Keywords
physical therapy and rehabilitation
neurotransmitter system
concentration of attention
cognitive deficit
neuromodulation
How to Cite
Abstract
In press
Background. Post-COVID syndrome is often accompanied by persistent cognitive impairments that reduce patients’ functional capacity and quality of life and require effective rehabilitation approaches. Neurorehabilitation programmes remain insufficiently standardised, which necessitates an assessment of their clinical effectiveness.
Aim. To investigate the effectiveness of neurorehabilitation programmes for patients with post-COVID cognitive dysfunction in terms of restoring cognitive function.
Research Ethics. The study was conducted in accordance with the World Medical Association Declaration of Helsinki (1964–2024) and approved by the Ethics Committee of the Kharkiv Institute of Medicine and Biomedical Sciences (Protocol No.33 of October 03, 2024). All participants provided informed consent to participate in the study, and the data obtained were anonymised to ensure confidentiality.
Materials and Methods. For the analysis of cognitive recovery dynamics, 71 participants who completed the rehabilitation course were included. Assessment was performed using the TAP (Test for Attentional Performance) upon admission and after treatment. The FSMC (Fatigue Scale for Motor and Cognitive Functions) and the MoCA (Montreal Cognitive Assessment) were also used to determine the level of general and cognitive fatigue and the presence of cognitive deficit. Statistical analysis was performed using descriptive and inferential statistics. Calculations were carried out using Excel 365 (Microsoft, USA). The research was conducted as a private initiative of the authors, without grant support and state registration of the topic.
Results. The mean age of the participants was 49.5 years (SD (Standard Deviation) =10.10), and 70.4% (50 out of 71) were women. The mean time since initial COVID-19 infection was 29 months (SD=8.11). It was found that 27.0% of patients had cognitive deficit (MoCA<26), which was significantly lower compared to participants who dropped out (38.0%, p<0.001). After rehabilitation, improvements were observed in all TAP subscales: pathological reaction times in the alertness subtest decreased from 70.4% to 50.7%, sustained attention from 54.9% to 42.3%, working memory from 26.8% to 19.7%, and divided attention from 32.4% to 25.4%. The changes were statistically significant (p<0.05).
Conclusions. The data confirm the feasibility of using standardised cognitive tests (TAP, MoCA, FSMC) in clinical practice to monitor the dynamics of cognitive recovery after COVID-19.
Keywords: neurology, physical therapy and rehabilitation, neurotransmitter system, concentration of attention, cognitive deficit, neuromodulation.
References
AlShamrani M, Farahat F, Assiri A, AlHajjar S, Albarrak A, AlHashemi H, et al. Consensus based recommendations for the management of post-COVID long-term sequelae (Long COVID): A regional perspective. Front Med. 2025;12:1453167. DOI: 10.3389/fmed.2025.1453167. PMID: 40842528.
Aziz AA, Latif AA, Elseesy SW. Cognitive impairment, depressive and anxiety disorders among post-COVID-19 survivors: A follow-up study. Middle East Curr Psychiatry. 2025;32(1):8. DOI: 10.1186/s43045-025-00502-4.
Becker JH, Watson E, Zubair N, Carnavali F, Bagiella E, Reich D, et al. Preliminary evaluation of a cognitive rehabilitation intervention for post-COVID-19 cognitive impairment: A pilot randomized controlled trial. Neuropsychol Rehabil. 2026;36(5):853-64. DOI: 10.1080/09602011.2025.2552154. PMID: 40991647.
Beka SG, Griffiths RF, Myers JA, Skirrow PM. Appropriate screening tests to assess post-COVID-19 cognitive dysfunction in aeromedical settings. Aerosp Med Hum Perform. 2025;96(5):414-24. DOI: 10.3357/amhp.6500.2025. PMID: 40643301.
Chen Y, Jan J, Yang C, Yen T, Linh TTD, Annavajjula S, et al. Cognitive sequelae of COVID-19: Mechanistic insights and therapeutic approaches. CNS Neurosci Ther. 2025;31(3):e70348. DOI: 10.1111/cns.70348. PMID: 40152069.
