229 - Considerations for the Use of Osteopathic Manipulative Medicine for Long-COVID Syndrome Patients: A Review of the Literature

Objectives: Over half of COVID19 survivors up to one year following infection experience either pulmonary, gastrointestinal, neuropsychiatric, and/or cardiac complications, a condition known as “Long-COVID Syndrome”. Currently, it appears that rehabilitation, exercise, and the management of pre-existing diseases is the most secure form of care. In an effort to expand therapeutic options, the purpose of this study is to examine how osteopathic manipulative treatment (OMT) could potentially help manage complications of Long-COVID.

Design: A review of the current literature was completed. Articles were included if they contained the key words “Long-COVID” AND “COVID19” AND “OSTEOPATHIC MANIPULATIVE TREATMENT OR OMT”. Databases such as PubMed, CDC, Embase, JOM, and SCOPUS were used as primary sources for literature. Studies were divided by body system complications and how they were affected by OMT. Outcome measures examined in-hospital mortality rates, changes in pain perception, alterations to intimal thickening and circulation, developments in exercise capability, olfactory improvements, and changes to kidney mobility. Articles examined included clinical trials, cohort studies, case studies, and other literature reviews.

Results: 68 articles addressed improvements in Long-COVID complications via OMT. Respiratory complications improved with rib raising and lymphatic release. Cardiovascular complications improved with balanced ligamentous tension and rib mobilization. Gastrointestinal complications improved with OMM that targets the abdomen and local inflammatory responses. Neurological complications improved with cervical joint mobilization, lymphatic drainage techniques, and visceral/autonomic manipulations. Renal complications improved with lymphatics that reduce local inflammation.

Conclusions: Our study suggests the beneficial effects of OMT in treating complications of Long-COVID Syndrome. This review argues in favor of OMT providing a non-invasive and non-pharmacologic intervention towards the treatment of Long-COVID. Further studies in this field should consider incorporating OMT and expanding patient sample sizes in clinical trials regarding Long-COVID patient management in order to strengthen the evidence of OMM in clinically-relevant Long-COVID recovery scenarios.