled trial. Ann Phys Rehabil Med. 2023;66(1):101709. https://doi.org/10.1016/j.rehab.2022.101709

    Article  PubMed  Google Scholar 

  36. Jimeno-Almazan A, Buendia-Romero A, Martinez-Cava A, et al. Effects of a concurrent training, respiratory muscle exercise, and self-management recommendations on recovery from post-COVID-19 conditions: the RECOVE trial. J Appl Physiol (1985). 2023;134(1):95-104. https://doi.org/10.1152/japplphysiol.00489.2022

  37. Palau P, Dominguez E, Gonzalez C et al. Effect of a home-based inspiratory muscle training programme on functional capacity in postdischarged patients with long COVID: the InsCOVID trial. BMJ Open Respir Res. 2022;9(1):e001439. https://doi.org/10.1136/bmjresp-2022-001439

    Article  PubMed  Google Scholar 

  38. Graf D, Gschwenter S, Kuzdas-Sallaberger M, et al. Effects of an inpatient rehabilitation programme on functional capacity, quality of life and psychological distress in patients with post covid-19 condition: an observational study. J Rehabil Med. 2023;55:jrm12437. https://doi.org/10.2340/jrm.v55.12437

  39. Palladini M, Bravi B, Colombo F et al. Cognitive remediation therapy for post-acute persistent cognitive deficits in COVID-19 survivors: A proof-of-concept study. Neuropsychol Rehabil. 2023;33(7):1207-1224. https://doi.org/10.1080/09602011.2022.2075016

    Article  PubMed  Google Scholar 

  40. Ogonowska-Slodownik A, Labecka MK, Maciejewska-Skrendo A, et al. Effect of Water-Based vs. Land-Based Exercise Intervention (postCOVIDkids) on Exercise Capacity, Fatigue, and Quality of Life in Children with Post COVID-19 Condition: A Randomized Controlled Trial. J Clin Med. 2023;12(19):6244. https://doi.org/10.3390/jcm12196244

    Article  PubMed  PubMed Central  Google Scholar 

  41. Jimeno-Almazan A, Franco-Lopez F, Buendia-Romero A et al. Rehabilitation for post-COVID-19 condition through a supervised exercise intervention: A randomized controlled trial. Scand J Med Sci Sports. 2022;32(12):1791-1801. https://doi.org/10.1111/sms.14240

    Article  PubMed  Google Scholar 

  42. Kerling A, Beyer S, Dirks M et al. Effects of a randomized-controlled and online-supported physical activity intervention on exercise capacity, fatigue and health related quality of life in patients with post-COVID-19 syndrome. BMC Sports Sci Med Rehabil. 2024;16(1):33. https://doi.org/10.1186/s13102-024-00817-5

    Article  PubMed  PubMed Central  Google Scholar 

  43. Mooren JM, Garbsch R, Schafer H et al. Medical Rehabilitation of Patients with Post-COVID-19 Syndrome-A Comparison of Aerobic Interval and Continuous Training. J Clin Med. 2023;12(21):6739. https://doi.org/10.3390/jcm12216739

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Espinoza-Bravo C, Arnal-Gomez A, Martinez-Arnau FM, et al. Effectiveness of Functional or Aerobic Exercise Combined With Breathing Techniques in Telerehabilitation for Patients With Long COVID: A Randomized Controlled Trial. Phys Ther. 2023;103(11):pzad118. https://doi.org/10.1093/ptj/pzad118

  45. Stavrou VT, Vavougios GD, Kalogiannis P et al. Breathlessness and exercise with virtual reality system in long-post-coronavirus disease 2019 patients. Front Public Health. 2023;11:1115393. https://doi.org/10.3389/fpubh.2023.1115393

    Article  PubMed  PubMed Central  Google Scholar 

  46. Kuut TA, Muller F, Csorba I et al. Efficacy of Cognitive-Behavioral Therapy Targeting Severe Fatigue Following Coronavirus Disease 2019: Results of a Randomized Controlled Trial. Clin Infect Dis. 2023;77(5):687-695. https://doi.org/10.1093/cid/ciad257

    Article  PubMed  PubMed Central  Google Scholar 

  47. Hausswirth C, Schmit C, Rougier Y, Coste A. Positive Impacts of a Four-Week Neuro-Meditation Program on Cognitive Function in Post-Acute Sequelae of COVID-19 Patients: A Randomized Controlled Trial. Int J Environ Res Public Health. 2023;20(2):1361. https://doi.org/10.3390/ijerph20021361

