Cognitive remediation therapy for post-acute persistent cognitive deficits in COVID-19 survivors: A proof-of-concept study

Palladini, Mariagrazia; Bravi, B.; Colombo, Federica; Caselani, Elisa; Pasquasio, Camilla Di; D'Orsi, G.; Rovere‐Querini, Patrizia; Poletti, Sara; Benedetti, Francesco; Mazza, Mario Gennaro

doi:10.1080/09602011.2022.2075016

Cited by 15 publications

(10 citation statements)

References 57 publications

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“…Executive function is a crucial cognitive ability for most daily activities and has been linked to QoL in a variety of conditions. 36,37 Palladini et al 40 found an effect of improvements in executive function on QoL, and Poletti et al 41 found that impaired executive function in SARS-CoV2-infected people affected the Self-Care and Mobility dimensions of the EQ-5D.…”

Section: Discussionmentioning

confidence: 99%

“…Executive function is a crucial cognitive ability for most daily activities and has been linked to QoL in a variety of conditions 36,37 . Palladini et al 40 . found an effect of improvements in executive function on QoL, and Poletti et al 41 .…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have examined the relationship between cognition, QoL/HRQoL, and functioning in individuals after COVID‐19, with none including PCC groups. Improvements in verbal fluency and executive function after cognitive rehabilitation were accompanied by improvements in QoL 40 . Impairments in verbal memory, fluency, mental processing speed, and executive function affected the self‐care dimension, and executive function affected the mobility dimension of the EuroQoL‐5D HRQoL scale 41 .…”

Section: Introductionmentioning

confidence: 99%

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Cognitive and emotional predictors of quality of life and functioning after COVID‐19

Ariza,

Cano,

Segura

et al. 2023

Ann Clin Transl Neurol

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ObjectiveA long‐term decline in health‐related quality of life (HRQoL) has been reported after coronavirus disease 2019 (COVID‐19). Studies with people with persistent symptoms showed inconsistent outcomes. Cognition and emotion are important determinants in HRQoL, but few studies have examined their prognostic significance for HRQoL and functionality in post‐COVID patients with persisting symptoms. We aimed to describe QoL, HRQoL, and functioning in individuals post‐COVID with varying COVID‐19 severities and to investigate the predictive value of cognitive and emotional variables for QoL, HRQoL, and functioning.MethodsIn total, 492 participants (398 post‐COVID and 124 healthy controls) underwent a neurobehavioral examination that included assessments of cognition, mood, QoL/HRQoL (WHOQOL‐BREF, EQ‐5D), and functioning (WHODAS‐II). Analysis of covariance and linear regression models were used to study intergroup differences and the relationship between cognitive and emotional variables and QoL and functioning.ResultsThe Physical and Psychological dimensions of WHOQoL, EQ‐5D, and WHODAS Cognition, Mobility, Life Activities, and Participation dimensions were significantly lower in post‐COVID groups compared with a control group. Regression models explaining 23.9%–53.9% of variance were obtained for the WHOQoL‐BREF dimensions and EQ‐5D, with depressive symptoms, post‐COVID symptoms, employment status, income, and mental speed processing as main predictors. For the WHODAS, models explaining 17%–60.2% of the variance were obtained. Fatigue, depressive symptoms, mental speed processing, and post‐COVID symptoms were the main predictors.InterpretationQoL/HRQoL and functioning after COVID‐19 in individuals with persistent symptoms were lower than in non‐affected persons. Depressive symptoms, fatigue, and slower mental processing speed were predictors of lower QoL/HRQoL and functioning.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cognitive and emotional predictors of quality of life and functioning after COVID‐19

Ariza,

Cano,

Segura

et al. 2023

Ann Clin Transl Neurol

View full text Add to dashboard Cite

show abstract

“…Each one was a controlled study on the efficacy of the H2 antagonist famotidine ( Momtazmanesh et al, 2023 ) or donezepil hydrochloride ( Pooladgar et al, 2023 ), and one investigated the effectiveness of a neuro-meditation program ( Hausswirth et al, 2023 ). A case control study evaluated the efficacy of cognitive remediation therapy ( Palladini et al, 2023 ), a feasibility pilot study was carried out on a personalized computerized cognitive training ( Dunabeitia et al, 2023 ), and one observational pilot study evaluated a multimodal therapy concept with behavioral therapy-oriented, disorder-specific psychotherapy and exercise therapy ( Kupferschmitt et al, 2023 ). Moreover, a retrospective analysis was performed with data from 64 patients suffering from PCS who were treated with a day-by-day individualized psychological intervention of cognitive stimulation in addition to a standard in-hospital rehabilitation program ( Rabaiotti et al, 2023 ).…”

Section: Resultsmentioning

confidence: 99%

Management of cognitive impairment associated with post-COVID-19 syndrome: recommendations for primary care

Zifko,

Guendling,

Seet

et al. 2024

Front. Pharmacol.

