SOMA.COV
Long COVID: Psychological Risk Factors and Their Modification
Background
A significant number of affected individuals report persistent somatic symptoms after a SARS-CoV-2 infection has resolved. This phenomenon is now widely referred to as “Long COVID”. An increasing number of studies are investigating potential risk factors for the development of Long COVID. In addition to pathophysiological mechanisms, research findings point to the involvement of psychological factors in the development of persistent symptoms after COVID-19. Of the potentially modifiable psychological risk factors, illness-related anxiety and dysfunctional symptom expectations in particular seem to play an important role in symptom persistence. With regard to the development of effective therapies, it is therefore important to investigate whether symptoms of Long COVID can be improved by a targeted modification of illness-related anxiety and dysfunctional symptom expectations. The project is conducted in collaboration with the DFG-funded Research Unit SOMACROSS (RU 5211).
Aims
Our primary aim is to investigate whether symptoms of Long COVID can be improved by modifying illness-related anxiety and dysfunctional symptom expectations. Second, we aim to identify additional psychosocial risk factors for symptom persistence. Finally, in an exploratory approach, we aim to compare risk factors leading to symptom persistence in Long COVID with conditions under investigation in RU 5211.
Working programme
To assess whether Long COVID symptoms can be improved by modifying illness-related anxiety and dysfunctional symptom expectations, we will conduct an observer-blinded, 3-arm randomized controlled trial. 258 patients with Long COVID will be randomized into 3 groups: targeted expectation management aiming to reduce illness-related anxiety and dysfunctional symptom expectations in addition to treatment as usual (intervention 1), non-specific supportive treatment in addition to treatment as usual (intervention 2), or treatment as usual only (control). Both active intervention groups will comprise 3 individual online video consultation sessions and a booster session after 3 months.
The primary outcome is baseline to post-interventional change in overall somatic symptom severity. Additional risk factors for symptom persistence will be identified in the untreated control group.
Comparisons with risk factors for other conditions identified in RU 5211 will be conducted to provide evidence of disease-specific and generic mechanisms of actions for the persistence of somatic symptoms.
Expected impact
The study will shed light onto the efficacy and mechanisms of action of a targeted expectation management intervention for patients with Long COVID, which, if proven effective, can be used stand-alone or in the context of broader therapeutic approaches. In addition, the project will provide a better understanding of symptom persistence in Long COVID by identifying additional disease-specific risk factors.
Comparisons with RU 5211 will clarify which risk factors and mechanisms of symptom persistence are disease-specific and which are valid across diseases. Further, the detailed analysis of the complex biopsychosocial mechanisms will allow the further advancement of aetiological models and according evidence-based intervention strategies for persistent somatic symptoms.
