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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT05890508
Other study ID # 2021HMRF
Secondary ID
Status Recruiting
Phase N/A
First received
Last updated
Start date March 1, 2024
Est. completion date April 30, 2026

Study information

Verified date May 2024
Source Hong Kong Baptist University
Contact Linda Zhong, MD., Ph.D
Phone 852 34116523
Email ldzhong0305@gmail.com
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

In this study, a 16-week randomized, sham-controlled, double-blinded clinical trial will be conducted to to investigate the efficacy and safety of electro-acupuncture compared to sham acupuncture for treatment of long covid neuropsychiatric symptoms.


Description:

This is a prospective, randomized, sham-controlled, double-blinded and multiple center trial on electro-acupuncture for treating neuropsychiatric symptoms in long covid patients. A total of 150 participants will be randomly assigned to the electro-acupuncture and the sham-control group with 1:1 ratio. Both groups will receive 32 sessions of interventions during 16-week treatment duration (2 session per week), and will be followed up for 8 weeks.


Recruitment information / eligibility

Status Recruiting
Enrollment 150
Est. completion date April 30, 2026
Est. primary completion date January 31, 2026
Accepts healthy volunteers No
Gender All
Age group 18 Years to 80 Years
Eligibility Inclusion Criteria: - adults over 18 years of age to 80; - history of SARS-CoV-2 PCR+ at least 4 weeks prior to study entry; SARS-CoV-2 negative (PCR) at study entry; - at least one persistent neurological symptom (impaired concentration, headache, sensory disturbances, or depression, or "brain fog") that began around the time of the acute COVID-19; - willing and able to consent, complete all assessment and study procedures. Exclusion Criteria: - any chronic or remote neurological disorder (i.e. stroke, head trauma, epilepsy, tumor); - intellectual disability pre-existing to the Covid-19 episode;cardiovascular diseases such as arrhythmia, heart failure, myocardial infarction, and patients with cardiac pacemakers, - acute brain injury or acute encephalopathy from another aetiology than covid (e.g., sepsis, liver or renal failure, alcohol or drug withdrawal, drug toxicity); - documented pre-existing history of psychiatric illness, including substance abuse; - open-heart cardiac surgery or cardiac arrest during the last 6 months; - current hospitalization; - pregnant women.

Study Design


Related Conditions & MeSH terms


Intervention

Device:
Acupuncture
Disposable acupuncture needles (0.20 mm in diameter) are are used in the study. The acupoints are GV20(Baihui), EX-HN1(Sishencong), EX-HN3(Yintang), SP6(Sanyinjiao), ST36(Zusanli), ST40(Fenglong), and LR3(Taichong). Electrical stimulation will be delivered with waves at 2-5 Hz from an electroacupuncture device. The needles will be retained in position for 30 minutes.
Sham-acupuncture
Streitberger's non-invasive acupuncture needles (Gauge 8 x 1.2"/ 0.30 x 30mm) will be applied to serve as a sham control at the same acupoints with the same stimulation modality and then connecting the needle to the incorrect output socket of the electrical acupuncture stimulation instrument. The sham points are "pseudo stimulation".

Locations

Country Name City State
Hong Kong Zhong Lidan Kowloon Tong Kowloon

Sponsors (1)

Lead Sponsor Collaborator
Hong Kong Baptist University

Country where clinical trial is conducted

Hong Kong, 

References & Publications (28)

Cheuk DK, Yeung WF, Chung KF, Wong V. Acupuncture for insomnia. Cochrane Database Syst Rev. 2012 Sep 12;(9):CD005472. doi: 10.1002/14651858.CD005472.pub3. — View Citation

Crook H, Raza S, Nowell J, Young M, Edison P. Long covid-mechanisms, risk factors, and management. BMJ. 2021 Jul 26;374:n1648. doi: 10.1136/bmj.n1648. Erratum In: BMJ. 2021 Aug 3;374:n1944. — View Citation

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Gong, Y., Si, X., & Zhang, Y. (2021). Clinical application and practice of acupuncture therapy in COVID- 19. Zhongguo Zhen Jiu, 41, 142-4.

Han Z, Zhang Y, Wang P, Tang Q, Zhang K. Is acupuncture effective in the treatment of COVID-19 related symptoms? Based on bioinformatics/network topology strategy. Brief Bioinform. 2021 Sep 2;22(5):bbab110. doi: 10.1093/bib/bbab110. — View Citation

He W, Li M, Han X, Zhang W. Acupuncture for Mild Cognitive Impairment and Dementia: An Overview of Systematic Reviews. Front Aging Neurosci. 2021 May 14;13:647629. doi: 10.3389/fnagi.2021.647629. eCollection 2021. — View Citation

Iadecola C, Anrather J, Kamel H. Effects of COVID-19 on the Nervous System. Cell. 2020 Oct 1;183(1):16-27.e1. doi: 10.1016/j.cell.2020.08.028. Epub 2020 Aug 19. — View Citation

