There is no lab test for Long Covid yet, nor are there widely accepted treatments. A small clinical trial published July 1 in JAMA Network Open explores whether cognitive rehabilitation, a technique used to help people recover from strokes and other neurological injuries, can help Long Covid patients—like Black, who was a participant in the trial—with some of their symptoms. Although the treatment didn’t affect people’s scores on cognitive tests, the team found that it positively affected their ability to achieve their goals.
Cognitive rehabilitation therapy involves learning new strategies for achieving tasks, says Martina Vanova, a researcher at Kingston University London and lead author of the new paper. For people with Long Covid symptoms that include having difficulty completing tasks—like cooking dinner, for instance—that can mean dividing them up into small chunks, taking frequent short breaks, and narrating each step to themselves as they go, a technique called “self instruction” that can help minimize distraction.
To be included in the study, Long Covid patients had to have objective cognitive impairment. Vanova or a colleague met with about 40 people for one hour a week for ten weeks, helping them set a series of personalized goals (like writing a report for 30 minutes without needing to stop), and teaching them strategies to try out to achieve them. A separate control group received no treatment.
Can cognitive rehab make a difference for Long Covid?
That might sound like not much of an effect. But a larger study published in 2025 found that Long Covid patients who received cognitive rehabilitation performed no better than patients in the control group who were told to work on computer games instead of receiving therapy. This discrepancy in findings might in part be due to the fact that patients in the 2025 study did not have to have a cognitive abnormality to participate, so the patients in the new study may have been more severely affected to start with, says Dr. David Knopman, a clinical neurologist at the Mayo Clinic in Rochester, Minnesota, and an author of that study.
These investigations are just the beginning
Beyond the context of clinical trials, doctors have been testing similar treatment approaches to Long Covid for some time, says Dr. Lindsay McAlpine, a neurologist at Yale School of Medicine who was not involved in the new study. “Overall, the findings are not surprising, but they are extremely encouraging because they validate what many of us have observed clinically,” she wrote in an email, noting that such therapies must be tailored to the individual patients and should take care to avoid triggering post-exertional malaise, where exertion, either cognitive or physical, can have negative aftereffects for patients. “These findings support the concept that the Long COVID brain retains substantial neuroplasticity and capacity for recovery, even in the setting of an ongoing disease process, similar to what we observe after stroke or in multiple sclerosis.”
For Adrian Black, the trial marked the beginning of a substantial improvement in his cognitive symptoms. “I was willing to try anything,” he recalls. His goals involved being able to give a short presentation without having to stop and being able to remember where he was in an activity after being distracted. After the sessions, “I thought, ‘Actually, that would have been really useful if I'd done that at age 20,’” he reflects—at that age, you take your cognitive abilities for granted. “But if you [lose that], you have to relearn.”
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