Exploration du traitement non conventionnel de la fatigue dans le syndrome post-COVID-19

Auteur/ices

  • Habib Hajji Service de médecine physique et de réadaptation, Faculté de médecine, Université de Monastir, Tunisie
  • Amine Kalai Service de médecine physique et de réadaptation, Laboratoire de recherche en technologie et imagerie médicale - LR12ES06, Centre de recherche en biomécanique musculosquelettique, Faculté de médecine, Université de Monastir, Monastir, Tunisie
  • Amr Chaabeni Service de médecine physique et de réadaptation, Faculté de médecine, Université de Monastir, Tunisie
  • Houda Migaou Service de médecine physique et de réadaptation, Faculté de médecine, Université de Monastir, Tunisie
  • Besma Jebali Service de médecine physique et de réadaptation, Faculté de médecine, Université de Monastir, Tunisie
  • Zohra Ben Salah Frih Service de médecine physique et de réadaptation, Faculté de médecine, Université de Monastir, Tunisie
  • Helmi Ben Saad Laboratoire de recherche LR12SP09 « Insuffisance cardiaque », Hôpital Farhat Hached, Université de Sousse, Sousse, Tunisie
  • Anis Jellad Service de médecine physique et de réadaptation, Laboratoire de recherche en technologie et imagerie médicale - LR12ES06, Centre de recherche en biomécanique musculosquelettique, Faculté de médecine, Université de Monastir, Monastir, Tunisie

DOI :

https://doi.org/10.62438/tunismed.v103i9.5926

Mots-clés :

Aromathérapie, COVID-19, COVID long, Fatigue, Rééducation, Thérapie complémentaire, Thérapie par acupuncture

Résumé

Introduction. Le syndrome post-maladie à coronavirus 2019 (COVID-19) est une affection multi-systémique complexe qui touche environ 75 millions de personnes dans le monde (Mai 2024). Le syndrome est défini par des symptômes persistant au-delà de quatre semaines après l’infection et se manifeste en phases subaiguë (4-12 semaines) et chronique (>12 semaines). La fatigue est l’un des symptômes les plus fréquents et invalidants, altérant considérablement la qualité de vie des patients atteints de ce syndrome. Sa prise en charge nécessite des stratégies thérapeutiques diversifiées allant au-delà des approches conventionnelles de rééducation.

Objectif. Cette revue narrative examine les interventions non conventionnelles utilisées dans le traitement de la fatigue liée au syndrome post-COVID-19, en mettant en avant les approches nutritionnelles, les modalités physiques et d’autres thérapies innovantes.

Méthodes. Revue narrative.

Résultats. Parmi les traitements rapportés dans la littérature figurent la mélatonine, le QingjinYiqi, les compléments nutritionnels, l’aromathérapie, les antioxydants, le Tai Chi, l’acupuncture, le yoga, le chant, l’oxygénothérapie hyperbare (OTHB), la thérapie par champ électromagnétique pulsé et la vibration corporelle globale. La mélatonine et le QingjinYiqi ont montré des effets bénéfiques sur la fatigue et la santé globale. Des compléments nutritionnels comme des combinaisons de vitamines et de minéraux améliorent la force musculaire, la performance physique et la qualité de vie. Le Tai Chi, l’acupuncture et le yoga réduisent la fatigue et renforcent le bien-être général. L’aromathérapie, le chant, l’OTHB et les thérapies électromagnétiques favorisent la récupération physique et cognitive.

Conclusion. Ces traitements non conventionnels constituent des approches complémentaires prometteuses aux stratégies de réhabilitation classiques.

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Références

Jackson CB, Farzan M, Chen B, Choe H. Mechanisms of SARS-CoV-2 entry into cells. Nat Rev Mol Cell Biol. 2022;23(1):3-20.

Ketfi A, Touahri R, Chabati O, Chemali S, Mahjoub M, Gharnaout M, et al. Severity factors in Algerian patients hospitalized for COVID-19. Tunis Med. 2021;99(7):734-43.

Alimohamadi Y, Sepandi M, Rashti R, Sedighinezhad H, Afrashteh S. COVID-19: Clinical features, case fatality, and the effect of symptoms on mortality in hospitalized cases in Iran. J Taibah Univ Med Sci. 2022;17(5):725-31.

