Vink, Mark, Vink-Niese, Alexandra · Healthcare (Basel, Switzerland) · 2020 · DOI
This study looked at whether cognitive behavioural therapy (CBT)—a talk therapy that focuses on changing thought patterns—is effective for long COVID and post-COVID fatigue. The researchers re-examined a previous study on a similar condition called Q-fever fatigue syndrome and found serious problems with how that study was done. They concluded that CBT likely doesn't actually help people with these post-infection fatigue conditions feel better or become more able to do daily activities.
This analysis is important because rehabilitation clinics have begun offering CBT for long COVID based on its purported effectiveness for ME/CFS, despite limited evidence specific to post-COVID fatigue. For ME/CFS patients, this study highlights critical methodological flaws in evidence cited to support behavioural interventions and raises questions about whether CBT should be a primary treatment recommendation for post-infectious fatigue syndromes.
This reanalysis of one previous study does not definitively prove that CBT has no value for any individual with post-infectious fatigue, nor does it establish the underlying mechanisms of long COVID or post-COVID fatigue. It also does not eliminate the possibility that CBT might be helpful when combined with other treatments or for specific subgroups, only that the evidence base for its effectiveness in homogeneous post-infectious fatigue populations is currently weak.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Vink, Mark & Vink-Niese, Alexandra (2020). Could Cognitive Behavioural Therapy Be an Effective Treatment for Long COVID and Post COVID-19 Fatigue Syndrome? Lessons from the Qure Study for Q-Fever Fatigue Syndrome.. Healthcare (Basel, Switzerland). https://doi.org/10.3390/healthcare8040552
BibTeX
@article{mecfsatlas-vink-2020-could-cognitive,
author = {Vink, Mark and Vink-Niese, Alexandra},
title = {Could Cognitive Behavioural Therapy Be an Effective Treatment for Long COVID and Post COVID-19 Fatigue Syndrome? Lessons from the Qure Study for Q-Fever Fatigue Syndrome.},
journal = {Healthcare (Basel, Switzerland)},
year = {2020},
doi = {10.3390/healthcare8040552},
note = {PubMed: 33322316},
url = {https://www.mecfsatlas.com/evidence/vink-2020-could-cognitive},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/vink-2020-could-cognitive
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