Beyond the basics: exploring non-conventional treatment for fatigue in post-acute COVID-19 syndrome

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Published Nov 9, 2025
https://doi.org/10.62438/tunismed.v103i9.5926
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Vol. 103 No. 9 (2025): Tunis Med sept 2025

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Habib Hajji
Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Monastir, Tunisia
Amine Kalai
Department of Physical Medicine and Rehabilitation, Research Laboratory of Technology and Medical Imaging - LR12ES06, Center for Musculoskeletal Biomechanics Research, Faculty of Medicine, University of Monastir, Monastir, Tunisia
Amr Chaabeni
Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Monastir, Tunisia
Houda Migaou
Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Monastir, Tunisia
Besma Jebali
Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Monastir, Tunisia
Zohra Ben Salah Frih
Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Monastir, Tunisia
Helmi Ben Saad
Research Laboratory LR12SP09 “Heart Failure”, Farhat Hached Hospital, University of Sousse, Sousse, Tunisia
Anis Jellad
Department of Physical Medicine and Rehabilitation, Research Laboratory of Technology and Medical Imaging - LR12ES06, Center for Musculoskeletal Biomechanics Research, Faculty of Medicine, University of Monastir, Monastir, Tunisia

Abstract

Introduction. Post-acute 2019 coronavirus disease syndrome (PACS) is a multifaceted, multisystem disorder affecting an estimated 75 million individuals globally (in May 2024). Defined by symptoms persisting beyond four weeks post-infection, PACS manifests in subacute (4-12 weeks) and chronic (>12 weeks) phases, with fatigue being a prominent and debilitating feature. Comprehensive management of PACS-associated fatigue needs diverse therapeutic strategies extending beyond conventional rehabilitation.


Aim. This narrative review explored non-conventional interventions for PACS-related fatigue, focusing on treatments involving nutritional rehabilitation, physical modalities, and other innovative therapies.


Methods. Narrative review.


Results. Treatments reported in the literature include melatonin, QingjinYiqi, nutritional supplements, aromatherapy, antioxidants, Tai Chi, acupuncture, yoga, singing, hyperbaric oxygen therapy (HBOT), pulsed electromagnetic field therapy, and whole-body vibration. Melatonin and QingjinYiqi have shown notable improvements in fatigue and overall health. Nutritional supplements such as vitamin-minerals combinations have demonstrated enhancements in muscle strength, physical performance, and quality of life. Tai Chi, acupuncture, and yoga have shown positive effects on fatigue, muscle strength, and overall well-being. Aromatherapy, singing, HBOT, pulsed electromagnetic field therapy, and whole-body vibration effectively reduce fatigue while enhancing physical and cognitive functions.


Conclusion. These non-conventional treatments offer promising supplementary benefits to conventional rehabilitation.

Keywords:

Acupuncture Therapy, Aromatherapy, Complementary Therapy, COVID-19, Fatigue, Long COVID-19, Rehabilitation

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