Preliminary evaluation of a mindfulness intervention program in women with long COVID dysautonomia symptoms, 2025, Vandenbogaart+

Preliminary evaluation of a mindfulness intervention program in women with long COVID dysautonomia symptoms
Vandenbogaart; Figueroa; Winston; Cole; Bower; Hsu

BACKGROUND
The symptom burden for patients with Long COVID-associated dysautonomia is high, yet there are currently no effective treatments. Mindfulness programs reduce psychological and physical symptoms as well as inflammatory gene expression in a variety of medical conditions. The study aim was to evaluate the effect of a six-week mindfulness program in women with Long COVID dysautonomia symptoms.

METHODS
Using a single arm, pre-and posttest design, women aged 18–54 years with Long COVID and orthostatic intolerance suggestive of dysautonomia were recruited from a single center. Participants attended a standardized, six-week, virtual mindfulness program. An active stand test and 6-min walk test (6MWT) were performed at baseline and post-intervention. Self-reported measures of physical and mental health symptoms collected at baseline, post-intervention and 4 week follow up included the composite autonomic symptom score (COMPASS-31), perceived stress (PSS), anxiety (GAD7), depression (PHQ8), COVID-19 event specific distress (IES-R), fatigue (FSI), sleep (ISI), well-being (MHC-SF), resilience (CD-RISC 10), and quality of life (SF-20). The effects on conserved transcriptional response to adversity (CTRA) were examined by next-generation sequencing of dried whole blood samples.

RESULTS
Twenty participants were enrolled with a mean age of 39.9 years (range 21–52 years). No significant changes were observed for the active stand test or 6MWT. A significant reduction in insomnia severity (ISI: 16.6 vs. 13.6; p = 0.001) was observed post-intervention, but scores reverted toward baseline levels at 4week follow-up. No significant improvements were seen in autonomic symptoms, anxiety, perceived stress, depression, well-being, or COVID-19 related distress. Proinflammatory CTRA gene expression decreased significantly from pre-to post-intervention (p = 0.004). Declines in CTRA gene expression were most significant among those with 3 COVID-19 positive events (p = 0.01), followed by 2 events (p = 0.04) and 1 event (p = 0.05). Declines in CTRA gene expression did not vary significantly as a function of recent illness, COVID-19 hospitalization, demographic characteristics, or general medical history.

CONCLUSION
A virtual, six-week mindfulness program may improve sleep quality in women with Long COVID dysautonomia. While no objective improvement in dysautonomia symptoms were observed, our findings suggest a favorable effect of the mindfulness intervention on inflammatory and antiviral biology with a decrease in CTRA gene expression. Nonetheless, the symptom burden in this population is very high, and more attention is needed to provide effective multi-modal clinical therapies to this population.

Link (Brain, Behavior, & Immunity - Health) [Open Access]

 

Paper reports: none of this works.

Paper manages to avoid saying "promising" but nevertheless concludes —

 

I'm not sure that there is much more to say.

Perhaps - even with a highly selected sample, even with a small sample, even with a whole lot of subjective outcomes, even with no controls, the best that they could come up with in terms of benefits to symptom burden was a very temporary cherry-picked reduction in self-reported insomnia. That's actually worse than I would have expected with all those biases at work.

But, but, the Background says

So, there must surely be some problem with the therapy that can be tweaked just a bit...


Based on the abstract:
I don't know what "conserved transcriptional response to adversity (CTRA)" is, but, even though it looks like they tried hard to correlate it with all sorts of things, it doesn't seem to have anything to do with symptom load.

 

recommends multi site studies ie job creation