Interventions for the management of post-COVID-19 condition (long COVID): protocol for a living systematic review and network meta-analysis
Background Up to 15% of survivors of COVID-19 infection experience long-term health effects, including fatigue, myalgia and impaired cognitive function, termed post-COVID-19 condition or long COVID. Several trials that study the benefits and harms of various interventions to manage long COVID have b...
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BMJ Publishing Group
2025-02-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/2/e086407.full |
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| author | Paul Garner Lawrence Mbuagbaw Jason W Busse Dena Zeraatkar Thomas Agoritsas Ariel Izcovich Tari Turner Lyn Turkstra Roger S McIntyre Rachel J Couban Tyler Pitre Sarah Kirsh Tanvir Jassal Michael Ling Samantha Chakraborty Signe A Flottorp |
| author_facet | Paul Garner Lawrence Mbuagbaw Jason W Busse Dena Zeraatkar Thomas Agoritsas Ariel Izcovich Tari Turner Lyn Turkstra Roger S McIntyre Rachel J Couban Tyler Pitre Sarah Kirsh Tanvir Jassal Michael Ling Samantha Chakraborty Signe A Flottorp |
| author_sort | Paul Garner |
| collection | DOAJ |
| description | Background Up to 15% of survivors of COVID-19 infection experience long-term health effects, including fatigue, myalgia and impaired cognitive function, termed post-COVID-19 condition or long COVID. Several trials that study the benefits and harms of various interventions to manage long COVID have been published and hundreds more are planned or are ongoing. Trustworthy systematic reviews that clarify the benefits and harms of interventions are critical to promote evidence-based practice.Objective To create and maintain a living systematic review and network meta-analysis addressing the benefits and harms of pharmacologic and non-pharmacologic interventions for the treatment and management of long COVID.Methods Eligible trials will randomise adults with long COVID to pharmacologic or non-pharmacologic interventions, placebo, sham or usual care. We will identify eligible studies by searching MEDLINE, EMBASE, CINAHL, PsycINFO, AMED and CENTRAL from inception, without language restrictions.Reviewers will work independently and in duplicate to screen search records, collect data from eligible trials, including trial and patient characteristics and outcomes of interest and assess risk of bias. Our outcomes of interest will include patient-reported fatigue, pain, postexertional malaise, changes in education or employment status, cognitive function, mental health, dyspnoea, quality of life, physical function, recovery and serious adverse events.For each outcome, when possible, we will perform a frequentist random-effects network meta-analysis. When there are compelling reasons to suspect that certain interventions are only applicable or effective for a subtype of long COVID, we will perform separate network meta-analyses. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach will guide our assessment of the certainty of evidence.We will update our living review biannually, on the publication of a seminal trial, or when new evidence emerges that may change clinical practice.Conclusion This living systematic review and network meta-analysis will provide comprehensive, trustworthy and up-to-date summaries of the evidence addressing the benefits and harms of interventions for the treatment and management of long COVID. We will make our findings available publicly and work with guideline-producing organisations to inform their recommendations.Ethics and dissemination The study describes the protocol for a systematic review that uses data from published trial reports. Therefore, the study is exempt from ethics review. We intend to deposit all data in a public repository and publish each iteration of the living review online. |
| format | Article |
| id | doaj-art-170dadb496414182857022458ec1d34b |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-170dadb496414182857022458ec1d34b2025-02-08T06:55:09ZengBMJ Publishing GroupBMJ Open2044-60552025-02-0115210.1136/bmjopen-2024-086407Interventions for the management of post-COVID-19 condition (long COVID): protocol for a living systematic review and network meta-analysisPaul Garner0Lawrence Mbuagbaw1Jason W Busse2Dena Zeraatkar3Thomas Agoritsas4Ariel Izcovich5Tari Turner6Lyn Turkstra7Roger S McIntyre8Rachel J Couban9Tyler Pitre10Sarah Kirsh11Tanvir Jassal12Michael Ling13Samantha Chakraborty14Signe A Flottorp1511 Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK2 Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada1 Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada1 Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada2 Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada7 Department of Medicine, Universidad del Salvador, Buenos Aires, Argentina4 