Greenhalgh T, Knight M, A'Court C, Buxton M, Husain L. Management of post-acute covid-19 in primary care. BMJ. 2020;370:m3026.

Ballering AV, van Zon SKR, Olde Hartman TC, Rosmalen JGM, Lifelines Corona Research I. Persistence of somatic symptoms after COVID-19 in the Netherlands: an observational cohort study. Lancet. 2022;400(10350):452-61.

Alwan NA, Johnson L. Defining long COVID: Going back to the start. Med. 2021;2(5):501-4.

Montani D, Savale L, Noel N, Meyrignac O, Colle R, Gasnier M, et al. Post-acute COVID-19 syndrome. Eur Respir Rev. 2022;31(163):210185.

Gheorghita R, Soldanescu I, Lobiuc A, Caliman Sturdza OA, Filip R, Constantinescu-Bercu A, et al. The knowns and unknowns of long COVID-19: from mechanisms to therapeutical approaches. Front Immunol. 2024;15:1344086.

Shah W, Hillman T, Playford ED, Hishmeh L. Managing the long term effects of covid-19: summary of NICE, SIGN, and RCGP rapid guideline. BMJ. 2021;372:n136.

Nasserie T, Hittle M, Goodman SN. Assessment of the frequency and variety of persistent symptoms among patients with COVID-19: A systematic review. JAMA Netw Open. 2021;4(5):e2111417.

Davis HE, McCorkell L, Vogel JM, Topol EJ. Long COVID: major findings, mechanisms and recommendations. Nat Rev Microbiol. 2023;21(3):133-46.

Clayton EW. Beyond myalgic encephalomyelitis/chronic fatigue syndrome: an IOM report on redefining an illness. JAMA. 2015;313(11):1101-2.

Zeraatkar D, Ling M, Kirsh S, Jassal T, Pitre T, Chakraborty S, et al. Interventions for the management of post-COVID-19 condition (long COVID): protocol for a living systematic review and network meta-analysis. BMJ Open. 2025;15(2):e086407.

Chuang HJ, Lin CW, Hsiao MY, Wang TG, Liang HW. Long COVID and rehabilitation. J Formos Med Assoc. 2024;123 Suppl 1:S61-S9.

Benzarti W, Toulgui E, Ghram A, Rahmani C, Aissa S, Ghannouchi I, et al. Impact of a pulmonary rehabilitation program on social disadvantage and physical activity data of postCOVID19 patients: A North-African pilot study. F1000Res. 2022;11:1226.

Benzarti W, Toulgui E, Prefaut C, Chamari K, Ben Saad H. General practitioners should provide the cardiorespiratory rehabilitation' 'minimum advice' for long COVID-19 patients. Libyan J Med. 2022;17(1):2009101.

Fernandez-Lazaro D, Santamaria G, Sanchez-Serrano N, Lantaron Caeiro E, Seco-Calvo J. Efficacy of therapeutic exercise in reversing decreased strength, impaired respiratory function, decreased physical fitness, and decreased quality of life caused by the post-COVID-19 syndrome. Viruses. 2022;14(12).

Cardinali DP, Brown GM, Pandi-Perumal SR. Possible application of melatonin in long COVID. Biomolecules. 2022;12(11).

Lempesis IG, Georgakopoulou VE, Reiter RJ, Spandidos DA. A mid‑pandemic night's dream: Melatonin, from harbinger of anti‑inflammation to mitochondrial savior in acute and long COVID‑19 (Review). Int J Mol Med. 2024;53(3).

Bantounou M, Plascevic J, Galley HF. Melatonin and related compounds: Antioxidant and anti-inflammatory actions. Antioxidants (Basel). 2022;11(3).

Souissi A, Dergaa I, Romdhani M, Ghram A, Irandoust K, Chamari K, et al. Can melatonin reduce the severity of post-COVID-19 syndrome? Excli J. 2023;22:173-87.

Souissi A, Prieto-Gonzalez P, Ben Saad H. Widespread pain syndrome in long COVID-19: melatonin as an adjuvant treatment. Front Pain Res 2025;6:1609095.

Pang W, Yang F, Zhao Y, Dai E, Feng J, Huang Y, et al. Qingjin Yiqi granules for post-COVID-19 condition: A randomized clinical trial. J Evid Based Med. 2022;15(1):30-8.