Cheng AL, Herman E, Abramoff B, Anderson JR, Azola A, Baratta JM, et al. Multidisciplinary collaborative guidance on the assessment and treatment of patients with Long COVID: A compendium statement. PM&R. 2025;17(6):684-708. DOI: 10.1002/pmrj.13397. PMID: 40261198.
Espinoza C, Martella D. Cognitive functions in COVID-19 survivors, approaches strategies, and impact on health systems: A qualitative systematic review. Eur Arch Psychiatry Clin Neurosci. 2023;275(1):5-49. DOI: 10.1007/s00406-023-01662-2. PMID: 37648954.
Jöbges M, Tempfli M, Kohl C, Herrmann C, Kelm S, Kupferschmitt A, et al. Neuropsychological outcome of indoor rehabilitation in post-COVID-19 condition–results of the PoCoRe study. Front Neurol. 2025;15:1486751. DOI: 10.3389/fneur.2024.1486751. PMID: 39835145.
Kaushik R, McAvay GJ, Murphy TE, Acampora D, Araujo K, Charpentier P, et al. In-hospital delirium and disability and cognitive impairment after COVID-19 hospitalization. JAMA Netw Open. 2024;7(7):e2419640. DOI: 10.1001/jamanetworkopen.2024.19640. PMID: 38954414.
Natarajan A, Shetty A, Delanerolle G, Zeng Y, Zhang Y, Raymont V, et al. A systematic review and meta-analysis of long COVID symptoms. Syst Rev. 2023;12(1):88. DOI: 10.1186/s13643-023-02250-0. PMID: 37245047.
Panagea E, Messinis L, Petri MC, Liampas I, Anyfantis E, Nasios G, et al. Neurocognitive impairment in long COVID: A systematic review. Arch Clin Neuropsychol. 2024;40(1):125-49. DOI: 10.1093/arclin/acae042. PMID: 38850628.
Rozenblum L, Debroucker T, Habert MO, Soret M, Desarnaud S, Lemercier VC, et al. Cognitive impairment and brain metabolic changes in post-acute sequelae of COVID-19. Clin Nucl Med. 2024;50(3):e146-53. DOI: 10.1097/RLU.0000000000005614. PMID: 39690505.
Patel AMR, Gilpin G, Koniotes A, Warren C, Xu C, Burgess PW, Chan D. Clinic evaluation of cognitive impairment in post-COVID syndrome: Performance on legacy pen-and-paper and new digital cognitive tests. Brain Behav Immun Health. 2025;43:100917. DOI: 10.1016/j.bbih.2024.100917. PMID: 39717873.
Popa E, Popa AE, Poroch M, Poroch V, Ungureanu MI, Slanina AM, et al. The molecular mechanisms of cognitive dysfunction in long COVID: A narrative review. Int J Mol Sci. 2025;26(11):5102. DOI: 10.3390/ijms26115102. PMID: 40507911.
Wijeratne T, Crewther SG. A systems neuroscience approach to diagnosis and rehabilitation of post COVID neurological syndrome based on the systems neuroscience test battery (SNTB) study protocol. NeuroRehabilitation. 2025;56(1):37-47. DOI: 10.1177/10538135241296773. PMID: 40183164.
Basso C, Zanella A, Simoni M, Fantozzi C, Gollin D, Ruaro C, et al. Usability and feasibility of INFORMA platform for computerized cognitive stimulation in mild cognitive impairment and early dementia: an 8-week multicenter study. Aging Clin Exp Res. 2026;38(1):99. DOI: 10.1007/s40520-026-03346-y. PMID: 41824213.
Seibert S, Eckert I, Widmann CN, Ebrahimi T, Bösl F, Franke C, et al. Correction: Validity of the Test for Attentional Performance in neurological post-COVID condition. Sci Rep. 2025;15(1). DOI: 10.1038/s41598-025-18191-8. PMID: 40968183.
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