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Cognitive-behavioral therapy for post COVID-19 condition: A pilot randomized controlled trial.

Karoline Sophie Sauer·Anne-Kathrin Bräscher·Sylvan Germer·Daniel Huth·Johanna Kolb·Kaline Mütze·Michael Witthöft
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Abstract

BACKGROUND: The post COVID-19 condition (PCC) is a disabling condition with urgent need for effective treatments. This pilot randomized controlled trial examined the feasibility and efficacy of a cognitive-behavioral therapy (CBT) for PCC in a parallel-group design. METHODS: N = 53 individuals with PCC were randomized to CBT (n = 27) or 16-week wait-list control (WLC) condition (n = 26). One participant allocated to WLC was excluded after randomization, resulting in an intention-to-treat (ITT) sample of N = 52 participants (CBT: n = 27, age: M = 48.59, SD = 11.52, 77.8% female; WLC: n = 25, Age: M = 48.44, SD = 9.81, 60% female). CBT comprised eight group and five individual sessions addressing cognitive and behavioral factors of symptom maintenance (treatment duration if completed: M = 14 weeks, SD = 1 week). Primary outcomes included fatigue (FSS), overall somatic symptom burden (PHQ-15), and respiratory and cardiovascular symptoms (SBQ™-LC "Breathing" and "Circulation"), assessed at pre-, post-assessment, and follow-up. RESULTS: Participants receiving CBT showed a significant medium-sized reduction in fatigue directly after treatment compared to the WLC condition (d = -0.58, p = .045), whereas the WLC group showed a significant increase in overall somatic symptoms (d = 0.60, p = .027). Results for respiratory symptoms were mixed, showing inconsistent patterns across analyses. Retrospectively assessed feasibility and treatment satisfaction were good, with few adverse effects reported. CONCLUSIONS: This pilot trial suggests the feasibility and preliminary efficacy of CBT for PCC. Larger RCTs with active control groups should confirm these findings.

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HumansFemaleCognitive Behavioral TherapyPilot ProjectsCOVID-19Middle AgedAdultMaleTreatment OutcomeFeasibility StudiesFatiguePost-Acute COVID-19 SyndromeSARS-CoV-2PandemicsCognitive-behavioral therapyPost COVID-19 conditionJournal ArticleRandomized Controlled Trial

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Karoline Sophie Sauer, Anne-Kathrin Bräscher, Sylvan Germer, Daniel Huth, Johanna Kolb, Kaline Mütze, Michael Witthöft. 2026-07-07. Cognitive-behavioral therapy for post COVID-19 condition: A pilot randomized controlled trial.. https://doi.org/10.1016/j.jpsychores.2026.112920

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