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Introduction: Although post-COVID-19 syndrome (PCS) with cognitive impairment is increasingly encountered in primary care, evidence-based recommendations for its appropriate management are lacking.Methods: A systematic literature search evaluating the diagnosis and treatment of cognitive impairment associated with PCS was conducted. Practical recommendations for the management of PCS-associated cognitive impairment in primary care are summarized, based on an evaluation of pharmacological plausibility and clinical applications.Results: Currently, the pathology of cognitive impairment associated with PCS remains unclear with no high-quality data to support targeted interventions. Existing treatment approaches are directed towards symptom relief where counseling on the chronicity of the disease and regular reassessments at 4- to 8-week intervals is considered reasonable. Patients should be informed and encouraged to adopt a healthy lifestyle that centers around balanced nutrition and appropriate physical activities. They may also benefit from the intake of vitamins, micronutrients, and probiotics. The administration of Ginkgo biloba extract could offer a safe and potentially beneficial treatment option. Other non-pharmacological measures include physiotherapy, digitally supported cognitive training, and, if indicated, ergotherapy or speech therapy. In most patients, symptoms improve within 8 weeks. If serious, ambiguous, or when new symptoms occur, specialized diagnostic measures such as comprehensive neurocognitive testing or neuroimaging should be initiated. Very few patients would require inpatient rehabilitation.Conclusion: PCS with cognitive impairment is a debilitating condition that could affect daily functioning and reduce work productivity. Management in primary care should adopt a multidisciplinary approach, centering around physical, cognitive, and pharmacological therapies.

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“…Studies on cognitive rehabilitation for patients with persisting symptoms after COVID-19 are scarce [146,147]. A proof-of-concept study drawing upon principles used in acquired brain injury (ABI) reha-bilitation, and the rehabilitation of psychiatric populations has demonstrated potential benefits of computerized cognitive training [148]. As presented in WHO recommendations [149], specific evidence for training programs targeting COVID-19-related cognitive impairments predominantly relies on experiences and knowledge gained from cognitive dysfunctions caused by other factors.…”

Section: Cognitive Rehabilitationmentioning

confidence: 99%

Cognitive dysfunction in post‐COVID‐19 condition: Mechanisms, management, and rehabilitation

Möller,

Borg,

Janson

et al. 2023

J Intern Med

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The long‐term effects of COVID‐19 on cognitive function have become an area of increasing concern. This paper provides an overview of characteristics, risk factors, possible mechanisms, and management strategies for cognitive dysfunction in post‐COVID‐19 condition (PCC).Prolonged cognitive dysfunction is one of the most common impairments in PCC, affecting between 17% and 28% of the individuals more than 12 weeks after the infection and persisting in some cases for several years. Cognitive dysfunctions can be manifested as a wide range of symptoms including memory impairment, attention deficit, executive dysfunction, and reduced processing speed. Risk factors for developing PCC, with or without cognitive impairments, include advanced age, preexisting medical conditions, and the severity of acute illness. The underlying mechanisms remain unclear, but proposed contributors include neuroinflammation, hypoxia, vascular damage, and latent virus reactivation not excluding the possibility of direct viral invasion of the central nervous system, illustrating complex viral pathology.As the individual variation of the cognitive impairments is large, a neuropsychological examination and a person‐centered multidimensional approach are required. According to the World Health Organization, limited evidence on COVID‐19‐related cognitive impairments necessitates implementing rehabilitation interventions from established practices of similar conditions. Psychoeducation and compensatory skills training are recommended. Assistive products and environmental modifications adapted to individual needs might be helpful. In specific attention‐ and working memory dysfunctions, cognitive training—carefully monitored for intensity—might be effective for people who do not suffer from post‐exertional malaise. Further research is crucial for evidence‐based interventions specific to COVID‐19‐related cognitive impairments.

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Cognitive remediation therapy for post-acute persistent cognitive deficits in COVID-19 survivors: A proof-of-concept study

Cited by 15 publications

References 57 publications

Cognitive and emotional predictors of quality of life and functioning after COVID‐19

Cognitive and emotional predictors of quality of life and functioning after COVID‐19

Management of cognitive impairment associated with post-COVID-19 syndrome: recommendations for primary care

Cognitive dysfunction in post‐COVID‐19 condition: Mechanisms, management, and rehabilitation

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