New study gives hope: Norwegian Inger-Johanne recovered after long covid

By NRK - Erik Andreassen– Journalist - 21 December 2024

A recent Norwegian study gives hope to many with long covid.

Most people who get corona recover, but some experience long-term problems. Inger-Johanne Thorstein quickly noticed that something was not right. Something settled in her chest when she was about to sing in the choir. The next day she became ill.

– I thought that's just the way it is, and tried my hand at work at first. But Inger-Johanne quickly realized that she wasn't getting better. – In the evenings, I had a strangely high heart rate even though I was sitting and watching TV. I was so tired, she says.

– Frustrating

After a series of examinations with the doctor and a visit to a heart specialist, she still had no answers. Weeks and months passed. In addition to the exhaustion itself, the uncertainty was eating away at her. – It was very frustrating. I realized it was long-covid, but I didn't know the way out. I was desperate to get well, and then I was afraid that I would never get well again.

What are the late effects of Covid-19?

For most people, COVID-19 is a mild and transient illness, but some experience persistent symptoms beyond the acute phase. Such long-term symptoms have been previously reported after a number of other infections, so it is not surprising that some people experience late effects after COVID-19.

Common symptoms

Among people with COVID-19 who were not hospitalized, the most commonly reported symptoms 6–12 months after illness are:

Impaired memory
Altered sense of taste and/or smell
Fatigue/tiredness
Impaired ability to think and concentrate (so-called “brain fog”)
Heavy breathing

Source: NIPH

Through my GP, an opportunity opened up for a study at the Coastal Hospital in Stavern .

Here they have been concerned with what the patients are able to cope with, and not symptoms, says consultant Tom Farmen Nerli.

– We don't work on alleviating symptoms from hour to hour, but on functioning over time. Exploring activities and tasks in arenas that patients miss, or that they want to do more of.

To achieve this, it is important that patients are confident about their symptoms and what they represent. Then it becomes easier to let them go, explains Nerli.

– There is an understanding that activities are actually needed for this to happen. The body has a fantastic ability to sort things out when we make the arrangements for it.

Startling results

Inger-Johanne Thorstein was afraid of doing anything that could make the disease worse again. She was told to put those thoughts aside.

The doctor teaches patients that it is not activities or work itself that cause symptoms, but the aftereffects of the virus.

– I started by saying that I wanted to go all in on the choir. I was going to try to sing like normal. Gradually it loosened up, and then more and more things loosened up as I tried. So he was right. – It's absolutely incredible that this is what was needed, says Thorstein. Over 300 people have participated in the study, and the results are startling:

Twice as many people recovered after treatment at the coastal hospital, compared to those who did not receive it.
On average, they only received four hours of treatment.

– This shows that it is entirely possible to recover from long covid, says Nerli.

Facts about the study:

The treatment was carried out by the Coastal Hospital in Stavern, but the study is a collaboration with the University of Oslo and Akershus University Hospital.
Was carried out from February 2022 to April 2024.
The Coastal Hospital in Stavern has previously developed a treatment for patients with persistent fatigue and long-term pain. It is this treatment that is used in the study.
The patients involved in the project have had mild or moderate symptoms for at least three months after contracting coronavirus.
310 patients have participated in the study. These were randomly divided into two groups. Half of them have received treatment under the auspices of the coastal hospital in Stavern. The other half have not received the treatment, but have instead tried, for example, rehabilitation elsewhere in the specialist health service, GP, physiotherapist and health centres.
The patients who receive help struggle with headaches, fatigue, brain fog, shortness of breath, heart palpitations and other symptoms.
Around 6 out of 10 of those who received treatment in Stavern recovered. Around 3 out of 10 of those who did not receive this treatment also recovered.
The results are measured through questionnaires.
The patients come from the South-Eastern Health Region: Agder, Telemark, Vestfold, Østfold, Akershus, Buskerud and Innlandet.
The program consisted of 2-8 outpatient meetings, with 2-6 weeks between each meeting.
Patients who have received treatment in Stavern first receive a doctor's appointment, then individual follow-up by a physiotherapist. The follow-up is cognitive and functionally focused.
Cognitive is about confidence about the condition and symptoms. It is also about understanding that future recovery requires exploration of mental and physical tasks.
The follow-up is functionally oriented in that the therapist and patient together find arenas to explore that reflect who the patient is and what they want more of in their healthy life.
The study is published in the American journal Jama Network Open.

The doctor hopes the treatment can be used for more people who struggle with fatigue after infections.

– Not necessarily just in hospitals, but also with GPs. Today, there are far too few who have good services for patients who struggle with fatigue, he believes.

– Encouraging

Head of Research at the Norwegian Institute of Public Health, Signe Flottorp, believes that more knowledge is needed about effective treatment of long-covid.

She finds the results from Stavern encouraging, and believes they fit well with other studies internationally.

– It shows that cognitive behavioral therapy and various types of training approaches have a positive effect for people struggling with late effects of corona.

She believes it would have strengthened the study if they had not only looked at patients with mild and moderate symptoms, but also those with the highest symptom burden – even if there is no evidence that they need a different treatment.

– And there is only one center included in the study. It would have been interesting to see what could be achieved in other places as well, says Flottorp.

With mild to moderate symptoms, it means that the patients have not been admitted to an intensive care unit, for example.

– They have not been 100 percent bedridden, but they have had very troublesome symptoms for at least three months. This probably includes over 90 percent of patients with long covid in Norway, emphasizes Nerli.

Disagreement about long covid

In November, another Norwegian study concluded that long covid may be an important cause of the record-high sick leave in Norway – a conclusion that the National Institute of Public Health disagreed with.

There is also disagreement about how long covid affects the brain.

Last year, a study at Ahus was criticized for overly psychologizing the symptoms of long covid.

Recently, a professional network advocated for a more holistic approach to people with fatigue conditions.

The treatment in Stavern has also been used on other patients with fatigue.

Farmen Nerli hopes the results will help more people not think either physically or mentally about long covid – but both.

– With the patient experiences I have, it is completely unreasonable not to see body and mind together. It always is, regardless of what condition you have, he says.

Read alsoLaila fought off late effects of corona

Get well

Inger-Johanne Thorstein only had two hours of treatment. A few months after the first visit in 2022, she felt well. – Today I feel very good. I sometimes notice that I can struggle a little with my memory. Apart from that, I have no problems, says Thorstein happily.

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