New research shows that individualized rehabilitation sessions provide lasting benefits for people experiencing persistent cognitive impairment after infection.


RT’s Three Key Takeaways:

  1. Meaningful Goal Progress: Patients with long COVID receiving individualized cognitive rehabilitation showed significantly higher goal attainment scores at three months compared to those receiving standard care.
  2. Durable Functional Gains: The clinical benefits of the rehabilitation program were sustained at a six-month follow-up, indicating that the therapy provides long-term support for daily activities.
  3. Scalable Telehealth Approach: The use of weekly telehealth sessions proved to be a feasible method for delivering specialized care, potentially increasing access for patients with mobility or fatigue issues.


Individualized, goal-oriented cognitive rehabilitation leads to significant and sustained improvements in functional outcomes for people with long COVID-related cognitive impairment, according to a study published in JAMA Network Open.1

The multicenter randomized clinical trial, conducted at three sites in the UK, found that a structured 10-week program helped patients achieve personally meaningful goals, such as returning to work or improving daily performance.1 The findings provide some of the first high-level evidence for a specific intervention to treat the cognitive symptoms often colloquially referred to as “brain fog.”1

“In this study, individualized, goal-oriented CR led to significant and sustained improvements in goal attainment in people with long COVID-related cognitive impairment,” the researchers wrote in the study.1 “These findings may guide and inform the provision of CR treatments and services for people living with long COVID.”1

Cognitive impairment affects more than 27% of COVID-19 survivors and can include deficits in executive function, memory, attention, and processing speed.1 These symptoms often lead to reduced quality of life, loss of income, and significant work absenteeism.1

The trial, known as the Cognitive Impairment in Long COVID: Phenotyping and Rehabilitation (CICERO) study, enrolled 78 adults aged 30 to 60 years.1 All participants had objective cognitive impairment, defined as scoring at least one standard deviation below age norms in two or more cognitive domains.1

Participants were randomized into two groups: those receiving cognitive rehabilitation and those receiving treatment as usual. The rehabilitation group participated in 10 weekly, one-hour telehealth sessions with a trained researcher.1 These sessions applied evidence-based strategies to three individually selected functional goals.1

At the three-month mark, the group receiving cognitive rehabilitation showed an adjusted mean goal attainment score of 7.84, compared to 4.97 in the standard care group.1 This represented a large and clinically meaningful treatment effect, researchers wrote.1

The researchers also conducted a follow-up at six months, finding that the benefits were sustained even after the sessions ended.1 While the treatment as usual group showed some improvement over time, the rehabilitation group remained stable at a significantly higher level of function.1

Beyond goal attainment, the therapy group also reported higher levels of satisfaction with their performance.1 While the study observed small improvements in cognitive flexibility and processing speed, there were no significant changes in other symptoms like fatigue, anxiety, depression, or sleep disturbance.1

The study authors noted that the remote delivery of the intervention via telehealth was successful and could help improve access to specialized healthcare services.1 However, they cautioned that future implementation must consider the risk of digital exclusion for some populations.1

The research team suggested that the improvements in daily function likely reflect patients learning to use task-specific strategies and managing their cognitive resources more efficiently, rather than an increase in underlying cognitive capacity.1


Reference

  1. 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