Many post COVID-19 patients suffer from cognitive deficits, even after 1 year afterhospitalization. These complaints have a huge impact on psychological well-being andquality of life. In rehabilitation programs in the Netherlands, most interventions arebased on physical therapy or learning how to cope with fatigue and low levels of energy.In former studies computerized training of cognition in other populations has been provento be effective. Knowledge on the effect of computerized training on attention andworking memory in patients suffering from COVID-19 is urgently needed, and may contributeto more evidence-based rehabilitation programs for these patients. Therefore theeffectiveness of computerized training of attention and working memory in post COVID-19patients with cognitive complaints will be studied in this study.
Since 2019, the world has been overwhelmed by COVID-19, a respiratory infectious disease.
Current evidence suggests that approximately 10%-20% of people experience symptoms of
post COVID-19 condition. Many post COVID-19 victims suffer from fatigue, cognitive
deficits and / or subjective cognitive complaints, even after 1 year after
hospitalization. Detailed research shows deficits in attention, both in sustained and
executive components. Furthermore, less capacity of working memory, inhibition deficits
and lower information processing speed is frequently reported. Fatigue and cognitive
impairment have been consistently reported to be some of the most common and debilitating
features of post COVID-19 condition. Like fatigue, cognitive complaints are associated
with anxiety and depression and have an impact on every day functioning, return to work
and account for diminished health-related quality of life (HR-QoL). There are no
established and effective treatments yet for these patients. In former studies
computerized training in other populations has been proven to be effective. Knowledge on
the effect of computerized training on attention and working memory in patients suffering
from COVID-19 is urgently needed, and may contribute to more evidence-based
rehabilitation programs.
Objective: The primary aim of this study is to evaluate the effect of a computerized
cognitive rehabilitation program (RehaCom) in post COVID-19 patients with cognitive
complaints. The secondary aim is to evaluate the effect of this computerized cognitive
rehabilitation program on subjective cognitive complaints, psychological outcome measures
and HR-QoL and to assess the feasibility of the program.
Study design: Randomized wait-list controlled pilot trial.
Study population: Participants of the multicentre prospective cohort study CO-FLOW
(NL74252.078.20) suffering from persistent cognitive complaints after 2 years after
hospitalization as measured with the Cognitive Failure Questionnaire (CFQ ) will be
invited.
Intervention: Computerized cognitive training, 10 weeks, 3 times/week 15 - 30
minutes/session.
Main study parameters/endpoints: Cognitive functioning (attention and working memory) and
psychological functioning (coping, anxiety, depression) and HR-QoL, using non-invasive
neuropsychological tests and standardized online questionnaires. All outcomes will be
assessed pre- and post-intervention and at 3 and 6 months follow-up.
Nature and extent of the burden and risks associated with participation, benefit and
group relatedness: The intervention is an online cognitive rehabilitation program, 3
times a week 15 - 30 minutes per session during 10 weeks. Participants can choose what
time of the day is most convenient for them to engage in the program in their home
environment. They might improve their attention and working memory, and therefore may
also improve quality of life.
Personal and disease characteristics are copied from patient records collected in the
CO-FLOW study and additional measurements are non-invasive and minimally physically
demanding.
Completion of online questionnaires, additional neuropsychological measurements and
joining the intervention require a certain time investment from patients and might lead
to temporary fatigue. By a maximum duration of 30 minutes per session for online
questionnaires and neuropsychological tests we aim to minimize the burden for patients.
Device: RehaCom
computerized cognitive training
Inclusion Criteria:
- aged 18 years and older;
- patient has sufficient knowledge of Dutch language;
- CFQ> 43 at 2 year follow-up of CO-FLOW, indicating persistent cognitive complaints;
- Computer and internet-access.
Exclusion Criteria:
- A potential participant who meets any of the following criteria will be excluded
from participation in this study:
- Incapacitated patients like patients diagnosed with dementia;
- Patients should not be involved in concurrent rehabilitation program, cognitive
behavioural therapy or psychotherapy targeting cognition, anxiety and/or
depression.
Rijndam Rehabilitation
Rotterdam, Zuid-Holland, Netherlands
Gerard Ribbers, Professor, Study Chair
Professor Rehabilitation Medicine and chair of the department