Hu W, Xu Y. The published trend of studies on COVID-19 and dietary supplements: Bibliometric analysis. Front Immunol. 2022;13:1065724.

Bell MG, Ganesh R, Bonnes SL. COVID-19, the gut, and nutritional implications. Curr Nutr Rep. 2023;12(2):263-9.

Ghram A, Ayadi H, Knechtle B, Ben Saad H. What should a family physician know about nutrition and physical exercise rehabilitation' advices to communicate to 'long-term COVID-19' patients? Postgrad Med. 2022;134(2):143-7.

Galluzzo V, Zazzara MB, Ciciarello F, Savera G, Pais C, Calvani R, et al. Fatigue in Covid-19 survivors: The potential impact of a nutritional supplement on muscle strength and function. Clin Nutr ESPEN. 2022;51:215-21.

Rossato MS, Brilli E, Ferri N, Giordano G, Tarantino G. Observational study on the benefit of a nutritional supplement, supporting immune function and energy metabolism, on chronic fatigue associated with the SARS-CoV-2 post-infection progress. Clin Nutr ESPEN. 2021;46:510-8.

Webster K, Cella D, Yost K. The functional assessment of chronic illness therapy (FACIT) measurement system: properties, applications, and interpretation. Health Qual Life Outcomes. 2003;1:79.

Chalder T, Berelowitz G, Pawlikowska T, Watts L, Wessely S, Wright D, et al. Development of a fatigue scale. J Psychosom Res. 1993;37(2):147-53.

Balestroni G, Bertolotti G. EuroQol-5D (EQ-5D): an instrument for measuring quality of life. Monaldi Arch Chest Dis. 2012;78(3):155-9.

Landi F, Martone AM, Ciciarello F, Galluzzo V, Savera G, Calvani R, et al. Effects of a new multicomponent nutritional supplement on muscle mass and physical performance in adult and old patients recovered from COVID-19: A pilot observational case-control study. Nutrients. 2022;14(11).

Farrar AJ, Farrar FC. Clinical aromatherapy. Nurs Clin North Am. 2020;55(4):489-504.

Hawkins J, Hires C, Keenan L, Dunne E. Aromatherapy blend of thyme, orange, clove bud, and frankincense boosts energy levels in post-COVID-19 female patients: A randomized, double-blinded, placebo controlled clinical trial. Complement Ther Med. 2022;67:102823.

Smets EM, Garssen B, Bonke B, De Haes JC. The multidimensional fatigue inventory (MFI) psychometric qualities of an instrument to assess fatigue. J Psychosom Res. 1995;39(3):315-25.

Wood E, Hall KH, Tate W. Role of mitochondria, oxidative stress and the response to antioxidants in myalgic encephalomyelitis/chronic fatigue syndrome: A possible approach to SARS-CoV-2 'long-haulers'? Chronic Dis Transl Med. 2021;7(1):14-26.

Cuevas-Sierra A, de la OV, Higuera-Gomez A, Chero-Sandoval L, de Cuevillas B, Martinez-Urbistondo M, et al. Mediterranean diet and olive oil redox interactions on lactate dehydrogenase mediated by gut oscillibacter in patients with long-COVID-19 syndrome. Antioxidants (Basel). 2024;13(11).

Al-Hakeim HK, Al-Rubaye HT, Al-Hadrawi DS, Almulla AF, Maes M. Long-COVID post-viral chronic fatigue and affective symptoms are associated with oxidative damage, lowered antioxidant defenses and inflammation: a proof of concept and mechanism study. Mol Psychiatry. 2023;28(2):564-78.

Molnar T, Lehoczki A, Fekete M, Varnai R, Zavori L, Erdo-Bonyar S, et al. Mitochondrial dysfunction in long COVID: mechanisms, consequences, and potential therapeutic approaches. Geroscience. 2024;46(5):5267-86.

Bellone S, Siegel ER, Santin AD. N-acetylcysteine (NAC) supplementation improves dyspnea and may normalize von Willebrand plasma levels in gynecologic patients with Post-acute-covid-sequela (PASC)/long COVID. Gynecol Oncol Rep. 2025;57:101682.

