Cognitive Rehabilitation Improved Self-Reported Cognitive Skills in Individuals With Long COVID: An Observational Study

Marie Saxon; Steven Jackson; Manasi Seth; Igor J Koralnik; Leora R Cherney

doi:10.1016/j.apmr.2025.02.009

Cognitive Rehabilitation Improved Self-Reported Cognitive Skills in Individuals With Long COVID: An Observational Study

Arch Phys Med Rehabil. 2025 Feb 22:S0003-9993(25)00538-6. doi: 10.1016/j.apmr.2025.02.009. Online ahead of print.

Authors

Marie Saxon¹, Steven Jackson², Manasi Seth², Igor J Koralnik³, Leora R Cherney⁴

Affiliations

¹ Shirley Ryan AbilityLab, Chicago, IL; Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL.
² Shirley Ryan AbilityLab, Chicago, IL.
³ Ken & Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL.
⁴ Shirley Ryan AbilityLab, Chicago, IL; Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL; Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL. Electronic address: Lcherney@sralab.org.

PMID: 39993494
DOI: 10.1016/j.apmr.2025.02.009

Abstract

Objective: To describe the effects of cognitive rehabilitation provided to patients with lingering cognitive difficulties or "brain fog" after coronavirus disease 2019 (COVID-19).

Design: Retrospective cohort study.

Setting: Outpatient rehabilitation setting.

Participants: Seventy consecutive patients with Long COVID who 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 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 women, and 69% were White. There were no differences in demographics, race, ethnicity, or objective cognitive measures before 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 before treatment. Patients with higher anxiety before treatment demonstrated less improvement in cognitive quality of life measures after treatment. Of the 50 patients who completed their POC, 45 (90%) met all short-term goals. There was a significant increase in Quality of Life in Neurological Disorders 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.

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

Keywords: Cognition; Cognitive rehabilitation; Long COVID; Rehabilitation.