Long COVID support with digital therapy and Caspar Health

Over the past summer, the number of Corona infections continued to fall, making the pandemic far less present in our everyday lives. Since then, however, the coronavirus has once again become a major topic, and the number of patients suffering from long COVID is also rising steadily. In the first two years of the pandemic, at least 17 million people from the 53 countries classified by the World Health Organization as “European” were reported to be living with mild to debilitating symptoms long COVID symptoms for three months or more post-infection. These findings come from an analysis for the World Health Organization (WHO) of the 53 member states, based on a model calculation by the University of Washington. The study also shows that women are at higher risk of long covid than men. 

Those afflicted suffer from a wide array of symptoms – a fact that was stipulated by the official German guidelines for long COVID patients, developed by professional societies and self-help groups. According to the guidelines, patients regularly report that their performance is limited in many areas of their lives, and they often become exhausted after even short periods of physical or mental exertion. They find it difficult to process complex information, or to concentrate for long periods. Often, their psychological well-being is also impaired. And because the symptoms tend to come in waves, it is not uncommon for patients to have periods of feeling well, followed by periods of marked deterioration. Given this, the persistent after-effects of a coronavirus infection often present serious restrictions of the quality of life with regard to the patients’ social, familial, and professional life. 

Treatment of coronavirus infections and their aftermath

Rehabilitation facilities admitting patients with long COVID as their primary referral diagnosis – or even as a significant comorbidity – are once again facing major challenges in light of sharply rising infection rates and the associated increase in those affected. The question now is: How can digital therapy services provide effective support to facilities for their long COVID patients? Furthermore, how has our knowledge changed – and which measures are effective, and which are not? Is it possible to offer critical aftercare safely and effectively, even under especially challenging conditions for patients*? We believe so. 

In a new guide, Caspar Health has summarized the expertise on supportive monitoring of long COVID rehabilitation in aftercare. Here, our colleagues from the Research and Development team and the Caspar Clinic explain the basics of this new publication and its uses. 

Why did you decide to create this guide for our partner clinics? 

We wanted to give clinic staff access to relevant, customized therapeutic content in a quick and targeted manner – both during medical rehabilitation and during the aftercare phase. The guide is intended to help them implement therapy recommendations in accordance with the official guidelines, and to enable as many patients as possible to receive qualified aftercare in the future. It provides a useful companion and a good reference point in everyday therapeutic practices, and it also helps staff make optimal use of our software’s therapeutic content. It’s important to note that although the guide contains professional tips and advice, it is not a ready-made rehabilitation program, and the medical-therapeutic staff in the rehabilitation facilities always make the final decision when it comes to the manner and extent of its use. We see the guide as a supplemental tool to improve everyday therapy sessions with Caspar’s content.

We are fully aware that clinics want to do their best to support their patients. We’re talking about a population who need additional help on top of their prescribed therapy during their recovery. That’s why we want to showcase how the work can be made easier through digital support. 

After two years of the pandemic, what guidelines and practical lessons were you able to draw on? 

Right now, rehabilitation treatment for patients dealing with long-term effects of COVID-19 in Germany is based on the relevant S1 guidelines of the Association of the Scientific Medical Societies (AWMF). The guidelines clearly state that, effective treatment needs to address the patient’s specific symptoms. However, they also stipulates that the treatment should always be holistic in nature. This means that the respective bio-psychosocial conditions of the patients – such as their respective family, professional, private, and/or social environment – should also be taken into account during their treatment.  

Our guide also takes into account the experiences and knowledge that rehabilitation clinics have gained through their therapy sessions over the past two years. For example, we know from the Federal Working Group for Rehabilitation (BAR)'s current assessment from spring 2022 that of 134 rehabilitation facilities surveyed about long COVID, 72% stated that both the intensity and duration of follow-up care for patients with long COVID are higher compared to other diseases.

