European Psychiatry (Jan 2024)

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

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

DOI
https://doi.org/10.1192/j.eurpsy.2024.1770
Journal volume & issue
Vol. 67

Abstract

Read online

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