Barlattani T, Celenza G, Cavatassi A, Minutillo F, Socci V, Pinci C, et al. Neuropsychiatric manifestations of COVID-19 disease and post COVID syndrome: The role of N-acetylcysteine and Acetyl-L-carnitine. Curr Neuropharmacol. 2025;23(6):686-704.

Hempel S, Taylor SL, Marshall NJ, Miake-Lye IM, Beroes JM, Shanman R, et al. Evidence map of mindfulness. VA evidence-based synthesis program reports. Washington (DC)2014.

Wayne PM, Kaptchuk TJ. Challenges inherent to t'ai chi research: part II-defining the intervention and optimal study design. J Altern Complement Med. 2008;14(2):191-7.

Huston P, McFarlane B. Health benefits of tai chi: What is the evidence? Can Fam Physician. 2016;62(11):881-90.

Ngai SP, Jones AY, Tam WW. Tai Chi for chronic obstructive pulmonary disease (COPD). Cochrane Database Syst Rev. 2016;2016(6):CD009953.

Shu C, Feng S, Cui Q, Cheng S, Wang Y. Impact of Tai Chi on CRP, TNF-alpha and IL-6 in inflammation: a systematic review and meta-analysis. Ann Palliat Med. 2021;10(7):7468-78.

Castro JP, Kierkegaard M, Zeitelhofer M. A Call to use the multicomponent exercise Tai Chi to improve recovery from COVID-19 and long COVID. Front Public Health. 2022;10:827645.

Wang M, Liu W, Ge J, Liu S. The immunomodulatory mechanisms for acupuncture practice. Front Immunol. 2023;14:1147718.

Zhang CS, Pannirselvan M, Xue CC, Xie YM. Relationship between buckling of acupuncture needles and the handle type. Acupunct Med. 2014;32(5):400-5.

Mallory MJ, Do A, Bublitz SE, Veleber SJ, Bauer BA, Bhagra A. Puncturing the myths of acupuncture. J Integr Med. 2016;14(5):311-4.

Bae H, Bae H, Min BI, Cho S. Efficacy of acupuncture in reducing preoperative anxiety: a meta-analysis. Evid Based Complement Alternat Med. 2014;2014:850367.

Cohen AJ, Menter A, Hale L. Acupuncture: role in comprehensive cancer care--a primer for the oncologist and review of the literature. Integr Cancer Ther. 2005;4(2):131-43.

Williams JE, Moramarco J. The role of acupuncture for long COVID: Mechanisms and models. Med Acupunct. 2022;34(3):159-66.

Trager RJ, Brewka EC, Kaiser CM, Patterson AJ, Dusek JA. Acupuncture in multidisciplinary treatment for post-COVID-19 syndrome. Med Acupunct. 2022;34(3):177-83.

Rioux JG. Yoga Therapy Research: A Whole-systems perspective on comparative effectiveness and patient-centered outcomes. Int J Yoga Therap. 2015;25(1):9-19.

Moncer R, Hajji H, Naija S, Ben Amor S, Jemni S, Ben Saad H. Effects of Yoga-like exercises on mild and moderate Alzheimer disease: A randomized controlled trial protocol. Tunis Med. 2025;103(1):58-64.

Shah K, Adhikari C, Saha S, Saxena D. Yoga, immunity and COVID-19: A scoping review. J Family Med Prim Care. 2022;11(5):1683-701.

Capela Santos D, Jaconiano S, Macedo S, Ribeiro F, Ponte S, Soares P, et al. Yoga for COVID-19: An ancient practice for a new condition - A literature review. Complement Ther Clin Pract. 2023;50:101717.

Armer JS, Lutgendorf SK. The Impact of yoga on fatigue in cancer survivorship: A Meta-Analysis. JNCI Cancer Spectr. 2020;4(2):pkz098.

Kaminsky DA, Guntupalli KK, Lippmann J, Burns SM, Brock MA, Skelly J, et al. Effect of Yoga breathing (Pranayama) on exercise tolerance in patients with chronic obstructive pulmonary disease: A randomized, controlled trial. J Altern Complement Med. 2017;23(9):696-704.

