A review of interventions and support options for long-term COVID patients returning to work

In a recent study published on medRxiv* preprint server, researchers review recent studies that address interventions and support for people with long coronavirus disease (long COVID) or other similar conditions involving fatigue that occur after viral infections to help them return to normal activity levels.

Study: What are the interventions or best practices to help people with long COVID, or similar post-viral conditions or conditions characterized by fatigue, return to normal activities: a quick review. Image Credit: Drazen Zigic/Shutterstock


Extensive research indicates that long COVID symptoms such as fatigue, dyspnea, myalgia and cognitive impairment affect the quality of life of patients with coronavirus disease 2019 (COVID-19) long after they have recovered from respiratory syndrome severe acute coronavirus 2 (SARS-CoV -2) infection.

Some systematic reviews have identified similarities between long COVID and other post-viral conditions such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and fibromyalgia, with common symptoms such as fatigue, dizziness, pain chest pain, neurological and cognitive difficulties, as well as post-exercise malaise leading to a decrease in physical activity.

Understanding how governments can provide support to long-term COVID patients to ensure their speedy recovery and resumption of normal activities is essential for their overall well-being, as well as for the economic growth of the country.

About the study

In this study, researchers examine systematic reviews, clinical guidelines, qualitative studies and cohort studies published between 2014 and 2022. This information was used to assess intervention strategies and support needed to help patients with long COVID and similar post viral infections. resume normal activities and work.

The researchers used the Population, Intervention, Comparison, and Outcome (PICO) framework to select studies included in the review. These studies were conducted on adults with long COVID or similar conditions who were receiving usual care for the disease. Outcomes examined included ‘return to work’, ‘absenteeism’, ’employment’ and ‘life activities’, among others.

Key databases were searched for systematic reviews and clinical guidelines that considered non-pharmaceutical interventions (NPIs) to help patients with long-term COVID return to normal levels of daily activity. Data from these studies were extracted and their quality was assessed.

Study results

Long COVID studies suggest that people with this condition should be treated similarly to people with disabilities in terms of workplace accommodations, with care and support provided as needed. Suggested workplace arrangements included part-time working hours, a hybrid work system or work-from-home opportunities.

While two systematic reviews reported that NPIs were useful for patients with long-term COVID and chronic fatigue syndrome (CFS) to improve function and return to normal activity levels, another systematic review stated that there was a lack of solid evidence on the success of NPIs.

One study suggested that methods such as behavioral self-management, electrical nerve stimulation, exercise therapy, as well as sleep and touch therapy may be effective. Some of the specific situations in which these methods would be applicable include home-based activities, as well as psychological and physical support groups. Regardless of the approach, each individual’s fatigue levels must be considered in the context of their lifestyle.

Although one systematic review considered work capacity as one of the outcomes, no previous studies had assessed the effect of interventions on the ability to return to work or on normal activity levels. However, one study including patients with CFS reported an 18% increase in patient employment after a written self-management program.

Characterization of long COVID as a post-viral condition is ongoing and further complicated by the myriad of symptoms experienced by these patients, as well as the varying severity and unpredictability of long COVID symptoms.

Self-management therapy, occupational therapy, and cognitive-behavioral therapy were some of the patient-centered intervention options offered by the authors, many of which are similar to those offered to patients with ME/CFS. Additionally, the authors recommend that employers allow certain accommodations, such as part-time or hybrid work options, for patients unable to return to full-time work.


Many studies have examined the impact of treatments and interventions for long-lasting COVID on outcomes such as work capacity and the ability to return to normal activities. Based on the studies assessed in this review, the authors recommend a patient-centered, needs-based approach to providing support for long-term COVID patients, including occupational accommodations that help patients resume partial levels of d work activity.

*Important Notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be considered conclusive, guide clinical practice/health-related behaviors, or treated as established information.

Journal reference:

  • Spencer, LH, Hendry, A., Makanjuola, A., et al. (2023). What are the interventions or best practices to help people with long COVID, or similar post-viral conditions or conditions characterized by fatigue, return to normal activities: a quick review. medRxiv. doi:10.1101/2023.01.24.23284947.

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