School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia5 School of Rehabilitation Science and Program in Neuroscience, McMaster University, Hamilton, Ontario, Canada6 Department of Psychiatry and Pharmacology, University of Toronto, Toronto, Ontario, Canada1 Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada3 Division of Respirology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada2 Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada1 Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada1 Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada4 School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia10 Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, NorwayBackground Up to 15% of survivors of COVID-19 infection experience long-term health effects, including fatigue, myalgia and impaired cognitive function, termed post-COVID-19 condition or long COVID. Several trials that study the benefits and harms of various interventions to manage long COVID have been published and hundreds more are planned or are ongoing. Trustworthy systematic reviews that clarify the benefits and harms of interventions are critical to promote evidence-based practice.Objective To create and maintain a living systematic review and network meta-analysis addressing the benefits and harms of pharmacologic and non-pharmacologic interventions for the treatment and management of long COVID.Methods Eligible trials will randomise adults with long COVID to pharmacologic or non-pharmacologic interventions, placebo, sham or usual care. We will identify eligible studies by searching MEDLINE, EMBASE, CINAHL, PsycINFO, AMED and CENTRAL from inception, without language restrictions.Reviewers will work independently and in duplicate to screen search records, collect data from eligible trials, including trial and patient characteristics and outcomes of interest and assess risk of bias. Our outcomes of interest will include patient-reported fatigue, pain, postexertional malaise, changes in education or employment status, cognitive function, mental health, dyspnoea, quality of life, physical function, recovery and serious adverse events.For each outcome, when possible, we will perform a frequentist random-effects network meta-analysis. When there are compelling reasons to suspect that certain interventions are only applicable or effective for a subtype of long COVID, we will perform separate network meta-analyses. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach will guide our assessment of the certainty of evidence.We will update our living review biannually, on the publication of a seminal trial, or when new evidence emerges that may change clinical practice.Conclusion This living systematic review and network meta-analysis will provide comprehensive, trustworthy and up-to-date summaries of the evidence addressing the benefits and harms of interventions for the treatment and management of long COVID. We will make our findings available publicly and work with guideline-producing organisations to inform their recommendations.Ethics and dissemination The study describes the protocol for a systematic review that uses data from published trial reports. Therefore, the study is exempt from ethics review. We intend to deposit all data in a public repository and publish each iteration of the living review online.https://bmjopen.bmj.com/content/15/2/e086407.full |
| spellingShingle | Paul Garner Lawrence Mbuagbaw Jason W Busse Dena Zeraatkar Thomas Agoritsas Ariel Izcovich Tari Turner Lyn Turkstra Roger S McIntyre Rachel J Couban Tyler Pitre Sarah Kirsh Tanvir Jassal Michael Ling Samantha Chakraborty Signe A Flottorp Interventions for the management of post-COVID-19 condition (long COVID): protocol for a living systematic review and network meta-analysis BMJ Open |
| title | Interventions for the management of post-COVID-19 condition (long COVID): protocol for a living systematic review and network meta-analysis |
| title_full | Interventions for the management of post-COVID-19 condition (long COVID): protocol for a living systematic review and network meta-analysis |
| title_fullStr | Interventions for the management of post-COVID-19 condition (long COVID): protocol for a living systematic review and network meta-analysis |
| title_full_unstemmed | Interventions for the management of post-COVID-19 condition (long COVID): protocol for a living systematic review and network meta-analysis |
| title_short | Interventions for the management of post-COVID-19 condition (long COVID): protocol for a living systematic review and network meta-analysis |
| title_sort | interventions for the management of post covid 19 condition long covid protocol for a living systematic review and network meta analysis |
| url | https://bmjopen.bmj.com/content/15/2/e086407.full |
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