MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

So-called alternative medicine (SCAM) interventions are growing in popularity and are even advocated as treatments for long COVID symptoms. However, comprehensive analysis of current evidence in this setting is still lacking. This study aims to review existing published studies on the use of SCAM interventions for patients experiencing long COVID through a systematic review of randomized controlled trials (RCTs).
A comprehensive electronic literature search was performed in multiple databases and clinical trial registries from September 2019 to January 2023. RCTs evaluating efficacy and safety of SCAM for long COVID were included. Methodological quality of each included trial
was appraised with the Cochrane ‘risk of bias’ tool. A qualitative analysis was conducted due to heterogeneity of included studies.

A total of 14 RCTs with 1195 participants were included in this review. Study findings demonstrated that SCAM interventions could benefit patients with long COVID, especially those suffering from

  • neuropsychiatric disorders,
  • olfactory dysfunction,
  • cognitive impairment,
  • fatigue,
  • breathlessness,
  • mild-to-moderate lung fibrosis.

The main interventions reported were:

  • self-administered transcutaneous auricular vagus nerve stimulation,
  • neuro-meditation,
  • dietary supplements,
  • olfactory training,
  • aromatherapy,
  • inspiratory muscle training,
  • concurrent training,
  • online breathing programs,
  • online well-being programs.

The authors concluded that SCAM interventions may be effective, safe, and acceptable to patients with symptoms of long COVID. However, the findings from this systematic review should be interpreted with caution due to various methodological limitations. More rigorous trials focused on CAM for long COVID are warranted in the future.

Such wishy-washy conclusions seem to be popular in the fantasy land of SCAM. Yet, they are, in my view, most ojectionable because:

  1. they tell us nothing of value;
  2. that something “MAY BE EFFECTIVE” has been known before and cannot be the result of but is the reason for a systematic review;
  3. a review of 14 RCTs of almost as many interventions cannot possibly tell us anything about the SAFETY of these treatments;
  4. it also does not provide evidence of effectiveness and merely indicates a lack of independent replications;
  5. if the abstract mentions an assessment of the study rigor, one expects that it also informs us about this important aspect.

Once we do come around looking at the methodological quality of the primary studies we realize that it is mostly miserable. This means that the conclusions of the review are not just irritating but plainly misleading. Responsible researchers should have concluded along the following lines:

The quantity and the quality of the evidence are both low. Therefore, the effectiveness and safety of SCAM interventions for long COVID remains unproven.

PS

This project was financially supported by The HEAD Foundation, Singapore and in part by the grant from the NIH R61 AT01218.

Shame on the authors, journal editors, peer-reviewers, and funders of this dangerous nonsense!

9 Responses to A systematic review of so-called alternative medicine (SCAM) for ‘long COVID’

  • So the alternative is to do nothing and wait for the NHS…

    • why wait for the NHS?
      that’s nonsense;
      I’d just treat the symptoms as they arise with the best options we currently have.
      and even if we had noe – do you think that justifies promoting BS?

      • I give an example: My granddaughter started suffering from intermittent abdominal pain 4 years ago. After many visits to A&E and her local GP, an ultrasound showed gall-stones (after 3 years!).

        We started trying alternatives e.g. apple-cider vinegar that did not work, then some “cures” on Amazon – no good (all this time she is drinking 1 – 2 liters of water every day) and finally, without any faith in anything, we tried lemon juice (an ounce and a half with water every day, she is tiny) and within *two* days, there is no more pain, and that was two months ago without any pain – I am just as surprised as she is because we *could* have done that 4 years ago, at a cost of £3.99 for a bottle from the supermarket.

        But this is of course “anecdotal” and also “medical advice” which is prohibited because only RCTs are allowed, run by the likes of Pfizer/FDA etc. Hence lemon-juice, that is there to be found e.g. typing “lemon juice cure for gallstones” does the trick, but you have to know the answer beforehand to find it 🙂

        • I give you another example:
          my gran smoked 20 cigaretts/day most of her life – and she never died of lung cancer.
          so, smoking prevents lung cancer?
          LONG LIVE THE ANECDOTE!

          • Smoking is a good example of anecdote e.g. Humphrey Bogart called them “coffin nails” long before it was officially acknowledged (one of David Niven’s books) and the tobacco industry misused “science” to “prove” the opposite – so I agree: long live the anecdote (and the conspiracy theory).

        • @Old Bob

          I am glad your granddaughter is felling better. I bet if you do an ultrasound now, you wouldn’t see the gallstones. In any case, who cares about RCTs. I heard cow urine works wonders on gallstones: https://cowurine.com/en/gallbladder-disease-treatment. Better keep this one is your back pocket in case the lemon juice cure fails to work.

        • Your daughter has bad physicians. Ater 3 Yrs gall-stones were detected. If EBM is used one can detect gall-stones after some month. And a therapy shoule end with the finding of an ultrasound control, that she is free of gall-stones. Her complaints are over- but what happens wirh the gall-stone?

        • “Hence lemon-juice, that is there to be found e.g. typing “lemon juice cure for gallstones” does the trick, but you have to know the answer beforehand to find it 🙂”

          Clearly, your search lacked imagination…

          Calcined wild boar (Su scrofa) faeces is a preparation of traditional Tibetan medicine used to treat stomach and gallbladder diseases, such as dyspepsia, anorexia, jaundice, gallstones and nausea.

          Dubost, JM., Kongchack, P., Deharo, E. et al.
          Zootherapeutic uses of animals excreta: the case of elephant dung and urine use in Sayaboury province, Laos.
          J Ethnobiology Ethnomedicine 17, 62 (2021).
          DOI: 10.1186/s13002-021-00484-7

          • @Pete Attkins

            Calcined wild boar (Su scrofa) faeces is a preparation of traditional Tibetan medicine … Zootherapeutic uses of animals excreta: the case of elephant dung and urine use …

            Luckily, advanced research in this area has shown us that all these exotic and hard-to-obtain therapeutical substances can be replaced by one generic, ubiquitous remedy by the name of bubulum stercus.

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