News items Behavioral therapy helps with persistent fatigue after COVID-19

9 May 2023

People with persistent fatigue after COVID-19 benefit from cognitive behavioral therapy. They are less tired and can concentrate better after treatment. Other physical complaints also decrease. This is the conclusion from research conducted by Amsterdam UMC and the Radboud university medical center together with three other hospitals. Researcher Hans Knoop: 'After behavioral therapy, patients function better both physically and socially, even after six months.'

Some people retain symptoms after COVID-19. This is called pulmonary COVID or post-COVID syndrome. The most common complaint is severe and disabling fatigue. The ReCOVer study, subsidized by ZonMw, investigated the effect of cognitive behavioral therapy on this fatigue in a group of 114 patients. For this study, patients who received behavioral therapy were compared with patients who received standard treatment. The standard often consisted of counseling by the general practitioner, specialist, and/or physiotherapy.

Addressing fatigue 

Cognitive behavioral therapy for patients with persistent fatigue after COVID-19 focuses on dealing with the problematic fatigue. Together with the patient, changes in lifestyle are considered aiming to reduce symptoms from the acute phase of COVID-19. Hans Knoop from Amsterdam UMC: ‘For example, we consider together with patients how they can improve their sleep-wake rhythm. We also help them become more active again with small, safe steps. For example, by going for short walks.'

Better concentration

Cognitive behavioral therapy has clear results for these patients. Most participants reported significantly reduced fatigue after cognitive behavioral therapy and were able to concentrate better. They also made clear progress socially. In addition, the results persisted over time. After six months, the differences from standard care were still present. Knoop: ‘Cognitive behavioral therapy also appears to be a safe treatment. Our study shows that symptoms did not increase. Furthermore, compared with standard care, new complaints occurred less often in  patients treated with cognitive behavioral therapy.'

More research needed

The researchers stress that the fact that cognitive behavioral therapy can help does not mean that the cause of the complaints is psychological. Furthermore, not everyone benefits from cognitive behavioral therapy. Chantal Rovers of the Radboudumc says: ‘It is therefore of great importance that we continue to search for other effective treatments and the physical causes of post-COVID syndrome.’

About the publication

This study was published in Clinical Infectious Diseases: Efficacy of cognitive behavioral therapy targeting severe fatigue following COVID-19: results of a randomized controlled trial. Tanja A. Kuut, Fabiola Müller, Irene Csorba, Annemarie Braamse, Arnoud Aldenkamp, Brent Appelman, Eleonoor Assmann-Schuilwerve, Suzanne E. Geerlings, Katherine B. Gibney, Richard A. A. Kanaan, Kirsten Mooij-Kalverda, Tim C. Olde Hartman, Dominique Pauëlsen, Maria Prins, Kitty Slieker, Michele van Vugt, Stephan P. Keijmel, Pythia Nieuwkerk, Chantal P. Rovers and Hans Knoop.

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