A well-conducted RCT from Amsterdam1 found that Cognitive Behavioural Therapy (CBT) was effective for long COVID.
Patients had to have proof of being COVID-positive and had fatigue 3-12 months after and were randomised to 17 weeks of CBT or care as usual.
The majority of patients were not hospitalised for COVID-19. The outcomes were done at six months. Patients were omitted if they had significant depression.
The CBT was aimed at sleep, unhelpful beliefs about fatigue, low activity level, perceived low social support, fears and worries around COVID-19 and poor coping with pain.
Some CBT was done online, and some face-to-face. The effect sizes were NNT = 4 for reduced severe fatigue and 2.5 for not being chronically fatigued. Most participants were no longer severely fatigued, but a group of patients remained severely fatigued.