Long COVID rehab program helps with return to work and focus
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Ten weeks of cognitive rehabilitation can help people with long COVID symptoms such as brain fog achieve their goals in returning to work and hobbies, a new clinical trial led by University College London (UCL) researchers has found.
This is the first treatment to have a clinically meaningful and lasting benefit for the cognitive difficulties associated with long COVID.
The treatment, delivered in hourlong one-to-one video calls in which a therapist helped people with long COVID devise strategies to achieve rehabilitation goals, yielded benefits that lasted for at least six months for most participants, according to the findings published in JAMA Network Open.
Lead author Dr. Martina Vanova, who completed the research at UCL before moving to Kingston University, said, "As many as one in three people with COVID go on to develop long COVID, and cognitive difficulties are among the most common symptoms that can persist for months, disrupting day-to-day functioning and quality of life. People might find it hard to focus or hold on to their thoughts as they struggle with memory, attention and planning, often compounded by fatigue.
"In our study, we used well-established strategies of goal-oriented cognitive rehabilitation to help people develop ways to tackle the challenges that are most meaningful to them."
Goals tied to daily life
The study involved 78 participants in England who had been experiencing cognitive long COVID symptoms for at least three months. Half received the rehabilitation treatment, while half continued with standard NHS treatments (which varied by region) as a comparison group.
Before beginning the treatment, all participants completed an online goal-setting interview to identify three key goals they wanted to attain. Most of these were work-related, as participants sought to regain their proficiencies, but many participants also set hobby-related goals, such as remaining focused while watching an entire film or staying focused on a book. Therapists could then help participants implement strategies tailored to their specific goals.
Benefits that persisted for months
The researchers found that the large majority (84%) of participants who underwent cognitive rehabilitation therapy reported a significant improvement in goal attainment (which they reported using a 10-point scale) three months after completing the treatment, compared with just over half (53%) of the control (comparison) group who received standard care.
Notably, after six months, just over half (53%) of those who had cognitive rehabilitation reported a substantial improvement in goal attainment, defined as an improvement of four or more points on the 10-point scale, compared with just 15% of those in the control group.
These benefits were underscored by measured improvements in executive function, as participants improved their scores on tests measuring cognitive flexibility and processing speed.
One participant's recovery strategies
Emma Sullivan, one of the study participants who benefited from cognitive rehabilitation, said, "I first got COVID in August 2021, and by December was diagnosed with long COVID. It was terrible, affecting my life in lots of ways, but particularly mentally; I could no longer concentrate or multitask and struggled with reading, exhaustion and speaking in full sentences.
"The sessions in the trial were really helpful, as they taught me to break tasks down into smaller pieces and stop getting so overwhelmed, and to visualize words that I couldn't find. I built up my concentration abilities once again so I can finish a 1,000-piece jigsaw puzzle by myself, after previously struggling with my granddaughter's 30-piece puzzle.
"I can now accept that long COVID has changed my life, because now I can manage it better, therefore I'm living better."
Hopes for wider rollout
The researchers say early findings of an accompanying analysis suggest the program is cost-effective.
Joint senior author and chief investigator Professor Dennis Chan (UCL Institute of Cognitive Neuroscience) said, "Since the COVID-19 pandemic, we have been trying to better understand long COVID-related brain fog and have been exploring ways to address it. With this study, we have found that an individualized treatment program of cognitive rehabilitation can help those affected return to normal function."
Joint senior author Dr. Aida Suarez-Gonzalez (UCL Queen Square Institute of Neurology) said, "We have found a treatment that provides clinically meaningful and sustained benefit for people with cognitive long COVID symptoms. As this program is based on established cognitive rehabilitation techniques that have been used for other conditions, we hope that it can be easily rolled out as a treatment option for people currently living with long COVID."
Publication details
Cognitive Rehabilitation and Functional Outcomes in Long COVID–Related Cognitive Impairment, JAMA Network Open (2026). DOI: 10.1001/jamanetworkopen.2026.20687
Journal information: JAMA Network Open
Key medical concepts
Cognitive TrainingPost-Acute COVID-19 SyndromeMental FatigueExecutive Function
Clinical categories
NeurologyAllied healthPsychology & Mental healthCommon illnesses & Prevention Provided by University College London Who's behind this story?
Sadie Harley
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