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Editor’s note: Find the latest long COVID news and guidance in Medscape’s Long COVID Resource Center.

People with long COVID significantly reduced their fatigue after completing 17 weeks of cognitive behavioral therapy, compared to people with similar long COVID fatigue levels who didn’t participate in therapy, a new study shows.

Cognitive behavioral therapy, or CBT, is a structured talk therapy approach in which a trained therapist helps a person become aware of their own perspective and learn to change how they respond to situations and challenges. 

Led by researchers from Amsterdam University Medical Center, the study followed 114 people in The Netherlands who had experienced severe fatigue for at least 3 months after being infected with COVID. Half of the patients were randomly assigned to participate in 17 weeks of cognitive behavioral therapy focused on their fatigue, and the other participants received no special intervention and just continued their usual care for long COVID. People in the study who were assigned to CBT could do online or in-person therapy. 

The researchers tailored the therapy plan to the specific aspects of fatigue associated with long COVID.

The therapy plan addressed seven areas:

  1. A disrupted sleep-wake pattern

  2. Unhelpful beliefs about fatigue

  3. A low or unevenly distributed activity level

  4. Perceived low social support

  5. Problems with psychological processing of COVID-19

  6. Fears and worries regarding COVID

  7. Poor coping with pain

The CBT participants not only reduced their fatigue but also reported fewer concentration problems, less severe physical symptoms, cipro administration oral and improved physical and social functioning. The findings were published Monday in the journal Clinical Infectious Diseases.

“Together with patients, we look, for example, at 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,” said researcher and medical psychology professor Hans Knoop, PhD, in a statement. 

“After behavioral therapy, patients not only had less symptoms but also functioned better both physically and socially,”  Knoop said. “Those improvements were still present even after six months.”

CDC data shows that 11% of people in the U.S. who ever had COVID reported having long COVID, which is characterized by experiencing virus symptoms for an extended period of time. Long COVID is included as a covered condition under the Americans With Disabilities Act.

The authors noted that their study had limitations that could have influenced the findings, including that none of the participants had been hospitalized for COVID. Also, all of the participants had been self-referred and therefore may have been more motivated to participate in therapy than if people were selected for the study in a different way.


Amsterdam University Medical Center: “Cognitive behavioral therapy lessens post-viral fatigue after COVID-19.”

Clinical Infectious Diseases: “Efficacy of cognitive behavioral therapy targeting severe fatigue following COVID-19: results of a randomized controlled trial.”

KFF: “Long COVID: What Do the Latest Data Show?”

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