Cognitive rehabilitation improved self-reported cognitive skills in patients with Long COVID: An observational study.

Abstract

Objective: To describe the effects of cognitive rehabilitation provided to patients with lingering cognitive difficulties or "brain fog" after COVID-19.

Design: Retrospective cohort study SETTING: Outpatient rehabilitation setting PARTICIPANTS: Seventy consecutive patients with Long COVID that were referred from a Neuro-COVID clinic and evaluated and treated by speech-language pathologists INTERVENTIONS: Usual care cognitive rehabilitation MAIN OUTCOME MEASURES: Patients completed the Quality of Life in Neurological Disorders (NeuroQoL) Cognition Function Short Form and the Rivermead Behavioral Memory Test Story Recall assessments before and after treatment. Demographics, goals, treatment frequency/duration, and interventions were analyzed to determine treatment outcomes and patterns of care.

Results: Of 70 patients, 83% were never hospitalized for COVID-19, the average age was 46.5 years, 77% were female and 69% were white. There were no differences in demographics, race, ethnicity or objective cognitive measures prior to starting treatment between the 50 individuals who completed their plan of care (POC) versus the 20 who did not. However, patients who did not complete their POC reported higher anxiety prior to treatment. Patients with higher anxiety prior to treatment demonstrated less improvement in cognitive quality of life measures following treatment. Of the 50 patients who completed their POC, 45 (90%) met all short-term goals. There was a significant increase in NeuroQoL Cognition Function scores from pre- to post cognitive rehabilitation in 36 patients tested, but no significant differences in objective measures of memory in 23 patients tested.

Conclusion: Cognitive rehabilitation resulted in self-reported improvement in functional cognition. However, anxiety limited the favorable impact of treatment and should be addressed in conjunction with cognitive therapy to maximize outcomes.