A comparison of allied healthcare versus no allied healthcare on participation, fatigue, physical functioning and health-related quality of life for patients with persistent complaints after a COVID-19 infection

To assess the effectiveness of allied healthcare versus no allied healthcare. Data from the ParaCOV cohort (allied healthcare, n = 1,451) and the LongCOVID cohort (no allied healthcare/control, n = 1427) were analyzed. Average treatment effects (ATEs) between groups were estimated using Targeted Maximum Likelihood Estimation adjusted for age, sex, body mass index, smoking status, comorbidities, and effect outcomes’ baseline values. A ≥ 10% between-group difference in improvement from baseline (BTGD) was considered clinically relevant for participation, fatigue, and physical functioning, and ≥0.062 for health-related quality of life. Patients receiving allied healthcare were older (49.2 vs. 41.2 years), less often female (63.3% vs. 70.1%), had higher BMI (28.2 vs. 26.1), smoked less frequently (5.0% vs. 9.0%), had more comorbidities (49.2% vs. 41.9%), and lower baseline anxiety and depression scores compared to those not receiving allied healthcare. For participation, ATEs after 6 and 12 months were respectively −2.62 (95%CI: −4.39; −0.86) and −1.68 (95%CI: −4.81;1.45), with BTGDs of 4.7% and 1.8% favoring the control. For fatigue, ATEs were 1.72 (95%CI: −0.14; 3.58) and 0.97 (95%CI: −1.48; 3.41), with BTGDs of 6.5% and 3.7% favoring the control. For physical functioning, ATEs were 5.75 (95% CI: 4.42; 7.09) and 6.36 (95%CI: 4.84; 7.88), with BTGDs of 1.4% and 2.2% favoring allied healthcare. For health-related quality of life, ATEs were 0.017 (95%CI: −0.008; 0.0044) and 0.033 (95%CI: 0.011; 0.054). Patients with persistent complaints after a COVID-19 infection showed significantly lower participation after 6 months, higher health-related quality of life after 12 months, and better physical functioning after 6 and 12 months of allied healthcare, however, BTGDs were not clinically relevant. Study limitations warrant cautious results interpretation. Although health-related quality of life and physical functioning improved in Long COVID patients, this cannot be definitively attributed to allied healthcare.The observed outcome differences between Long COVID patients with and without allied healthcare were not clinically relevant.More research is needed for tailored rehabilitation treatments for these patients. Although health-related quality of life and physical functioning improved in Long COVID patients, this cannot be definitively attributed to allied healthcare. The observed outcome differences between Long COVID patients with and without allied healthcare were not clinically relevant. More research is needed for tailored rehabilitation treatments for these patients.