Studies Examining Treatment Options

• "Pulmonary rehabilitation for patients with coronavirus disease 2019 (COVID-19)" is a paper that takes a look at Chinese guidelines for pulmonary rehabilitation in both acute COVID-19 patients and patients that have been discharged from the hospital. While it is not a direct look into "long haul" patients, it provides insights into therapies that could work for them.
• "The British Thoracic Society survey of rehabilitation to support recovery of the Post COVID-19 population." This survey focused on assessing which interventions were being used to treat patients that had overcome the acute phase of the COVID-19 infection.
• "Could Cognitive Behavioural Therapy Be an Effective Treatment for Long COVID and Post COVID-19 Fatigue Syndrome? Lessons from the Qure Study for Q-Fever Fatigue Syndrome". This study takes a look at a prior study in which the use of cognitive behavioral therapy (CBT) was used to treat patients suffering long-term sequels from an infectious disease.
• However, the study found that there was no evidence to prove that CBT could have a beneficial effect in these patients.
• "Role of mitochondria, oxidative stress and the response to antioxidants in myalgic encephalomyelitis/chronic fatigue syndrome: a possible approach to SARS-CoV-2 ‘long-haulers’?" This review provides an in-depth analysis of how the possible pathophysiology of COVID-19 could be examined to use antioxidants as treatment for "long haul" COVID-19 patients.
• "Can Kratom (Mitragyna speciosa) Alleviate COVID-19 Pain? A Case Study." This case study examines the option of using a plant, Mitragyna speciosa, to manage pain in patients with COVID-19. "Long covid" patients are also mentioned as a population that could benefit from this therapy.
• "Efficacy of corticosteroid therapy in the treatment of long- lasting olfactory disorders in COVID-19 patients." This paper focuses on the long-term olfactory effects of COVID-19 and the use of corticosteroids to treat these effects.
• "A clinic blueprint for post-COVID-19 RECOVERY: Learning from the past, looking to the future." This paper proposes a model for "long covid" recovery, establishing how a multidisciplinary team could manage the symptoms presented by post-COVID-19 patients.
• "Management of post-acute covid-19 in primary care" is a practice pointer research that provides a comprehensive look at "long covid". It explains different symptoms that can be present and provides management options for them.
• "Post COVID-19 syndrome associated with orthostatic cerebral hypoperfusion syndrome, small fiber neuropathy and benefit of immunotherapy: a case report." This case study proposes a possible pathophysiologic pathway for "long covid" and its neuronal symptoms as well as immunotherapy as a possible treatment option.

Studies Recommending Treatment and Management Considerations

• "Multi-organ impairment in low-risk individuals with long COVID." While this study does not examine "long covid" treatment in depth, it does recommend a cross-specialty approach for the management of these patients.
• "Patient outcomes after hospitalisation with COVID-19 and implications for follow-up: results from a prospective UK cohort." While this study does not offer evidence-based treatment information, it does suggest the need for psychological and physical therapy in the case of "long haul" COVID-19 patients.
• "Attributes and predictors of Long-COVID: analysis of COVID cases and their symptoms collected by the Covid Symptoms Study App". This study suggests that the assessment of risk factors for suffering "long covid" through the use of an app could help in providing early intervention.
• "Developing services for long Covid: lessons from a study of wounded healers." This empirical study interviewed healthcare professionals suffering from "long haul" COVID-19. The study proposes Long Covid Clinical Quality Standards that can be implemented for better management.
• "Persistent symptoms after Covid-19: qualitative study of 114 “long Covid” patients and draft quality criteria for services." This study highlights the need for multidisciplinary rehabilitation in long COVID-19 patients as well as the need for continued research regarding its management.
• "Follow-up study of the pulmonary function and related physiological characteristics of COVID-19 survivors three months after recovery." This study proposes that D-dimer levels during hospitalization could predict the appearance of "long covid" and allow for early intervention.
• "Finding the 'right' GP: a qualitative study of the experiences of people with long-COVID." This study looks at the experiences of "long haul" patients and suggests the creation of guidelines for their treatment and management.
• "A Cytokine-based model for the pathophysiology of Long COVID symptoms." This study proposes an inflammation model as the pathophysiology for "long covid" pointing out that further research on the subject could shed additional light into pathways towards recovery.
• "Deleterious Outcomes in Long-Hauler COVID-19: The Effects of SARS-CoV-2 on the CNS in Chronic COVID Syndrome." This study focuses on the neurocognitive symptoms seen in "long covid" patients. In addition, it emphasizes the need for further studies to determine the physiopathology as well as management strategies in these cases.
• "Long-COVID: An evolving problem with an extensive impact." This clinical update provides insights into the fact that "long covid" patients might be treated in primary care centers but that they also might benefit from at-home rehabilitation.
• "Three-month outcomes in hospitalized COVID-19 patients." After an assessment of the neurological consequences of COVID-19 in the long term, this study suggests the need for targeted rehabilitation focused on the neurological symptoms presented by these patients.

Management Strategies — Advice from Medical Associations

• The Royal College of Occupational Therapists has issued information for "long covid" patients, providing advice on how to conserve their energy. 
• The NHS has provided an information package in which strategies to manage post-COVID fatigue are highlighted.
• The World Health Organization has issued a leaflet providing information on post-COVID-19 management.

Research Strategy