Dear Editor
I was disappointed to read “Finding ways to help recovery from long Covid” by Victoria Cairns because it focused mainly on one research paper of dubious quality without considering wider issues. In discussing the vagus nerve theory and related purported treatments without referring to the many other biological mechanisms implicated in Long Covid or the limitations of research, Cairns risks exposing patients to, at best, misplaced hope and, at worst, harm.
In discussing treatments, Cairns presents claims which could be highly damaging for Long Covid patients. Cairns reports that physical exercise can help reduce inflammation, citing a review of yoga interventions for chronic health conditions which included no studies on Long Covid. The ME Association UK and public health researchers are clear about the need to be extremely cautious in recommending activity to patients with Long Covid because such programs can easily produce a serious relapse.
The paper on which Cairns focuses, Khan et al. (2024), is of extremely poor quality, making leaps between concepts with very little evidence linking them. Where evidence is presented it is from pilot studies with underpowered samples or patients with acute (not chronic) Covid-19.
What patients have repeatedly called out for is recognition and targeted research on well founded hypotheses that have a close affinity with treatment pathways. It is crucial that a critical eye is used when choosing research relating to “recovery”.
I hope that Cairns is recovering and/or resting well after her recent illness.
Emma B
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