The impact of a home-based personalized computerized training program on cognitive dysfunction associated with Long COVID: a before-and-after feasibility study
Authors: Duñabeitia Jon Andoni , Mera Francisco , Baro Óscar , Jadad-Garcia Tamen , Jadad Alejandro R. 
Published: September 2022

Background

Long COVID—also known as post-acute sequelae of COVID-19 or PASC—is a systemic syndrome affecting a large number of persons in the aftermath of the pandemic. Cognitive dysfunction (or brain fog) is one of its most common manifestations of PACS, and there are no effective interventions to mitigate it. Home-based personalized computerized cognitive training (CCT), which has shown effectiveness to improve other conditions, could offer hope to relieve the cognitive dysfunction in people with a previous history of COVID-19.

Objective

To evaluate the feasibility and potential benefit of a personalized CCT intervention to improve cognitive function among people living with PACS.

Methods

Adult individuals who self-reported cognitive dysfunction more than 3 months after a diagnosis of COVID-19 were recruited through an online platform designed for the study. Those who were eligible assessed their general cognitive function before completing as many cognitive daily training sessions as they wished during an 8-week period, using a personalized CCT application at home. The sessions included gamified tasks that tapped into five cognitive domains (attention, coordination, memory, perception and reasoning) and were tailored to the specific cognitive strengths and weaknesses detected at each point. At the end of this period, participants repeated the general cognitive function assessment. The differences between the scores at 8 weeks and baseline was the main outcome, complemented with analyses of the changes based on the participants’ age, training time, self-reported health level at baseline and time since the initial COVID-19 infection. Participants’ cognitive assessment scores were also computed in terms of percentiles according to the normative database of the test, considering their corresponding age- and gender-based reference sample.

Results

The participants had significant cognitive dysfunction at baseline, even though 80% of them had had the initial episode of COVID-19 more than a year before enrolling in the study. Eighty nine percent reported negative levels of self-reported health at baseline. On average, 51 training sessions (range: 10 to 251) were completed over a mean time of 435 minutes (range 78 to 2448). Most of the participants obtained higher scores after CCT in each of the domains as compared with baseline (attention: 81% of the sample; memory: 86%; coordination: 82%; perception: 88%; reasoning: 77%). The magnitude of the score increase at post-test was high across domains (attention: 31% of change; memory: 37%; coordination: 52%; perception: 42%; reasoning: 26%). Following CCT, there were also improvements in the percentile data in all the domains (attention: 14 points; memory: 18 points; coordination: 18 points; perception: 17 points; reasoning: 11 points).

Conclusions

This study suggests that a self-administered CCT based on gamified cognitive tasks could be an effective way to ameliorate cognitive dysfunction in persons with PASC.