Bhargav H, Raghavan V, Rao NP, Gulati K, Binumon KV, Anu KN, et al. Validation and efficacy of a tele-yoga intervention for improving psychological stress, mental health and sleep difficulties of stressed adults diagnosed with long COVID: a prospective, multi-center, open-label single-arm study. Front Psychol. 2024;15:1436691.

Kim SJ, Yeo MS, Kim SY. Singing interventions in pulmonary rehabilitation: A scoping review. Int J Environ Res Public Health. 2023;20(2).

Lewis A, Philip KEJ, Lound A, Cave P, Russell J, Hopkinson NS. The physiology of singing and implications for 'Singing for Lung Health' as a therapy for individuals with chronic obstructive pulmonary disease. BMJ Open Respir Res. 2021;8(1).

Bonilha AG, Onofre F, Vieira ML, Prado MY, Martinez JA. Effects of singing classes on pulmonary function and quality of life of COPD patients. Int J Chron Obstruct Pulmon Dis. 2009;4:1-8.

Cahalan RM, Meade C, Mockler S. SingStrong-A singing and breathing retraining intervention for respiratory and other common symptoms of long COVID: A pilot study. Can J Respir Ther. 2022;58:20-7.

Ortega MA, Fraile-Martinez O, Garcia-Montero C, Callejon-Pelaez E, Saez MA, Alvarez-Mon MA, et al. A general overview on the hyperbaric oxygen therapy: Applications, mechanisms and translational opportunities. Medicina (Kaunas). 2021;57(9).

Pawlik MT, Rinneberg G, Koch A, Meyringer H, Loew TH, Kjellberg A. Is there a rationale for hyperbaric oxygen therapy in the patients with Post COVID syndrome? : A critical review. Eur Arch Psychiatry Clin Neurosci. 2024;274(8):1797-817.

Bhaiyat AM, Sasson E, Wang Z, Khairy S, Ginzarly M, Qureshi U, et al. Hyperbaric oxygen treatment for long coronavirus disease-19: a case report. J Med Case Rep. 2022;16(1):80.

Vadala M, Morales-Medina JC, Vallelunga A, Palmieri B, Laurino C, Iannitti T. Mechanisms and therapeutic effectiveness of pulsed electromagnetic field therapy in oncology. Cancer Med. 2016;5(11):3128-39.

Hartard M, Fenneni MA, Scharla S, Hartard C, Hartard D, Mueller S, et al. Electromagnetic induction for treatment of unspecific back pain: A prospective randomized sham-controlled clinical trial. J Rehabil Med. 2023;55:jrm00389.

Schaefer LV, Bittmann FN. Case report: Individualized pulsed electromagnetic field therapy in a Long COVID patient using the Adaptive Force as biomarker. Front Med (Lausanne). 2022;9:879971.

Maloney-Hinds C, Petrofsky JS, Zimmerman G. The effect of 30 Hz vs. 50 Hz passive vibration and duration of vibration on skin blood flow in the arm. Med Sci Monit. 2008;14(3):CR112-6.

Sanudo B, Seixas A, Gloeckl R, Rittweger J, Rawer R, Taiar R, et al. Potential application of whole body vibration exercise for improving the clinical conditions of COVID-19 infected individuals: A narrative review from the World Association of Vibration Exercise Experts (WAVex) Panel. Int J Environ Res Public Health. 2020;17(10).

Hartard M, Hartard C, Scharla S, Scharla S, Hartard D, Herrera D, et al. Influence of heat therapy and/or vibration on nonspecific back pain: A prospective, open, randomized, controlled, parallel-group clinical study. Tunis Med. 2025;03(06):566-70.

Hartard M, Seiler A, Spitzenpfeil P, Engel L, Hartard D, Fenneni MA, et al. Sex-specific response to whole-body vibration training: a randomized controlled trial. Biol Sport. 2022;39(1):207-17.

Dincher A. Effects of 12 weeks whole body vibration training on long COVID syndrome symptoms - A Single Case Study. 2023;1:9-15.

Dergaa I, Ben Saad H. Artificial intelligence and promoting open access in academic publishing. Tunis Med. 2023;101(6):533-6.

Hidouri S, Kamoun H, Salah S, Jellad A, Ben Saad H. Key guidelines for responding to reviewers. F1000Res. 2024;13:921.

Fichiers supplémentaires

Publiée

2025-11-09