Cognitive behavioral therapy (CBT) and a program of physical and mental rehabilitation probably improve symptoms of long COVID, but the effects are modest, finds a review of the latest evidence published in The BMJ . Intermittent aerobic exercise also probably improves physical function compared with continuous aerobic exercise. But the researchers found no compelling evidence to support the effectiveness of other interventions, including certain drugs, dietary supplements , inspiratory muscle training, transcranial direct current stimulation , hyperbaric oxygen therapy , or mobile education apps.

Although most patients recover from COVID-19, up to 15% (an estimated 65 million people globally) might experience long term health effects, including fatigue, muscle pain (myalgia), and impaired cognitive function. Health care providers are increasingly seeing patients with long COVID, and in the absence of trustworthy and up-to-date summaries of the evidence, patients may receive unproven, costly, and ineffective or harmful treatments. To address this, researchers trawled databases for trials randomizing adults with long COVID to drug or non-drug interventions, placebo or sham, or usual care.

They found 24 relevant trials involving 3,695 patients investigating drugs, physical activity or rehabilitation, behavioral interventions, dietary interventions, medical devices and technologies, and combinations of physical exercise and mental health rehabilitation. The trials were of varyin.