A new clinical trial led by researchers at University College London (UCL) has found that 10 weeks of cognitive rehabilitation can help people with long-term coronavirus symptoms, such as brain fog, achieve their goals of returning to work or hobbies.
This is the first treatment to have a clinically meaningful and durable effect on the cognitive impairment associated with long-term COVID-19 infection.
The treatment, delivered over an hour-long one-on-one video call, saw therapists help people with long-term COVID-19 to develop strategies to achieve their rehabilitation goals, with results that lasted at least six months for most participants, according to the findings published in . JAMA network open.
Lead author Dr Martina Vanova, who completed her research at UCL before moving to Kingston University, said:One in three people infected with COVID-19 have long-term COVID-19 infection, and cognitive impairment is one of the most common symptoms that can last for months, disrupting daily functioning and quality of life. People may find it difficult to concentrate and hold their thoughts, as memory, attention, and planning deteriorate, which is exacerbated by fatigue.
“In our study, we used established strategies of goal-directed cognitive rehabilitation to help people develop ways to engage with the tasks that are most meaningful to them.. ”
The study, funded by the National Institute for Health Research (NIHR), involved 78 participants in the UK who had experienced long-term coronavirus symptoms with cognitive impairment for at least three months. Half of them received rehabilitation treatment and half continued on standard NHS treatment (which varied by region) as a comparison group.
Before starting treatment, all participants completed an online goal-setting interview and identified three important goals they wanted to achieve. Most of these were work-related as participants sought to regain proficiency, but many also had hobby-related goals, such as staying focused on watching a movie through to the end, or staying focused on a book. Therapists help participants implement strategies tailored to their specific goals.
The researchers found that the majority (84%) of participants who received cognitive rehabilitation therapy reported significant improvements in goal attainment (reported on a 10-point scale) three months after completing treatment, compared with just over half (53%) of the control group who received standard treatment.
Remarkably, after six months, just over half (53%) of those who underwent cognitive rehabilitation reported significant improvements in goal achievement (defined as an improvement of 4 or more points out of 10), compared to just 15% of the control group.
These benefits were highlighted by measured improvements in executive function, as participants improved scores on tests measuring cognitive flexibility and processing speed.
Emma Sullivan, one of the study participants who benefited from cognitive rehabilitation, commented:I first contracted Covid in August 2021 and by December I was diagnosed with long Covid. It was terrible and affected my life in many ways, but especially mentally. I had trouble concentrating and multitasking, had difficulty reading, was fatigued, and struggled to speak full sentences.
“The sessions at the trial were really helpful as they taught me to break down tasks into smaller parts so I don’t get too overwhelmed and to visualize missing words. I once again trained my concentration to be able to complete a 1,000 piece jigsaw puzzle myself after previously struggling with my granddaughter’s 30 piece puzzle.
“I can now accept that COVID-19 has changed my life for a long time, because now I can cope with it better and live a better life.”. ”
The researchers say early results from an accompanying analysis suggest the program is cost-effective.
Since the COVID-19 pandemic, we have sought to better understand the long-term brain fog associated with COVID-19 and explore ways to combat it. This study found that individualized treatment programs for cognitive rehabilitation can help affected people return to normal functioning. ”
Professor Dennis Chan, co-senior author and principal investigator; UCL Institute of Cognitive Neuroscience
Co-author Dr Aida Suárez González (UCL Queen Square Institute of Neurology) said:We have discovered a treatment that provides clinically meaningful and lasting benefits for people with long-term cognitive symptoms of COVID-19. Because the program is based on established cognitive rehabilitation techniques that are also used for other conditions, we hope it can be easily deployed as a treatment option for people currently living with coronavirus for long periods of time.”
sauce:
university college london
Reference magazines:
Wanova, M., others. (2026) Cognitive rehabilitation and functional outcomes in long-term COVID-19-associated cognitive impairment: a randomized clinical trial. JAMA network open. DOI: 10.1001/jamanetworkopen.2026.20687. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2851024