    Article  PubMed  PubMed Central  Google Scholar 

  48. Toussaint LL, Bratty AJ. Amygdala and Insula Retraining (AIR) Significantly Reduces Fatigue and Increases Energy in People with Long COVID. Evid Based Complement Alternat Med. 2023;2023:7068326. https://doi.org/10.1155/2023/7068326

    Article  PubMed  PubMed Central  Google Scholar 

  49. Onal R, Kutay Ordu Gokkaya N, Korkmaz S, Utku B, Yasar E. Effect of yoga-based exercises on functional capacity, dyspnea, quality of life, depression, anxiety, and sleep of infected healthcare workers during the COVID-19 pandemic: A prospective clinical trial. Turk J Phys Med Rehabil. 2023;69(4):488-499. https://doi.org/10.5606/tftrd.2023.11605

  50. Tosato M, Calvani R, Picca A et al. Effects of l-Arginine Plus Vitamin C Supplementation on Physical Performance, Endothelial Function, and Persistent Fatigue in Adults with Long COVID: A Single-Blind Randomized Controlled Trial. Nutrients. 2022;14(23):4984. https://doi.org/10.3390/nu14234984

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Izzo R, Trimarco V, Mone P et al. Combining L-Arginine with vitamin C improves long-COVID symptoms: The LINCOLN Survey. Pharmacol Res. 2022;183:106360. https://doi.org/10.1016/j.phrs.2022.106360

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Versace V, Ortelli P, Dezi S et al. Co-ultramicronized palmitoylethanolamide/luteolin normalizes GABA(B)-ergic activity and cortical plasticity in long COVID-19 syndrome. Clin Neurophysiol. Jan 2023;145:81-88. https://doi.org/10.1016/j.clinph.2022.10.017

    Article  PubMed  Google Scholar 

  53. Landi F, Martone AM, Ciciarello F et al. Effects of a New Multicomponent Nutritional Supplement on Muscle Mass and Physical Performance in Adult and Old Patients Recovered from COVID-19: A Pilot Observational Case-Control Study. Nutrients. 2022;14(11):2316. https://doi.org/10.3390/nu14112316

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Tereshin AE, Kiryanova VV, Reshetnik DA. Correction of Mitochondrial Dysfunction in the Complex Rehabilitation of COVID-19 Patients. Neurosci Behav Physiol. 2022;52(4):511-514. https://doi.org/10.1007/s11055-022-01269-5

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Kharaeva Z, Shokarova A, Shomakhova Z et al. Fermented Carica papaya and Morinda citrifolia as Perspective Food Supplements for the Treatment of Post-COVID Symptoms: Randomized Placebo-Controlled Clinical Laboratory Study. Nutrients. 2022;14(11):2203-2228. https://doi.org/10.3390/nu14112203

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Karosanidze I, Kiladze U, Kirtadze N et al. Efficacy of Adaptogens in Patients with Long COVID-19: A Randomized, Quadruple-Blind, Placebo-Controlled Trial. Pharmaceuticals (Basel). 2022;15(3):345. https://doi.org/10.3390/ph15030345

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  57. Barletta MA, Marino G, Spagnolo B et al. Coenzyme Q10 + alpha lipoic acid for chronic COVID syndrome. Clin Exp Med. Jul 2023;23(3):667-678. https://doi.org/10.1007/s10238-022-00871-8

    Article  CAS  PubMed  Google Scholar 

  58. Kucharska J, Sumbalova Z, Rausova Z et al. Benefit of mountain spa rehabilitation and ubiquinol treatment in patients with post-COVID-19 syndrome. Bratisl Lek Listy. 2023;124(2):89-96. https://doi.org/10.4149/BLL_2023_013

    Article  PubMed  Google Scholar 

  59. Gvozdjakova A, Sumbalova Z, Kucharska J et al. Mountain spa rehabilitation improved health of patients with post-COVID-19 syndrome: pilot study. Environ Sci Pollut Res Int. 2023;30(6):14200-14211. https://doi.org/10.1007/s11356-022-22949-2

    Article  PubMed  Google Scholar 

  60. Cash A, Kaufman DL. Oxaloacetate Treatment For Mental And Physical Fatigue In Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Long-COVID fatigue patients: a non-randomized controlled clinical trial. J Transl Med. 2022;20(1):295. https://doi.org/10.1186/s12967-022-03488-3

