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Long Covid quality of life improved via online group rehab, research suggests

An online rehabilitation programme can improve quality of life for adults with long Covid, a UK randomised controlled trial has found.

Researchers at the University of Warwick said it was the first high-quality evidence confirming the sustained clinical benefit and lack of harm with rehabilitation programmes for long Covid.

Those taking part in the eight-week REGAIN programme had weekly live online supervised, group exercise and psychological support sessions that they took part in from home.

Reporting the findings in the BMJ, the researchers said that at three months, 17% of the intervention group reported that their overall health was ‘much better now’ compared with 8% in the usual care group.

The study of 585 participants who were randomly assigned to the programme or a control group, which involved a one-off advice session, was also shown to be clinically effective at improving health related quality of life at one year.

Sustained improvements were seen in fatigue, anxiety, depression, pain, and other measures of general health, among participants, the researchers said.

Those taking part had an average age of 56 years and had all been hospitalised with Covid-19. They had all reported substantial ongoing physical and/or mental health problems more than three months after they were discharged.

National surveys have reported more than one million people in the UK report Covid-19 symptoms persisting for more than 12 weeks, with over 750,000 reporting ongoing symptoms more than two years after infection.

Debilitating symptoms can include fatigue, shortness of breath, cognitive dysfunction, pain, reduced physical capacity, and poor emotional wellbeing, all of which can profoundly affect quality of life.

Study leader Professor Gordon McGregor, professor of clinical exercise physiology and rehabilitation, at the University of Warwick, said: ‘There was no precedent for how best to treat people with long Covid.

‘We knew that centre-based NHS rehabilitation services did not have the capacity to support the numbers of people recovering from Covid-19, so alternative long-term strategies were needed.

He added that the REGAIN programme has the potential to reduce the chronic burden of Covid-19 and widen access to support. An economic evaluation of the study is also being undertaken.

‘Apart from the direct benefits for those concerned, improving the general health of people with long Covid can reduce demand on health and social care more widely and improve economic productivity,’ he said.

Dr Emily Fraser, consultant in respiratory medicine at Oxford University Hospitals NHS Foundation Trust, and clinical lead of a Post Covid clinic, said the study was not looking at a biomedical explanation for long Covid, which is proving difficult to pin down, but on what can practically be done to support patients. 

‘A focus on rehabilitation and holistic care is essential for both management of symptom burden and supporting recovery of these patients, and group programmes that are online and accessible have been shown at our local level to be really beneficial.  

‘Feeling supported, understood and reducing the sense of isolation that many patients have after hospital discharge is really important, alongside setting realistic expectations of recovery and what this looks like.’

But she pointed out a post-hospitalised group are demographically distinct from the community-managed post-Covid patients they see much more commonly. 

It is ‘difficult to draw similarities to a female in their 40s who was previously healthy with a full-time job, three kids and an initial relatively mild acute illness’, she said, although rehab strategies should still be the focus.

A version of this article was originally published by our sister publication Pulse.