Evaluation of Interventions for Cognitive Symptoms in Long COVID

作者：David S. Knopman, Deborah Koltai, Daniel T. Laskowitz, Jacqueline Becker, Leigh Charvet, Juan P. Wisnivesky, Alex D. Federman, Adam M. Silverstein, Yuliya Lokhnygina, Giuseppina Pilloni, Michelle M. Haddad, Henry W. Mahncke, Tom Van Vleet, Rong Huang, Wendy C. Cox, Diana Terry, Jeannie Karwowski, Netia McCray, Jenny Lin, Grace A. McComsey, Upinder Singh, Linda N. Geng, Helen Y. Chu, Rebecca Reece, James N. Moy, Zoe Arvanitakis, Sairam Parthasarathy, Thomas F. Patterson, Aditi Gupta, Luis Ostrosky‐Zeichner, Jeffrey Parsonnet, Elaine T Kiriakopoulos, Tamara G. Fong, Janet Mullington, Sarah E. Jolley, Nirav S. Shah, Sarah Shizuko Morimoto, Joyce Lee‐Iannotti, William D. S. Killgore, Brigid Dwyer, William W. Stringer, Carmen Isache, Jennifer Frontera, Jerry A. Krishnan, Ashley O’Steen, Melissa James, Barrie Harper, Kanecia O. Zimmerman, Andrew Lawler, Brandon M. Johnson, Chloe E. Pitsch, Elen Feuerriegel, Jeffrey McKeehan, Joie Molden, Kayleigh M. Reid, Kristine M. Erlandson, Sarah Dowling, Thomas Wodushek, Diara Canton, Dilara Turut, Ethan Sheppard, Jennifer Scott‐Sutherland, Kristine Hauser, Lynn Shaughnessy, Michael L. Doyle, Michelle L. Beck, Sabrina Heisey, Vaishanvi Katragadda, Amidat Yusuff, Amy Perlack, Anh Phuong Tran, Brigid Dwyer, Caroline Altaras, Christie Merisme, David Krause, Duncan Schulte, Fabiola Dupre, Gina A. Montealegre Sanchez, Maxine Krengel, Monica T. Ly, Olanike Asupoto, Quinneil Simmons, Ryan W. Schroeder, Shannon Timlin, Ycar Devis, Della Carter, Leomaris Caba Caceres, Miguel Grande Rodríguez, Zariya Alvarez, Amin Yakubov, Celia Engelson, Michael Reyes, Alvin Youkhana, Cheryl Jennings, David Andrés González, Dina Naquiallah, Dylan Behun, Ellen Stephen, Emily Timm, Farrah Bilimoria, Grace Li, Stricker, Jimena Torres, María L. García, Michelle Thomas, Minnie Kang, Rebeca Tojo Suarez, Tania Carmona, Ana Ramírez, Grace Kadubek, Aileen Baker, Andrea Romo-Serna, Barbara Predki, Cindy Leman, Cristina Panhans, Genevieve E. Roth, Gowrisree Rudraraju, Hannah Miller, Julie A. DeLisa, Kat Williams, Kimberly S. Woodson, Kyle J. Jennette, Laura Carrera‐García, Laura Villanueva, Maria Norwick, M. T. Martínez, Matt Rowley, M. D. Rutherford, Michael D. Carrithers, Neil H. Pliskin, Nicolás Pérez, Nicole M. Durkin, Nikita Maniar, Rachel Beety, Raktima Daspgupta, Ramaswamy Ramchandran, R. Jaramillo, Sharon Hasek, S Aguirre Macías, Tina Schuh, Sarah Ialacci, Christopher Bailey, Danielle Labbato, Amanda Hautmann, Beth Smith, Dia Nath, Jessica Meyer, Kathryn DiFrancesco, K. Walkup, Kimberly Pettinato, Lynette Curtis, Joviane Daher, Sarah Scott, Ziad Koberssy, Caleb Mavar, John Andrefsky, Alexander Merheb, Carla Hernandez, Jhony Baissary, Ornina Atieh, Carol Pereira, Deborah Carpenter, Jennifer Raynor, Kristine Brunton, Andreea Podgoreanu, P. C. Bunch, Richard Brown, Sean M. O’Brien, Sheila Dickey, Steven E. McNulty, Varsha Gajjar, Alec C. Neale, Cari Cohen, Carolina Escobar, Elizabeth Geary, Franco Campanella, Kirsten Anderson, Laura Prestige, Leslie Guidotti-Breting, Megan Biewer, Melissa Morton, Nicholas Mathenia, Oluwadamilola A. Adeyemi, Samanike Hengst, Wei Ning, Adam Vanderloo, Amanda Caplan, July Chen, Mary Ellen Acree, Michael S. Glickman, Mukund Nakhate, Zaw Nu Dan, Switzer Pk, Shambhu Aryal, Jessica Sanchez, Luke Sims, Rebecca Ferdinand, Mehriban Mammadova, Carolyn Z. Grimes, Elizabeth Vidales, Hau Pham, John J. López, Laura Nielsen, Maryjane Keller, Syeda Uruba, Maria Hernandez, Bela Patel, Matthew Lin, Virginia Umana-Sanchez, Chong Pak, Jeffery Gainer, R BURR, Ashleigh Trapuzzano, Brian G. Celso, Grace Bienkowski, Jennifer Bowman, Jorge Verdecia, Kathryn Zerwekh, Liliana Serrano, Meghan Marotz, Piper Propp, Yonatan Sarig, Annie Murphy, Brandon Comfort, Gina Brown, Iri Torres, Jeffrey A. Klein, Jessica Reed, John Walker, John J. Moore, Lisa Tempest-Browning, Mudassar Arain, Pamela Kemp, Samantha Sullivan, Sean M. O’Brien, Sonja Way, Jessica Chevalier, Carly Sykes, Carrie L. Kruck, Elaine T Kiriakopoulos, L. W. Sackett, Sarah Kaden, Claire Bang, Mary Hynes, Torrey L. Gallagher, Margaret Childers-Kakos, Ahmad Zia, AP South, Anne