This is an important statement, especially in light of the fact that current figures from the German Pension Fund show that fewer than one in five eligible patients have actively participated in a follow-up treatment program. That means we are now dealing with even more fraught conditions with very low baseline values – not to mention the current state of the pandemic! Based on what we know, the main explanations for the low follow-up rates are as follows: Firstly, the poor compatibility of face-to-face appointments with patients’ time commitments, secondly, work-related participation challenges, such as shift work and changing work locations, and thirdly, the fact that appropriate follow-up care services are often difficult to access or lacking completely. In addition to these already massive hurdles, there is another factor: namely, the gender distribution of long COVID. Specifically, it is now becoming apparent that women are more frequently affected than men. 

Furthermore, according to an analysis by the Hans Böckler Foundation in 2020, women in particular have taken on a major share of family care work as a result of the pandemic, placing them at a huge deficit in their careers. Because of this double burden, it’s particularly important to enable treatment options that can be easily integrated into everyday life in order to ensure sustainable therapeutic success. Experience has shown that this reduces the risk of patients discontinuing the aftercare program. This is precisely why we see tele-rehab aftercare as an optimal solution which stands to offer huge benefits to patients. After all, digital aftercare services are accessible throughout the country and can be accessed by anyone, regardless of time or location. 

What elements from Caspar Health's library have been incorporated into the guide? 

Long COVID rehabilitation is intended to cover a symptom complex of the very common possible symptoms such as fatigue ("exhaustion"), dyspnea ("shortness of breath"), limited physical and mental performance, headaches, psychological complaints, and olfactory as well as gustatory disorders, and to improve the aforementioned limitations over the long term. 

That is why we’ve selected therapeutically relevant pieces of content from our extensive catalog of more than 1,100 modules. This has resulted in a multimodal, individually adaptable program that contains movement therapy, breathing exercises, relaxation, and mindfulness training, and other informative content – all in one easy-to-manage place. 

How can we illustrate the practical benefits of Caspar Health's supportive digital therapy for long covid patients for our partner clinics? 

One practical advantage is obvious: Because our guide addresses content related to managing the long-term consequences of a COVID-19 infection, our partner clinics can access the information they need quickly and easily. This is why we also created a compact content overview with the most successful treatment options. Basically, we’ve developed a structured map to guide therapists through the entire catalog of therapy content. Therapists can then easily create customized therapy plans from with it. Our offer also aims to provide even better conditions for successful aftercare. Through our observations, the additional complication that the COVID-19 factor brings to rehabilitation often makes it even more difficult to initiate qualified aftercare for their original indication. However, aftercare is often a main factor in ensuring that patients can achieve therapeutic success over the long term. 

In practical terms, how can rehabilitation clinics use Caspar Health's services to provide therapeutic support for their patients with Long COVID?  

The benefit materializes when they make use of our offers already during the rehabilitation itself. In this respect, our tools to support long COVID therapy are no different from other services that we offer our partner clinics. Here, too, success means familiarizing patients with the digital modules at an early stage. There are different models for the follow-up care, because some partner clinics provide the care themselves through a specialist therapy team, but a growing number of clinics really hand over this task to our virtual Caspar Clinic. Incidentally, the Caspar Clinic itself also works in conjunction with our long COVID program. A practical report on this is already being planned. Incidentally, in our experience, using Caspar app presents a supreme advantage, especially for patients in aftercare, because it means they are in continuous contact with their therapy team and can be supported via chat and telephone. Due to the fact that aftercare for patients affected by long COVID is particularly demanding, this "direct line" is often exactly the point that can make the difference. 

The long COVID guide and treatment concept was designed by an interdisciplinary team at Caspar Health. Frank Merten, Constanze Pfefferle, Henrik Grobe and Hannah Kalitschke were involved.

Would you like to learn more and offer digitally supported therapy for Long Covid patients* with Caspar Health? Feel free to contact us at: longcovid@caspar-health.com