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Zilberman-Itskovich S, Catalogna M, Sasson E et al. Hyperbaric oxygen therapy improves neurocognitive functions and symptoms of post-COVID condition: randomized controlled trial. Sci Rep. 2022;12(1):11252. https://doi.org/10.1038/s41598-022-15565-0

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. Deodato M, Qualizza C, Martini M et al. Efficacy of dual-task augmented reality rehabilitation in non-hospitalized adults with self-reported long COVID fatigue and cognitive impairment: a pilot study. Neurol Sci. 2024;45(4):1325-1333. https://doi.org/10.1007/s10072-023-07268-9

    Article  PubMed  Google Scholar 

  63. Oliver-Mas S, Delgado-Alonso C, Delgado-Alvarez A et al. Transcranial direct current stimulation for post-COVID fatigue: a randomized, double-blind, controlled pilot study. Brain Commun. 2023;5(2):fcad117. https://doi.org/10.1093/braincomms/fcad117

    Article  PubMed  PubMed Central  Google Scholar 

  64. Hawkins J, Hires C, Keenan L, Dunne E. Aromatherapy blend of thyme, orange, clove bud, and frankincense boosts energy levels in post-COVID-19 female patients: A randomized, double-blinded, placebo controlled clinical trial. Complement Ther Med. 2022;67:102823. https://doi.org/10.1016/j.ctim.2022.102823

    Article  PubMed  PubMed Central  Google Scholar 

  65. Wisnivesky JP, Govindarajulu U, Bagiella E et al. Association of Vaccination with the Persistence of Post-COVID Symptoms. J Gen Intern Med. 2022;37(7):1748-1753. https://doi.org/10.1007/s11606-022-07465-w

    Article  PubMed  PubMed Central  Google Scholar 

  66. Karpman M, Zuckerman S, Morriss S. Health Care Access and Affordability Among US Adults Aged 18 to 64 Years With Self-reported Post-COVID-19 Condition. JAMA Netw Open. 2023;6(4):e237455. https://doi.org/10.1001/jamanetworkopen.2023.7455

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements:

The authors gratefully acknowledge the following individuals for their contributions to this project: Gowri Raman, MBBS, MS, Meghana Vijaysimha, MPH, Amanda Barbeau, MPH, Denise Bonds, MD, and William Lawrence, MD, MS, at PCORI for their support scoping the project and overall approach guidance; one group of experts for insight and reviewing our protocol, interview guides, and draft report (in alphabetical order): Charissa Fotinos, MD (Washington Health Care Authority); Rowena Ng, PhD (Kennedy Krieger Institute and Johns Hopkins University); Amy Price, PhD (Stanford University); Louise Walter, MD (University of California, San Francisco), and David Warburton, MD (University of Southern California and Children’s Hospital Los Angeles); second group of experts for insight into important interventions, outcomes, and disease burden (in alphabetical order): Alba Miranda Azola, MD (Johns Hopkins University), ZZ DeFonde; Dawn Jeanette Dore-Stites, PhD (C. S. Mott Children’s Hospital), Kurt Elward, MD, MPH (Virginia Department of Medical Assistance Services and Virginia Commonwealth University), Semhar Fisseha, MPH (Weill Cornell Medicine), Eric Herman, MD (Oregon Health & Science University), Katherine Tochtrop, David Weber, MD, MPH (University of North Carolina); ECRI members Allison Hedden-Gross, MS, MLS for developing search strategies, Helen Dunn for managing references, Kariann Hudson, Med for supporting gray literature search strategy development, and Britney Hall and Julia Barndt for editorial work; Lindsey Miller, DPT, PMP and Jesse Munn, MBA for project support; and Justin Zimmerman, MSME for providing the code to retrieve Reddit submissions.

Funding

This report was conducted under contract to the PCORI, Washington, DC (contract MSA-SOW#05-ECRI-ENG-11-07-2022).

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I.I. contributed to writing the original draft of the manuscript. All others contributed to the conceptualization, investigation, review, and editing of the original draft. All authors have approved the final manuscript.

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Correspondence to Ilya Ivlev MD, PhD, MBI.

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Study protocol: See the full report’s methods section. Statistical code: Not applicable. Data set: See the Supplement. Additional information is available from the investigators.

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Ivlev, I., Wagner, J., Phillips, T. et al. Interventions for Long COVID: A Narrative Review. J GEN INTERN MED (2025). https://doi.org/10.1007/s11606-024-09254-z

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