Oravets, Carolyn Ferreyra, Chad Glaze, Daphne-Dominique Villanueva, Erica Blystone, Jane Pritchard, Laura Alyward, Melissa Cooper, Michelle Chidester, R. Matt Alderson, Renee D. Clark, Sally Hodder, Arif R Sarwari, James M. Bardes, Joy Juskowich, Shelly Welch, Alyssa Civil, Ashley Bendl, Elisa Dicker, Hannah Hanson, Heather Viola, Janice Morinigo, Karisma Pantaleon, Kathryn Marcon, Kimberly Stone, Kiwan Stewart, Lorraine Evo-Ortega, Maria Loizos, Megan McVeety, Sabina Guliyeva, Eric Watson, Shayna Pehel, Tim Ko, Leah Caropolo, H. Deniz Kocas, Luis Ángel Fernández, Andrew O’Donnell, Corey Saperia, Daniel Thai, Divya Pathak, Jennifer M. Keller, Kelly Olszewski, Kimberly Clinton, Kirsten Cherian, L M Dutton, Ma Elepano, Rebecca Lin, Sukanya Mohapatra, Ting Chen, Tonita Wroolie, Zenita Leang, Sumana Shashidhar, T L Nguyen, Ashwath Ravisankar, Brycie Weiden, Daniel B. Brown, Dawn Bolliger, Heather Glesne, Jennifer Dixon, Praneeth Chebrolu, Zarine Gazali, Whitney Hurst, Avery Fry, Ganesh Murthy, Garrett Grischo, Heidi L. Erickson, Isaias Gomez, Jacquelynn Copeland, Judy Galaz, Lynn Autry, Marjorie DiLise-Russo, Michelle A. James, Mrinalini Kala, Nikki Marshell, Sabine Borwege, Sheila Vadovicky, Stephanie Marsh, William Hartley, Linda Murtagh, Anna Kennedy, Annie Meltzer-Christensen, Caitlyn Stringham, Ella Gaskin, Melissa Judd, Ryan Smith, Sarah Côté, Shreya Mahasenan, Todd Bjorklund, Cheryl E. Farner, Barbara S. Taylor, Bridgette Soileau, Cyrena Cote, Gabrielle A. Hromas, Irma Scholler, Lisa Longoria, Patricia Heard, Hillary Johnson, Johnnie Jones, Robin Tragus, Maya Harris, Alexis Pinones, Alyssa Anderson, Gabrielyd Hastings, jessica Courtright, Jessica Hernández, Madhumita Jayakumar, M Fischer, Michael B. Sullivan, Pamela Solis, Alex Harteloo, Anna Elias-Warren, Daniel Nguyen, Dylan McDonald, Helen Nguyen, Holly Rau, Jean Mernaugh, Jennifer Logue, Kathleen F. Pagulayan, Kino Watanabe, Kristen Huden, Laurel Peabody, Tiffany Mei, Catherine Ogunwuyi, Esther Cobbina, Ian Sankar, Lisa Nguyen, N. Fromm, R. Douglas Arnold, Stephanie Ogu, Ying Yuan, Homam Ibrahim, Izabella Szum, Jignesh Patel, Sonia Sultan, Yasmin Jazayeri, Timothy Hatlen, Betty Lise Anderson, Isabel Muñoz, Logan Rhys, Matthew Wright, Ryan Vane, Jessica Kim, Leticia M. Diaz, Nathan Yee, Robert Gruhn, Sarah Browngoetz, Thomas W. DeCato, Elisha Johnson, Arista Chand, E. Ortiz, Kenneth Bottrill, Kymberly Henderson, Lindsey Hildebrand, Johnson, Richard C. DeArmond, Trina Hughes · 发表于：JAMA Neurology · 年份：2025 · DOI：10.1001/jamaneurol.2025.4415 · 被引用次数：9 · 研究领域：Long-Term Effects of COVID-19、Intensive Care Unit Cognitive Disorders、Neuroinflammation and Neurodegeneration Mechanisms

Importance: Treatment for cognitive dysfunction due to postacute sequelae of long COVID (ie, symptoms of fatigue, malaise, weakness, confusion that persist beyond 12 weeks after an initial COVID infection) remains a significant unmet need. Objective: To test evidence-based rehabilitation strategies for improving cognitive symptoms in persons with long COVID. Design, Setting, and Participants: This was a 5-arm, multicenter, randomized clinical trial of 3 remotely delivered interventions conducted between August 17, 2023, and June 10, 2024. The study took place at 22 trial sites and included the screening of individuals with cognitive long COVID. Interventions: Participants were randomized to 1 of 5 arms: adaptive computerized cognitive training (BrainHQ [Posit Science]), cognitive-behavioral rehabilitation involving both group and individual counseling sessions (PASC-Cognitive Recovery [PASC-CoRE]) paired with BrainHQ, and transcranial direct current stimulation (tDCS) paired with BrainHQ. Two comparator arms were included as follows: unstructured computer puzzles and games (active comparator) and sham tDCS paired with BrainHQ. The interventions occurred 5 times per week over 10 weeks. Main Outcomes and Measures: Cognitive and behavioral in-person assessments were performed at baseline, midintervention, at the end of intervention, and 3 months after the end of the intervention. The primary outcome measure was the modified Everyday Cognition Scale 2 (ECog2) completed at the end...