Effectiveness of Internet-Based Group Supportive Psychotherapy on Psychic and Somatic Symptoms, Neutrophil-Lymphocyte Ratio, and Heart Rate Variability in Post COVID-19 Syndrome Patients

Hamzah Shatri, Dika Iyona Sinulingga, Cleopas Martin Rumende, Siti Setiati, Rudi Putranto, Eka Ginanjar, Iris Rengganis, Em Yunir, Raden Irawati Ismail, Petrin Redayani Lukman

Abstract


Background: COVID-19 can have serious long term health consequences, which is called Post-COVID-19 Syndrome (PCS). Currently, the available evidence and understanding of PCS management is limited. Because one of the symptoms of PCS is associated to psychological symptoms, psychotherapy is believed to have a role in the management of PCS. This study aimed to identify the effectiveness of supportive psychotherapy in PCS patients at Cipto Mangunkusumo National General Hospital. Methods: This study was a single blind randomized clinical trial using a pre-and post-test with control group study design. Participants were randomly divided into two groups: a psychotherapy group with 40 participants and an education group with 37 participants. Each group was given internet-based psychotherapy or education three times a week in a form of group consisting of 6-8 participants. Symptom Checklist-90 questionnaire was used to evaluate somatic and psychological symptoms. Heart rate variability and neutrophil lymphocyte ratio were also investigated. Data analysis was performed using the independent T test. Results: An improvement in the SCL-90 score was found to be 17.51 (SD 30.52) in the psychotherapy group and 19.79 (SD 35.10) in the education group, although there was no significant difference between the two groups (p = 0.771). There was no significant difference between the two groups in decreasing NLR (p = 0.178) and improving HRV (p = 0.560). Conclusion: Both internet-based group supportive psychotherapy and education improved psychological and somatic symptoms in PCS patients, although there was no significant difference between the two groups. There was no significant difference between the two groups in decreasing NLR and improving HRV. Suggestions for further research regarding adding frequency of internet-based group psychotherapy in PCS patients and held in the morning to achieve more optimal results.

Keywords


psychosomatic disorder; post COVID syndrome; internet-based group supportive psychotherapy; neutrophil lymphocyte ratio; heart rate variability

References


Pavli A, Theodoridou M, Maltezou HC. Post-COVID syndrome: Incidence, clinical spectrum, and challenges for primary healthcare professionals. Arch Med Res [Internet]. 2021;52(6):575–81. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0188440921000813

World Health Organization (WHO). A clinical case definition of post COVID-19 condition by a Delphi consensus data accessed :2021-12-23. WHO/2019-nCoV/Post_COVID-19_condition/Clinical_case_definition/20211. 2021;(October).

iyegbusi OL, Hughes SE, Turner G, et al. Symptoms, complications and management of long COVID: a review. J R Soc Med. 2021;114(9):428–42.

Townsend L, Dyer AH, Jones K, et al. Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection. PLoS One [Internet]. 2020;15(11 November):1–12. Available from: http://dx.doi.org/10.1371/journal.pone.0240784

Houben-Wilke S, Goërtz YMJ, Delbressine JM, et al. The impact of long COVID-19 on mental health: Observational 6-month follow-up study. JMIR Ment Heal. 2022;9(2):1–13.

Menges D, Ballouz T, Anagnostopoulos A, et al. Burden of post-COVID-19 syndrome and implications for healthcare service planning: A population-based cohort study. PLoS One. 2021;16(7 July):1–19.

Parker AM, Brigham E, Connolly B, et al. Addressing the post-acute sequelae of SARS-CoV-2 infection: a multidisciplinary model of care. Lancet Respir Med [Internet]. 2021;9(11):1328–41. Available from: http://dx.doi.org/10.1016/S2213-2600(21)00385-4

Bai F, Tomasoni D, Falcinella C, et al. Female gender is associated with long COVID syndrome: a prospective cohort study. Clin Microbiol Infect. 2022;28(4):611.e9-611.e16.

Perlis RH, Lunz Trujillo K, Safarpour A, et al. Association of post-COVID-19 condition symptoms and employment status. JAMA Netw Open. 2023;6(2):E2256152.

Al-Oraibi A, Naidu JS, Chaka A, et al. Prevalence of long COVID-19 among healthcare workers: A systematic review and meta-analysis protocol. BMJ Open. 2022;12(12):1–4.

Mohamed-Hussein AAR, Amin MT, Makhlouf HA, et al. Non-hospitalised COVID-19 patients have more frequent long COVID-19 symptoms. International Journal of Tuberculosis and Lung Disease. 2021;25:732.

Notarte KI, Catahay JA, Velasco JV, et al. Impact of COVID-19 vaccination on the risk of developing long-COVID and on existing long-COVID symptoms: A systematic review. eClinicalMedicine. 2022;53:1–19.

Mizrahi B, Sudry T, Flaks-Manov N, et al. Long covid outcomes at one year after mild SARS-CoV-2 infection: nationwide cohort study. BMJ. 2023.

National Institute for Health and Care Excellence (NICE) SIGN (SIGN) and RC of GP (RCGP). Covid19-Rapid-Guideline-Managing-the-Longterm-Effects-of-Covid19-Pdf-51035515742. 114 Publ 01032022 [Internet]. 2022;1–106. Available from: https://www.nice.org.uk/guidance/ng188

Clemente I, Sinatti G, Cirella A, Santini SJ, Balsano C. Alteration of inflammatory parameters and psychological post-traumatic syndrome in long-COVID patients. Int J Environ Res Public Health. 2022;19(12):7103.

Maamar M, Artime A, Pariente E, et al. Post-COVID-19 syndrome, low-grade inflammation and inflammatory markers: a cross-sectional study. Curr Med Res Opin [Internet]. 2022;38(6):901–9. Available from: https://doi.org/10.1080/03007995.2022.2042991

Asarcikli LD, Hayiroglu Mİ, Osken A, Keskin K, Kolak Z, Aksu T. Heart rate variability and cardiac autonomic functions in post-COVID period. J Interv Card Electrophysiol. 2022;63(3):715–21.

Kuut TA, Müller F, Aldenkamp A, et al. A randomised controlled trial testing the efficacy of Fit after COVID, a cognitive behavioural therapy targeting severe post-infectious fatigue following COVID-19 (ReCOVer): study protocol. Trials. 2021;22(1):1–15.

Yong SJ. Long COVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments. Infect Dis (Auckl) [Internet]. 2021;53(10):737–54. Available from: https://doi.org/10.1080/23744235.2021.1924397

Weinberg H. Group dynamics: Online Group Psychotherapy: Challenges and possibilities during COVID-19 — A practice review. 2020;24(3):201–11.

Weinberg H. Obstacles, challenges, and benefits of online group psychotherapy. Am J Psychother. 2021;74(2):83–8.

Dempsey K. When’s the best time of day for counselling and therapy? [Internet]. 2020 [cited 2023 May 21]. Available from: https://theawarenesscentre.com/whens-best-time-day-counselling-and-therapy/

Quintana DS, Heathers JAJ. Considerations in the assessment of heart rate variability in biobehavioral research. Front Psychol. 2014;5(JUL):1–10.

Fatisson J, Oswald V, Lalonde F, et al. Physical activity and heart rate variability in older adults: The Cardiovascular Health Study. Circulation. 1987;4 AUG(4):256–62.

Petermann F. Group therapy. Kindheit und Entwicklung. 2018;27(4):195–8.


Full Text: PDF

Refbacks

  • There are currently no refbacks.