Wait-list control study of a digital CBT informed self-management intervention for Long COVID

Abstract

Long-COVID refer to ongoing illness (at least three months) following acute COVID-19 infection with symptoms that include breathlessness, fatigue, and reduced functioning sometimes linking to high levels of anxiety and low mood. There are currently no identified curative treatments and prognosis remains uncertain. Supporting people to manage the impact of the condition is then crucial. Owing to high levels of fatigue, digital interventions that can be accessed at the person's convenience have a major advantage. There is a lack of evidence of the impact of these interventions on patients' outcomes. We conducted a wait-list controlled study of the digital "HOPE" intervention, a CBT informed self-management program. Baseline and end of intervention measures were mental wellbeing, fatigue, depression, anxiety, self-efficacy and loneliness. 91 patients were allocated to intervention (n=47) or wait-list (n=44). 34 were retained in the intervention and completed outcomes, with 39 retained in the control group. Per-protocol ANCOVA analysis found only depression scores were significantly different at follow-up between the groups. No retention bias was observed based on baseline characteristics. Limitations are considered, including the need to include a longer term follow-up as there may be a delay in patients implementing strategies. Further, adaptations to intervention are suggested.