Digital-first approach to Long COVID management: feasibility and efficacy of the Avid health programme. (Preprint)
Authors: Tan Laura Joo Peng , Newiss Moira , McGee Alice , Martin Guy , Nehme Jean 
Published: September 2024

BACKGROUND

Long COVID is characterised by an array of physical and psychological symptoms that can be debilitating. Given the enormous number of individuals affected by long COVID, it presents a significant, and poorly understood emerging long-term medical and socioeconomic challenge. As such, there is a pressing need to develop and test new holistic and efficient approaches to whole-person treatment and rehabilitation at scale for patients with long COVID.

OBJECTIVE

To evaluate the effectiveness of a new human-centred, digital-first health platform - Avid - for the management of long COVID by examining its impact on participants quality of life scores and symptom severity in the short-term, and the platform’s usability and acceptability for end-users.

METHODS

37 participants (35 female, mean age 46.5 years, 8.1% previously hospitalised with acute COVID) with long Covid were recruited into the Avid program. Avid is a human-centred, digital-first platform that delivers a 6-week program providing structured, personalised health coaching and tailored digital content aligned to specific weekly goals. The approach facilitates a standardised approach through evidenced-based treatment strategies, whilst simultaneously supporting personalised, adaptable care at scale. A quasi-experimental single arm pre-post intervention design was employed to evaluate the platform. The primary outcome measures were C19-YRSm and EQ5D-5L quality of life scores. Usability and acceptability of the program for participants was examined through Net Promoter Scores (NPS) and qualitative semi-structured interviews.

RESULTS

The Avid program led to significant and sustained improvements in C19-YRSm scores at week 6 (5.57 (SD 1.79) vs. 3.95 (SD 1.35), p=0.0001, mean improvement 41.0%); week 10 (5.07 (SD1.78) vs. 3.93 (1.18), p=0.0003, mean improvement 29.0%); and week 22 (5.08 (SD 1.68) vs. 3.88 (SD 1.13), p=0.0001, mean improvement 30.9%). The program also led to significant improvements in EQ5D-5L Index scores at week 6 (0.54 (SD 0.25) vs. 0.44 (SD 0.23) p=0.0005, mean improvement 25.0%); week 10 (0.51 (SD 0.25) vs. 0.44 (SD 0.24), p=0.0382, mean improvement 15.9%); and week 22 (0.54 (SD 0.23) vs. 0.46 (SD 0.23), p=0.0103, mean improvement 17.4%. The program was well received with 100% engagement and completion at 6 weeks. NPS scores showed 70% of participants were promoters of the program with a mean individual score of 8.64.

CONCLUSIONS

The pilot study indicates that the Avid platform is safe, feasible and effective. It produces significant and sustained improvements in the symptoms and severity of long COVID, and wider measures of quality of life in the short-term. These findings suggest that the approach may provide a clinically impactful, cost-effective, and scalable platform that can successfully manage the challenges of long COVID. The modular approach of the platform also readily facilitates its rapid development and expansion to address other health challenges and long-term conditions in the future.