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. 2024 Sep 27;67(1):e60.
doi: 10.1192/j.eurpsy.2024.1770.

Research evidence on the management of the cognitive impairment component of the post-COVID condition: a qualitative systematic review

Antonio Melillo  1 , Andrea Perrottelli  1 , Edoardo Caporusso  1 , Andrea Coltorti  1   2 , Giulia Maria Giordano  1 , Luigi Giuliani  1 , Pasquale Pezzella  1 , Paola Bucci  1 , Armida Mucci  1 , Silvana Galderisi  1 , Mario Maj  1
Affiliations

Research evidence on the management of the cognitive impairment component of the post-COVID condition: a qualitative systematic review

Antonio Melillo et al. Eur Psychiatry. .

Abstract

Background: Cognitive impairment (CI) is one of the most prevalent and burdensome consequences of COVID-19 infection, which can persist up to months or even years after remission of the infection. Current guidelines on post-COVID CI are based on available knowledge on treatments used for improving CI in other conditions. The current review aims to provide an updated overview of the existing evidence on the efficacy of treatments for post-COVID CI.

Methods: A systematic literature search was conducted for studies published up to December 2023 using three databases (PubMed-Scopus-ProQuest). Controlled and noncontrolled trials, cohort studies, case series, and reports testing interventions on subjects with CI following COVID-19 infection were included.

Results: After screening 7790 articles, 29 studies were included. Multidisciplinary approaches, particularly those combining cognitive remediation interventions, physical exercise, and dietary and sleep support, may improve CI and address the different needs of individuals with post-COVID-19 condition. Cognitive remediation interventions can provide a safe, cost-effective option and may be tailored to deficits in specific cognitive domains. Noninvasive brain stimulation techniques and hyperbaric oxygen therapy showed mixed and preliminary results. Evidence for other interventions, including pharmacological ones, remains sparse. Challenges in interpreting existing evidence include heterogeneity in study designs, assessment tools, and recruitment criteria; lack of long-term follow-up; and under-characterization of samples in relation to confounding factors.

Conclusions: Further research, grounded on shared definitions of the post-COVID condition and on the accurate assessment of COVID-related CI, in well-defined study samples and with longer follow-ups, is crucial to address this significant unmet need.

Keywords: COVID-19; cognitive impairment; long COVID; rehabilitation; treatment.

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Conflict of interest statement

Giulia Maria Giordano reports consulting fees from Angelini. Armida Mucci reports consulting fees from Pierre Fabre, Rovi, and Boehringer Ingelheim; patents with Pierre Fabre; and participation on data safety monitoring boards with Angelini and Boehringer Ingelheim. Silvana Galderisi reports consulting fees from Gedeon Richter; honoraria from Angelini, Boehringer Ingelheim, Gedeon Richter, Janssen, Lundbeck, Otsuka, Recordati, and Rovi; and participation on data safety monitoring boards with Angelini, Boehringer Ingelheim, Janssen, and Rovi. No other competing interests were declared.

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