{
  "abstract": "Background: Persistent fatigue is one of the most common and disabling symptoms of long COVID, yet no pharmacological treatments are currently established. Non-drug strategies are increasingly used, but evidence directly comparing these approaches remains limited. This systematic review and meta-analysis evaluated the effects of non-pharmacological interventions on fatigue in adults with long COVID and explored potential sources of heterogeneity. Materials and Methods: Following PRISMA 2020 and the Cochrane Handbook, we searched four databases from inception to December 2025 for RCTs comparing non-pharmacological interventions with control conditions in adults with WHO-defined long COVID. The primary outcome was pre-specified as fatigue severity; no secondary outcomes were pre-specified. Methodological quality was assessed using the RoB 2 tool. Random-effects models were used to pool SMDs, with exploratory subgroup, sensitivity, and publication bias analyses. Results: Thirteen RCTs (1276 participants) were included. Non-pharmacological interventions significantly reduced fatigue [SMD = -0.43, 95% CI: -0.68 to -0.18, p < 0.001], with substantial heterogeneity (I² = 72.1%). Subgroup analyses showed that exercise training yielded significant benefit [SMD = -0.64, 95% CI: -1.11 to -0.18, p = 0.006], whereas cognitive behavioural therapy, non-invasive neuromodulation, and nutritional supplementation did not reach statistical significance. Interventions lasting ≥8 weeks were associated with greater improvement (between-subgroup p = 0.027). Sensitivity analyses confirmed robustness, and no publication bias was detected. Conclusions: Non-pharmacological interventions, particularly exercise-based programmes, are associated with reduced fatigue in people with long COVID, with interventions lasting ≥8 weeks showing greater average improvements. Exercise-based rehabilitation currently has the most consistent evidence base among the evaluated modalities, although the difference in effects between intervention modalities was not statistically significant (p = 0.286). Further high-quality trials are required to determine the comparative effectiveness of emerging approaches and to identify optimal treatment strategies.",
  "abstract_shown": true,
  "affiliations": [
    "College of Integrated Chinese and Western Medicine, Changchun University of Traditional Chinese Medicine, Changchun 130117, China.",
    "Second Department of Pulmonary Diseases, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun 130021, China.",
    "Department of Gastroenterology, Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun 130021, China.",
    "Department of Pneumology, Affiliated Hospital of Changchun University of Traditional Chinese Medicine, Changchun 130021, China."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yanze Bi",
      "orcid": "0009-0002-5605-3884"
    },
    {
      "affs": [
        1
      ],
      "name": "Bo Yang"
    },
    {
      "affs": [
        0
      ],
      "name": "Siyu Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Qingrong Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Rong Xu"
    },
    {
      "affs": [
        0
      ],
      "name": "Wenbo Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Yunyi Yang"
    },
    {
      "affs": [
        2
      ],
      "name": "Wenshuang Zou"
    },
    {
      "affs": [
        3
      ],
      "name": "Shaodan Hu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6pfezyanyq8vq.bib",
  "cited_by": 0,
  "doi": "10.3390/healthcare14203483",
  "fulltext_url": "https://europepmc.org/articles/PMC13704095",
  "id": "6pfezyanyq8vq",
  "issns": [
    "2227-9032"
  ],
  "landing_url": "https://europepmc.org/article/MED/42940528",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2728|Long-Term Effects of COVID-19"
    ]
  ],
  "openalex": "W7222632578",
  "pdf_url": "https://europepmc.org/articles/PMC13704095?pdf=render",
  "pmcid": "PMC13704095",
  "pmid": "42940528",
  "published": "2026-10-16",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/6pfezyanyq8vq.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:22:12Z",
      "native_id": "MED:42940528",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42940528"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2728|Long-Term Effects of COVID-19",
      "subfield": "neurology"
    }
  ],
  "title": "Effectiveness of Non-Pharmacological Interventions for Fatigue in Long COVID: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.",
  "title_text": "Effectiveness of Non-Pharmacological Interventions for Fatigue in Long COVID: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:22:12Z",
  "url": "https://research.draconitic.com/paper/6pfezyanyq8vq",
  "venue": "Healthcare (Basel, Switzerland)",
  "versions": []
}