Digital Interventions for Treating Post-COVID or Long-COVID Symptoms: Scoping Review.

BACKGROUND: Patients with post-COVID/long-COVID symptoms need support, and health care professionals need to be able to provide evidence-based patient care. Digital interventions can meet these requirements, especially if personal contact is limited. OBJECTIVE: We reviewed evidence-based digital interventions that are currently available to help manage physical and mental health in patients with post-COVID/long-COVID symptoms. METHODS: A scoping review was carried out summarizing novel digital health interventions for treating post-COVID/long-COVID patients. Using the PICO (population, intervention, comparison, outcome) scheme, original studies were summarized, in which patients with post-COVID/long-COVID symptoms used digital interventions to help aid recovery. RESULTS: From all scanned articles, 8 original studies matched the inclusion criteria. Of the 8 studies, 3 were "pretest" studies, 3 described the implementation of a telerehabilitation program, 1 was a post-COVID/long-COVID program, and 1 described the results of qualitative interviews with patients who used an online peer-support group. Following the PICO scheme, we summarized previous studies. Studies varied in terms of participants (P), ranging from adults in different countries, such as former hospitalized patients with COVID-19, to individuals in disadvantaged communities in the United Kingdom, as well as health care workers. In addition, the studies included patients who had previously been infected with COVID-19 and who had ongoing symptoms. Some studies focused on individuals with specific symptoms, including those with either post-COVID-19 or long-term symptoms, while other studies included patients based on participation in online peer-support groups. The interventions (I) also varied. Most interventions used a combination of psychological and physical exercises, but they varied in duration, frequency, and social dimensions. The reviewed studies investigated the physical and mental health conditions of patients with post-COVID/long-COVID symptoms. Most studies had no control (C) group, and most studies reported outcomes (O) or improvements in physiological health perception, some physical conditions, fatigue, and some psychological aspects such as depression. However, some studies found no improvements in bowel or bladder problems, concentration, short-term memory, unpleasant dreams, physical ailments, perceived bodily pain, emotional ailments, and perceived mental health. CONCLUSIONS: More systematic research with larger sample sizes is required to overcome sampling bias and include health care professionals' perspectives, as well as help patients mobilize support from health care professionals and social network partners. The evidence so far suggests that patients should be provided with digital interventions to manage symptoms and reintegrate into everyday life, including work.

Therapeutic effects of traditional Chinese medicine (Maxingshigan-Weijing Decoction) on COVID-19: An open-label randomized controlled trial.

BACKGROUND: Wenzhou has achieved great progress in the prevention and control of the growing coronavirus disease 2019 (COVID-19) pandemic, and traditional Chinese medicine (TCM) has played an indispensable role in this fight. This study aimed to investigate the efficacy of Maxingshigan-Weijing decoction (MWD) in treating infected patients. METHODS: This study was an open-label randomized controlled trial. Inpatients with mild or moderate symptoms caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection were randomly treated with routine supportive care alone or a combination of routine supportive care and MWD. The primary outcome was the rate of symptom (fever, fatigue, cough and difficulty breathing) recovery. RESULTS: Fifty-nine inpatients were enrolled, of whom 29 received routine supportive care alone (control group) and 30 received combination therapy (treatment group). The rate of symptom recovery was significantly higher in the treatment group than in the control group. The time to recovery of fever (3 vs. 7 days), fatigue (9 vs. 12 days), coughing (9 vs. 14 days) and difficulty breathing (4.5 vs. 9.5 days) was also significantly shorter in the treatment group (all p < 0.001). The syndrome score was lower after MWD treatment. However, neither group differed in the viral assay findings, hospitalization days, medication time or the rate of conversion to severe cases. CONCLUSIONS: MWD increased the rate of symptom recovery and shortened the time to recovery of clinical symptoms without deterioration to death or critical care. These findings may provide opportunities for the use of complementary medicine in treating this infection. CLINICAL TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR2000030759.

Efficacy and safety of Lianhuaqingwen capsules, a repurposed Chinese herb, in patients with coronavirus disease 2019: A multicenter, prospective, randomized controlled trial.

BACKGROUND: Coronavirus disease 2019 (Covid-19) has resulted in a global outbreak. Few existing targeted medications are available. Lianhuaqingwen (LH) capsule, a repurposed marketed Chinese herb product, has been proven effective for influenza. PURPOSE: To determine the safety and efficacy of LH capsule in patients with Covid-19. METHODS: We did a prospective multicenter open-label randomized controlled trial on LH capsule in confirmed cases with Covid-19. Patients were randomized to receive usual treatment alone or in combination with LH capsules (4 capsules, thrice daily) for 14 days. The primary endpoint was the rate of symptom (fever, fatigue, coughing) recovery. RESULTS: We included 284 patients (142 each in treatment and control group) in the full-analysis set. The recovery rate was significantly higher in treatment group as compared with control group (91.5% vs. 82.4%, p = 0.022). The median time to symptom recovery was markedly shorter in treatment group (median: 7 vs. 10 days, p < 0.001). Time to recovery of fever (2 vs. 3 days), fatigue (3 vs. 6 days) and coughing (7 vs. 10 days) was also significantly shorter in treatment group (all p < 0.001). The rate of improvement in chest computed tomographic manifestations (83.8% vs. 64.1%, p < 0.001) and clinical cure (78.9% vs. 66.2%, p = 0.017) was also higher in treatment group. However, both groups did not differ in the rate of conversion to severe cases or viral assay findings (both p > 0.05). No serious adverse events were reported. CONCLUSION: In light of the safety and effectiveness profiles, LH capsules could be considered to ameliorate clinical symptoms of Covid-19.