Improvements in long COVID symptoms, functional level and the impact of illness perceptions after concentrated micro-choice-based rehabilitation: A1-year prospective uncontrolled study.

BACKGROUND

Patients with long COVID face persisting physical and psychiatric symptoms. Illness perceptions are associated with increased symptom burden and poorer recovery. However, little is known about how changes in illness perceptions in rehabilitation impact symptoms and functional levels. This study assessed longitudinal changes in symptoms of anxiety and depression, insomnia, fatigue, dyspnea, illness perception, and functional levels in patients with long COVID following a micro-choice-based intervention.

METHODS

This prospective uncontrolled study with 12-month follow-up included 78 patients with long COVID aged 19-67 years, mean age 40.3 ± 12.0 years. The intervention consisted of three equally important phases: pre-treatment preparation, a 3-day concentrated micro-choice-based intervention and integration of changes into daily life.

RESULTS

At 3- and 12-month follow-ups significant improvements were observed in symptoms of anxiety (p < 0.001), depression (p < 0.001), fatigue (p < 0.001), illness perceptions (p < 0.001) and functional levels (p < 0.001). Caseness of anxiety and depression were reduced from 26.9% at baseline to 10.0% 12-month follow-up and from 51.3% to 20.0%, respectively. Changes in functional level strongly correlated with changes in illness perception. Patients with a history of psychiatric illness did not experience the same short-term improvements in illness perception compared to those without such a history, but theses differences were not present at 12-month follow-up.

CONCLUSION

Patients with long COVID participating in a concentrated micro-choice-based rehabilitation showed consistent improvements in both psychiatric symptoms and functional levels, including those with a history of psychiatric illness. Changes in illness perception was associated with sustained reduction in symptom burden and increased functional levels.

CLINICAL TRIALS REGISTRATION: NCT05234281, with an approval date of 10 February 2022. The study were approved by the Western Norway Regional Committees for Medical and Health Research Ethics (REK 2020/101648).