“Cognitive Behavioral Therapy for COVID-19 Fatigue: Findings from Amsterdam UMC and Radboudumc Study”

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 has emerged from research by Amsterdam UMC and Radboudumc together with three other hospitals. Researcher Hans Knoop: ‘Patients functioned better both physically and socially after behavioral therapy, even after six months.’

Some people continue to have complaints after COVID-19. This is called lung COVID or post-COVID syndrome. The most common complaint is severe and disabling fatigue. In the ReCOVer study, funded by ZonMw, the effect of cognitive behavioral therapy on this fatigue was investigated in a group of 114 patients. For this study, patients who received behavioral therapy were compared with patients who were treated in a usual way. This usual care often consisted of supervision by the general practitioner or specialist, physiotherapy and/or occupational therapy.

Tackle fatigue

Cognitive behavioral therapy for patients with persistent fatigue after COVID-19 focuses on dealing with the problematic fatigue. Together with the patient, we look at what can be changed in this regard so that a reduction of complaints from the acute phase of COVID-19 becomes possible. Knoop: ‘Together with people, 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.’

Better concentration

Cognitive behavioral therapy has clear results for these patients. Most participants experienced significantly less fatigue and improved concentration after cognitive behavioral therapy. They also made significant progress socially. In addition, the results proved to be stable over time. After six months, the differences with usual care were still present. Knoop: ‘Cognitive behavioral therapy also appears to be a safe treatment. Our research shows that the complaints did not worsen. Furthermore, new complaints arose less often compared to usual care.’

Need more research

The researchers emphasize that the fact that behavioral therapy can help does not mean that the cause of the complaints is psychological. Furthermore, not everyone benefits from behavioral therapy. Radboudumc internist-infectiologist Chantal Rovers: ‘It is therefore very important that we continue to look for other effective treatments and the physical causes of the post-COVID syndrome.’

About the publication

This study is 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 AA 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.