Sustained improvements in sick leave, fatigue and functional status following a concentrated micro-choice based treatment for patients with long COVID: A 1 year prospective uncontrolled study
Bente Frisk, Marte Jürgensen, Birgitte Espehaug, Eirik Søfteland, Gerd Kvale
Abstract
BACKGROUND: Long COVID has affected approximately 200 million people globally, with substantial consequences for the individuals, healthcare systems and society. Treatment guidelines lack clear recommendations regarding increased activity. This study aimed to evaluate primary outcomes as patients' satisfaction, illness perception and patient activation. In addition, potential changes in functional levels, sick leave, fatigue, dyspnea, and exercise capacity from baseline to 12-month follow-up after a concentrated micro-choice-based intervention in patients with long COVID. METHODS: This prospective interventional study, study start 26 May 2021, with 12-month follow-up included 78 patients with long COVID aged 19-67 years, mean age 40.3 ± 12.0 years. The intervention was structured into three equally important phases: pre-treatment preparation, a 3-day concentrated micro-choice-based intervention and integrating the changes into everyday living. RESULTS: At 3 and 12-month follow-ups, 71 (91 %) and 65 (83 %) patients, respectively completed questionnaires and physical tests. The patients reported significant enhancements in illness perception and health activation. Sick leave decreased significantly from 63 % at baseline to 43 % and 23 % at 3 and 12-month, respectively (p < 0.001). Fatigue decreased significantly at 3-month (mean difference (MD) = -5.5, 95 % CI: -6.6 to -4.3) and at 12-month (MD = -7.0, CI: -8.3 to -5.7). Functional level and exercise capacity increased (p < 0.001), and dyspnea decreased (p < 0.001), at both follow-ups regardless of baseline fatigue severity. CONCLUSION: The micro-choice-based intervention for patients with long COVID was safe, highly satisfactory and significantly enhanced health activation alongside rapid improvements in functional levels and fatigue which continued improving throughout the follow-up year, together with significant reduction in sick leave.