Balneotherapy for the treatment of post-COVID syndrome: A randomized pilot trial

Abstract

Abstract Background Post-Acute COVID Syndrome (PACS) is a complex disorder that currently lacks effective evidenced-based therapies to manage it. This pilot randomized controlled trial aims to evaluate the effects of balneotherapy on PACS symptomatology. Methods Ninety-eight adults with PACS visited at Hospital del Mar Research Institute, Barcelona (Spain) were included to the study. Participants in the intervention group were allocated to 12 sessions of balneotherapy delivered in one month. The control group continued with their usual care. The primary outcome was to evaluate the absolute change in questionnaire scores between baseline and two follow-up points: immediately after balneotherapy (one-month post-baseline for the control group), and 2 months post-baseline. The following scales/questionnaires were employed: Post-COVID-19 functional status scale, mMRC dyspnea Scale, SF-36, Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), Memory failures in everyday life following severe head injury, and Visual Analogic Scale (VAS). Results Forty-seven patients in the balneotherapy group and 43 in the control group completed the study. After balneotherapy, significant improvement was detected in the balneotherapy group vs the control group in various SF-36 domains, PSQI total score, HAD’s anxiety subscale, and VAS. Among these, SF-36’s energy/fatigue and pain subscales exhibited the most prominent changes (p-value < 0.0001). One month after balneotherapy, some of these differences were lost between groups although persisting beneficial effects were maintained particularly in SF-36’s pain and energy/fatigue scales. Conclusion Balneotherapy comprise a safe and tolerable rehabilitative modality that can alleviate several symptoms that characterize PACS, particularly musculoskeletal pain and fatigue. Trial Registration: ClinicalTrials.gov: NCT05765591 (13/03/2023)