Psychosocial Interventions for Individuals Living with the Psychosocial Effects of Long-COVID: A Qualitative Interpretative Meta-Synthesis

Background and Purpose: Between 10 to 20% of people who are infected with COVID-19 develop post-acute COVID-19 syndrome – experiencing symptoms far beyond the duration of the acute infection (WHO, 2023). Long-COVID – as this novel disease is commonly called – is a frightening multisystem disease, with the potential for myriad negative psychosocial effects, including significant impacts on employment and mental health, and requiring long-term professional and familial care. Substantial psychosocial effects necessitate effective psychosocial interventions, yet research examining psychosocial treatment options specific to long-COVID appears to be limited. The present study synthesized and analyzed the extant qualitative literature to a) understand the extent to which individuals with long-Covid have access to effective psychosocial support and b) identify existing psychosocial interventions.

Methods: The authors conducted a qualitative interpretive meta-synthesis (QIMS). QIMS is a methodical approach for synthesizing qualitative studies on a given phenomenon to “create a new, deeper and broader understanding” of that phenomenon (Aguirre & Bolton, 2014, p.23). A comprehensive literature search was conducted using databases across disciplines (e.g. PubMed; PsychInfo; CINAHL) to identify studies that met the following criteria: 1) were published in peer-reviewed journals, theses, or dissertations; 2) were published in English; 3) employed qualitative methods as a singular or mixed methodology; 4) sampled people living with prolonged symptoms after a COVID-19 infection; and 5) focused fully or partially on the psychosocial effects of prolonged COVID-19 symptoms. The initial search yielded 45 articles for potential inclusion, which were further narrowed down to 22 articles after a careful abstract review. The researchers examined the remaining 22 articles for thematic content relevant to psychosocial intervention, identifying a final eight articles for inclusion.

Results: Findings revealed a concerning lack of access to effective psychosocial interventions for individuals living with long-COVID. Synthesized themes pointed to several prevailing factors underlying lack of access: a) barriers in patient-provider communication may interfere with treatment or appropriate referral; b) existing professional interventions specific to long-COVID may be hard to identify; (c) professional psychosocial care specific to long-COVID, when identified, may still be hard to access (e.g., long waitlists). The data also highlighted informal strategies individuals utilized to cope with persistent psychosocial effects.

Conclusions and Implications: The psychosocial consequences of long-COVID are profound, warranting the urgent attention of social work researchers and practitioners. Findings indicate the need for the development and implementation of relevant psychosocial interventions and suggest the need for further research to understand and address existing barriers to access. Given social work’s strong presence in medical and behavioral healthcare services, as a profession we are well-poised to address these significant gaps in research and corresponding treatment. The COVID-19 pandemic has resulted in 7.6 million cases of COVID as of April 2023 (WHO, 2023), indicating that there may be over 1.5 million people around the world experiencing long-COVID. This QIMS study consequently represents a critical step in developing multidisciplinary interventions to address the needs of this population.