Mindfulness programme may benefit COVID survivors

A mindfulness-based stress reduction (MBSR) programme may improve functional and psychosocial outcomes in patients with long COVID, a study suggests.

“This [study] provides evidence that physical, psychological, and cognitive symptom clusters exist among post-COVID-19 … survivors. Our results indicate … an immediate benefit after the MBSR programme,” said the researchers.

Of the 105 patients included, 93 (average age 60 years, 65.6 percent men) took part in the follow-up interviews and were included in the analyses. They were randomized 1:1 to MBSR or usual care (UC; drug therapy, treatment, evaluations). The average hospital stay was 28 days in the intensive care unit (ICU) and 19 days post-ICU. [Ann Ig 2025; 37:350-364]

Outcomes

Pain perception (least pain in the last 24 h domain in the BPI-SF* questionnaire) was lower in the MBSR than UC group at 6 months post-intervention (mean score, 0.9 vs 1.4; p=0.035). This effect was sustained at 12 months (mean score, 2.2 vs 2.8; p=0.012).

Pain interference also improved with MBSR vs UC, specifically the mean scores in these domains: interference with general activity (1.5 vs 2.2; p=0.004), with mood (2.6 vs 4.1; p=0.002), with sleep (3 vs 3.7; p=0.015), and with enjoyment of life (2.6 vs 3.6; p=0.007) at 6 months. At the 1-year mark, the domains that remained better with MBSR were interference with mood (2.4 vs 3.3; p=0.031) and interference with sleep (3 vs 3.7; p=0.017).

There were also significant between-group differences favouring MBSR over UC in the mean HADS**-Anxiety (11.2 vs 13.1; p<0.001) and HADS-Depression scores (9.9 vs 11.2; p=0.007) at 6 months. A similar pattern was observed at 12 months (10.8 vs 13.4; p<0.001 [HADS-Anxiety] and 9.6 vs 10.6; p=0.018 [HADS-Depression]).

The mean Insomnia Severity Index score was also significantly lower in the MBSR vs UC group, both at 6 (9 vs 13.6; p<0.001) and 12 months (9.1 vs 11.1; p<0.001).

The MBSR programme

MBSR is a structured and systematic programme employing mindfulness meditation as a central element to teach individuals to take better care of themselves and live a healthier and more adaptive life. It focuses on increasing awareness and acceptance of difficult experiences, enabling patients to adapt better to such situations. [JAMA 2008;300:1350-1352]

It includes mindfulness sessions (2 h/week for 8 weeks) carried out in groups. The themes for each session were: overview of mindfulness, facing difficulties, mindful breathing, staying present, allowing or letting it be, thoughts are not facts, taking care of yourself, and dealing with future struggles. Participants interacted amongst themselves to facilitate learning and were given homework.

Psychoeducation was also part of the programme. “[W]e added a brief segment of psychoeducation to the first session to reflect on the distress of the consequences of [long ICU stay] … and to show how mindfulness-based interventions [(MBIs) can help],” the researchers explained.

Co-interventions were allowed, except for other MBIs or similar modalities, such as meditation exercises, yoga, or cognitive behavioural therapies.

Implications

“Long COVID is an important public health problem, and one of the approaches to address this problem is through MBSR … Our findings show a reduction in the perception of least pain in the last 24 h, in the interference of pain with mood, general work, sleep, and enjoyment of life, [and in] anxiety, depression, and insomnia,” said the researchers.

Taken together, the findings suggest that the MBSR programme is a promising therapeutic modality for individuals with long COVID. Studies with larger sample sizes are warranted to reinforce the findings.