Demographics, Clinical Characteristics, and Outcomes of a Post-Coronavirus-19 Sample After Cognitive Rehabilitation: A Case Series

Abstract

The Coronavirus-19 (COVID-19) pandemic has infected millions of people resulting in ongoing symptoms now described as post-acute sequelae of SARS-COV2 Infection (PASC). Persistent neurological and behavioral sequelae including fatigue, depression, anxiety, sleep disorders, headache, memory loss, and cognitive complaints are common. Though there is increasing evidence related to treatment of physical symptoms such as fatigue through physical rehabilitation practices, to date there is very limited evidence about the efficacy of various treatment regimens directed at nonphysical symptoms such as cognitive concerns and behavioral sequelae.1 This case series discusses a series of 13 patients with PASC who underwent individualized multidisciplinary outpatient cognitive rehabilitation at a quaternary medical center. In this patient population the median age was 46 (Q1, Q3: 41, 50), 77% were female, and 85% were Caucasian. The median time from infection to treatment was 229 days (Q1, Q3: 117,367) and median length of stay in the program was 4.9 months (Q1, Q3: 3.1, 6.3). A history of depression and anxiety were found in 38% and 46% of this population respectively. Upon admission and at discharge the Mayo-Portland Adaptability Inventory-4 Participation Index (M2PI); the Satisfaction with Life Scale (SWLS); the Patient Health Questionnaire-9 (PHQ-9); and the Neurobehavioral Symptom Inventory-22 (NSI-22) were completed. After individualized outpatient cognitive therapy, no clear benefit was seen in any of the outcome measures. Ongoing investigation is important to better understand which approaches will benefit these patients.