Note: This table is included in the Appendix to provide additional information for clinicians who are treating patients for PASC-related cognitive symptoms. This is not intended to be a comprehensive list, but rather to provide clinical examples as they relate to health equity, health disparities, and social determinants of health. The literature demonstrates that all marginalized groups face socioeconomic barriers and access to care barriers, though these may or may not be barriers for a specific individual patient. People with intersectional identities (eg, those who identify with more than one underrepresented or marginalized group), often face enhanced levels of bias and discrimination. Abbreviation: PASC, postacute sequelae of SARS-CoV-2 infection.

Purpose of Review Extrapulmonary manifestations of COVID-19 are abundant, including after recovery of acute SARS-CoV-2 infection. This review seeks to explore the cognitive and neuropsychiatric manifestations of COVID-19 and post-acute sequelae of SARS-CoV-2 (PASC), including Long COVID syndromes. Furthermore, the review will discuss rehabilitation strategies for the emerging neurological consequences of COVID-19 to help those experiencing long-term effects of COVID-19. Recent Findings There is emerging evidence depicting the neural involvement of COVID-19. Health priorities have shifted from understanding pathogenesis and treatment of pulmonary symptoms to targeting the acute and chronic sequelae of COVID-19, including cognitive and neuropsychiatric symptoms. The sequelae of COVID-19 often co-occur with other medical problems and is best managed by assessment and care across multiple disciplines. Symptoms following infection are similar to those found by other syndromes and disorders that disrupt the central nervous system. Summary The acute and chronic sequelae of COVID-19 have become major targets of current health care providers given its significant public health impact, inclusive of cognitive and neuropsychiatric sequelae. Assessment and referral to rehabilitation based on each individual’s needs and symptoms can decrease morbidity and improve quality of life.

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Objective: This study examined the relationship between perceived stress appraisals and coping style during the COVID-19 pandemic, resulting distress reaction and effects on work engagement. Method: The sample (N = 423) was 78.6% female with average age and education of 38.5 and 18.4 years, respectively. Most respondents reported working in psychology/neuropsychology (31.7%) and rehabilitation/other therapies (29.7%). Surveys were distributed via Qualtrics among health care providers via listservs and referral emails from medical providers. Measures included: the Brief COPE Inventory, Work and Well Being Survey (UWES), Stress Appraisal Measure (SAM), Generalized Anxiety Disorder Screener (GAD-7), and the Screening Tool for Psychological Distress (STOP-D). Results: Health care workers endorsing problem-focused coping styles had lower levels of perceived threat and higher levels of perceived control in their response to the pandemic. Problemfocused coping was negatively associated with anxiety and depression in reaction to the pandemic when compared with health care workers who endorsed an emotion-focused coping style. Higher stress appraisal in response to perceived threat from the pandemic was not associated with lower work engagement or enthusiasm. Conclusions: Findings support the impact of coping style on psychological distress and work engagement during pandemic, with implications that these factors may be important considerations for mitigation of distress and burnout for health care workers during times of high stress. Initiatives to improve resiliency and wellness in health care workers may examine modifiable interventions for coping style. Public Significance StatementThis study suggests that, among health care workers, using a problem focused coping style in response to COVID-19 pandemic stress mitigates experience of psychological distress and burnout. Initiatives that focus on modifiable interventions for coping styles may improve wellness in health care workers during environments of high stress, such as a chronic pandemic state.

Health care providers practicing in rural settings face unique challenges, including a lack of behavioral health providers and training specific to the provision of rural mental health care for older adults. Even with the formation of the National Rural Health Advisory Committee in 1987, rural older adults still encounter barriers to adequate behavioral health services. In rural health care, this can be described as the "three-part problem": accessibility, acceptability, and availability (Smalley et al., 2010). This article provides an overview of the current state of rural behavioral health care in the United States, the importance of the Triple Aim initiative, and applying flexibility with the integration of behavioral health services into rural primary care settings. Specifically, the integrated Primary Care Behavioral Health consultation model will be discussed in the context of rural care for the older adult. Additionally, future directions addressing the training of behavioral health providers are discussed.