Cognitive Rehabilitation Improves Functional Outcomes in Adults With Post-COVID Cognitive Impairment: Study

Recruitment of the study population included adults between the ages of 30 to 60 years that had an existing history of COVID-19 infection and who were experiencing objective cognitive impairment characterized by performance at least 1SD below the age norm for two or more independent cognitive testing domains. Random allocation to intervention and control groups was done in a ratio of 1:1 where patients assigned to the intervention group were offered special cognitive rehabilitation (CR) services while those under the control group received treatment as usual (TAU) but still had access to general specialists' clinics.

Active CR involved 10 hours of individual sessions each lasting 1 hour per week for 10 weeks conducted by a clinical researcher. Sessions employed evidence-based cognitive techniques aimed solely at achieving three individually selected meaningful goals set by the participants. The outcome of interest is goal attainment score after 3 months from randomization obtained through Bangor Goal Setting Interview with long-term efficacy determined after 6 months.

Key findings:

• The patients included in the analysis were 24 males (30.8%) and 54 females (69.2%), having a mean age of 47.3 ± 7.2 years.
• At the 3-month post randomization mark, the difference in goal achievement was significantly higher for the active rehabilitation group than for the standard care group, resulting in an adjusted mean difference of 2.88 points (95% confidence interval, 2.03-3.73; P < .001).
• The effect size immediately after therapy was exceptionally high at 1.57 as measured by Cohen's d score, indicating a major therapeutic victory.
• The gains in function were highly statistically durable up to 6 months, still maintaining an adjusted mean difference of 1.72 points (95% confidence interval, 0.86-2.57; P < .001).
• Even though the effects of the therapy inevitably waned with time, the follow-up at 6 months still showed very durable and high effect sizes with a score of Cohen d = 0.91.

Thus, goal-directed CR was found to yield remarkable benefits for achieving goals in individuals with cognitive impairment due to long COVID. The results presented in the current paper might become a basis for organizing CR treatment in patients with long COVID. It is an important empirical basis for modern neurorehabilitation that proves the necessity of active mental training after viral infections.

Reference:

Vanova M, Patel AMR, Scott I, et al. Cognitive Rehabilitation and Functional Outcomes in Long COVID–Related Cognitive Impairment: A Randomized Clinical Trial. JAMA Netw Open. 2026;9(7):e2620687. doi:10.1001/jamanetworkopen.2026.20687