Ji S, Duan J, Hou X, Zhou L, Qin W, Niu H, Luo S, Zhang Y, Chan P, Jin X. The Role of Acupuncture Improving Cognitive Deficits due to Alzheimer's Disease or Vascular Diseases through Regulating Neuroplasticity. Neural Plast. 2021 Jan 12;2021:8868447. doi: 10.1155/2021/8868447. eCollection 2021. — View Citation

Jia H, Han Z, Zhang K, Tang Q, Sun K, Huang H, Qi F. Acupuncture and related interventions for anxiety in coronavirus disease 2019: A protocol for systematic review and meta-analysis. Medicine (Baltimore). 2020 Jul 24;99(30):e21317. doi: 10.1097/MD.0000000000021317. — View Citation

Johns Hopkins University of Medicine Coronavirus Resource Center . COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). 2022. https://coronavirus.jhu.edu/map.html(16 February 2022, date last accessed)

Lin CC, Chen MC, Yu SN, Ju MS. Chronic electrical stimulation of four acupuncture points on rat diabetic neuropathy. Conf Proc IEEE Eng Med Biol Soc. 2005;2005:4271-4. doi: 10.1109/IEMBS.2005.1615408. — View Citation

Liu WH, Guo SN, Wang F, Hao Y. Understanding of guidance for acupuncture and moxibustion interventions on COVID-19 (Second edition) issued by CAAM. World J Acupunct Moxibustion. 2020 Mar;30(1):1-4. doi: 10.1016/j.wjam.2020.03.005. Epub 2020 Mar 17. — View Citation

Morin CM, Belleville G, Belanger L, Ivers H. The Insomnia Severity Index: psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep. 2011 May 1;34(5):601-8. doi: 10.1093/sleep/34.5.601. — View Citation

Nalbandian A, Sehgal K, Gupta A, Madhavan MV, McGroder C, Stevens JS, Cook JR, Nordvig AS, Shalev D, Sehrawat TS, Ahluwalia N, Bikdeli B, Dietz D, Der-Nigoghossian C, Liyanage-Don N, Rosner GF, Bernstein EJ, Mohan S, Beckley AA, Seres DS, Choueiri TK, Uriel N, Ausiello JC, Accili D, Freedberg DE, Baldwin M, Schwartz A, Brodie D, Garcia CK, Elkind MSV, Connors JM, Bilezikian JP, Landry DW, Wan EY. Post-acute COVID-19 syndrome. Nat Med. 2021 Apr;27(4):601-615. doi: 10.1038/s41591-021-01283-z. Epub 2021 Mar 22. — View Citation

Pei W, Meng F, Deng Q, Zhang B, Gu Y, Jiao B, Xu H, Tan J, Zhou X, Li Z, He G, Ruan J, Ding Y. Electroacupuncture promotes the survival and synaptic plasticity of hippocampal neurons and improvement of sleep deprivation-induced spatial memory impairment. CNS Neurosci Ther. 2021 Dec;27(12):1472-1482. doi: 10.1111/cns.13722. Epub 2021 Oct 8. — View Citation

Spudich S, Nath A. Nervous system consequences of COVID-19. Science. 2022 Jan 21;375(6578):267-269. doi: 10.1126/science.abm2052. Epub 2022 Jan 20. — View Citation

Su XT, Wang LQ, Li JL, Zhang N, Wang L, Shi GX, Yang JW, Liu CZ. Acupuncture Therapy for Cognitive Impairment: A Delphi Expert Consensus Survey. Front Aging Neurosci. 2020 Nov 26;12:596081. doi: 10.3389/fnagi.2020.596081. eCollection 2020. — View Citation

Sun Y, Liu Y, Liu B, Zhou K, Yue Z, Zhang W, Fu W, Yang J, Li N, He L, Zang Z, Su T, Fang J, Ding Y, Qin Z, Song H, Hu H, Zhao H, Mo Q, Zhou J, Wu J, Liu X, Wang W, Pang R, Chen H, Wang X, Liu Z. Efficacy of Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome : A Randomized Trial. Ann Intern Med. 2021 Oct;174(10):1357-1366. doi: 10.7326/M21-1814. Epub 2021 Aug 17. — View Citation

Tan TT, Wang D, Huang JK, Zhou XM, Yuan X, Liang JP, Yin L, Xie HL, Jia XY, Shi J, Wang F, Yang HB, Chen SJ. Modulatory effects of acupuncture on brain networks in mild cognitive impairment patients. Neural Regen Res. 2017 Feb;12(2):250-258. doi: 10.4103/1673-5374.200808. — View Citation

