This multicenter RCT (3 sites in England, Feb 2023–Mar 2024) evaluated individualized, goal-oriented cognitive rehabilitation (CR) — 10 weekly 1-hour sessions — versus treatment as usual (TAU) in adults aged 30–60 with objective long COVID-related cognitive impairment (≥1 SD below age norm in ≥2 cognitive domains).
CR produced significantly greater goal attainment at 3 months vs. TAU (adjusted mean difference 2.88, 95% CI 2.03–3.73; P < .001; Cohen d = 1.57), a large clinically meaningful effect sustained at 6 months (adjusted mean difference 1.72, 95% CI 0.86–2.57; P < .001; Cohen d = 0.91).
- Small sample (n=78; target was 88), reducing statistical power. - Single-blind design; participant blinding was not possible given the nature of the intervention. - TAU was variable across participants, making the comparator group heterogeneous.
For adults with long COVID-related cognitive impairment, 10 weeks of individualized, goal-oriented cognitive rehabilitation produces large, sustained improvements in functional goal attainment — clinicians should consider referral to structured CR programs. No pharmacological treatment is yet proven for this condition, making CR a viable first-line option.
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