gms | German Medical Science

Background and status of (inter)national research: After acute coronavirus disease 19 (COVID-19), up to 20% of patients suffer from long-term sequelae, referred to as long COVID, or post-COVID syndrome. Typical symptoms include fatigue, memory impairment, dyspnea, sleep disturbances, and joint pain. To date, there is no causal therapy for long COVID, and evidence on treatment by conventional and complementary approaches is limited.

Research question and objective: The aim of this retrospective pilot study was to evaluate physicians’ experiences of treating long COVID with traditional Chinese medicine (TCM).

Methods: Physicians specialized in TCM were sent an online questionnaire to record characteristics, symptoms, treatments, and outcomes of up to 15 randomly selected patients diagnosed with long COVID who had consulted their physicians at least twice for long COVID complaints.

Results: Data from 79 patients (65% females, 47 years ± 16 SD) were collected from 11 TCM physicians (mean TCM experience, 15 ± 8 years) in Germany and Austria. 46% of the 79 patients were at least temporarily unable to work due to long COVID complaints. TCM treatment started on average 18 ± 28 weeks after acute COVID disease and comprised an average of 7± 4 TCM consultations (in 37 patients, TCM treatment was still ongoing at time of assessment). The most common TCM treatments were acupuncture (n=66; 85%), Chinese herbs (n=61; 77%), and Chinese dietary counseling (n=32; 41%). The most frequent reasons for seeking TCM treatment were fatigue (n=68), impaired physical performance (n=62), and exertional dyspnea (n=46). At time of assessment, physicians rated global symptom improvement on average at 62%±29%, with 53 out of 79 patients (67%) showing ≥50% improvement. Significant improvement was noted for a variety of symptoms, including the leading symptoms fatigue (Chi2=20.4, p=.002), impaired physical performance (Chi2=41.5, p<.001) and exertional dyspnea (Chi2=39.3, p<.001). Treatment was terminated in 32 out of 42 patients (76%) because of significant improvement, in 6 patients (14%) because of insufficient improvement, and in 4 patients (10%) for financial or personal reasons.

Discussion: Physicians observed significant improvement in the majority of patients with long COVID treated by TCM. Due to the retrospective study design and the small sample size, however, the results of this pilot study have to be interpreted with caution.

Appeal for practice (science and/or care) in one sentence: TCM is used by physicians as a complementary treatment approach for long COVID and should be given more attention in both research and practice.