Tu JF, Yang JW, Shi GX, Yu ZS, Li JL, Lin LL, Du YZ, Yu XG, Hu H, Liu ZS, Jia CS, Wang LQ, Zhao JJ, Wang J, Wang T, Wang Y, Wang TQ, Zhang N, Zou X, Wang Y, Shao JK, Liu CZ. Efficacy of Intensive Acupuncture Versus Sham Acupuncture in Knee Osteoarthritis: A Randomized Controlled Trial. Arthritis Rheumatol. 2021 Mar;73(3):448-458. doi: 10.1002/art.41584. Epub 2021 Jan 15. — View Citation

von Trott P, Oei SL, Ramsenthaler C. Acupuncture for Breathlessness in Advanced Diseases: A Systematic Review and Meta-analysis. J Pain Symptom Manage. 2020 Feb;59(2):327-338.e3. doi: 10.1016/j.jpainsymman.2019.09.007. Epub 2019 Sep 18. — View Citation

White AR, Filshie J, Cummings TM; International Acupuncture Research Forum. Clinical trials of acupuncture: consensus recommendations for optimal treatment, sham controls and blinding. Complement Ther Med. 2001 Dec;9(4):237-45. doi: 10.1054/ctim.2001.0489. — View Citation

Whiting M, Leavey G, Scammell A, Au S, King M. Using acupuncture to treat depression: a feasibility study. Complement Ther Med. 2008 Apr;16(2):87-91. doi: 10.1016/j.ctim.2007.07.005. Epub 2007 Sep 29. — View Citation

Zhang B, Zhang K, Tang Q, Sun K, Han Z. Acupuncture for breathlessness in COVID-19: A protocol for systematic review and meta-analysis. Medicine (Baltimore). 2020 Jul 2;99(27):e20701. doi: 10.1097/MD.0000000000020701. — View Citation

Zhang K, Gao C, Li C, Li Y, Wang S, Tang Q, Zhao C, Zhai J. Acupuncture for Acute Pancreatitis: A Systematic Review and Meta-analysis. Pancreas. 2019 Oct;48(9):1136-1147. doi: 10.1097/MPA.0000000000001399. — View Citation

Zhang Q, Xu X, Sun S, Cao F, Li J, Qi X, Ji G, Wang Y, Song B. Efficacy of acupuncture and moxibustion in adjuvant treatment of patients with novel coronavirus disease 2019 (COVID-19): A protocol for systematic review and meta analysis. Medicine (Baltimore). 2020 Jul 10;99(28):e21039. doi: 10.1097/MD.0000000000021039. — View Citation

Zheng YP, Lin KM. Comparison of the Chinese Depression Inventory and the Chinese version of the Beck Depression Inventory. Acta Psychiatr Scand. 1991 Dec;84(6):531-6. doi: 10.1111/j.1600-0447.1991.tb03189.x. — View Citation

* Note: There are 28 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Cognitive score on the Chinese version of the Mini-Mental State Examination (MMSE) scale The MMSE can evaluate of five different domains of cognitive functions: (1) Orientation, with a maximum of 10 points, (2) Memory, with a maximum of 6 points, (3) Attention and calculation, with a maximum of 5 points, (4) Language, with a maximum of 8 points, and (5) Design copying, with a maximum of 1 point. It has a maximum score of 30, with MMSE score denotes severity of cognitive impairment as follows; mild: MMSE 21 to 24, moderate: MMSE 10 to 20, severe: MMSE less than 10. At baseline (before intervention), at 4, 8, 12, 16 weeks (the end of intervention) and 2 months after intervention (the end of follow-up).
Primary Depression on the Chinese Beck Depression Inventory (CBDI) The scale has a total of 21 questions, with an overall score of 63, 14-19 being mild depression, 20-28 being moderate depression, and above 29 being severe depression. At baseline (before intervention), at 4, 8, 12, 16 weeks (the end of intervention) and 2 months after intervention (the end of follow-up).
Secondary Score of Insomnia Severity Index (ISI) The Insomnia Severity Index in Chinese includes 5 questions to assess the severity and impact of insomnia, on an 0 to 4 scale, with the higher score reflecting worse insomnia symptoms. At baseline (before intervention), at 4, 8, 12, 16 weeks (the end of intervention) and 2 months after intervention (the end of follow-up).
Secondary Score of Brief Fatigue Inventory-Taiwanese (BFI-T) Form BFI-T form is to assess the severity of fatigue and the impact of fatigue on daily functioning. Scoring Respondents rate each item on a 0-10 numeric scale, with 0 meaning "no fatigue" and 10 meaning "fatigue as bad as you can imagine." Scores are categorized as Mild (1-3), Moderate (4-6), and Severe (7-10). At baseline (before intervention), at 4, 8, 12, 16 weeks (the end of intervention) and 2 months after intervention (the end of follow-up).
Secondary Score of the Short Form 12 (SF12) The SF-12V2 is a widely used generic HRQoL instrument, and its Chinese version has been validated and normed in the general Chinese population in Hong Kong. It consists of 12 questions measuring eight domains of health, including physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional and mental health. The scores are generated using an algorithm to generate a combined physical and mental health score for comparison with normative data. In the normative data: 1) the mean score was set to 50; 2) a score > 50 indicated better physical or mental health than the mean; 3) a score < 50 indicated worse physical or mental health than the mean. At baseline (before intervention), at 4, 8, 12, 16 weeks (the end of intervention) and 2 months after intervention (the end of follow-up).