Long COVID brain fog treatment: An early-phase randomized controlled trial of constraint-induced cognitive therapy signals go.

The sample size was very small (14 analyzed), limiting the generalizability of the findings. The study was unblinded and open-label, which increases the risk of bias, particularly for self-reported outcomes like the COPM and symptom scales. There was no placebo or active control group, so the specific contribution of CICT components versus attention or expectation cannot be determined. Two participants in the TAU group withdrew before the second baseline, which may have inflated the apparent advantage of CICT. The participants were predominantly female and European American, and the study excluded those with severe depression or pre-existing cognitive impairment, so results may not apply to a broader or more diverse population. The study did not formally assess post-exertional malaise, a common and disabling symptom in long COVID, so the safety of this intensive therapy for patients with PEM is unknown.

The study was intramurally funded. The authors declared no other conflicts of interest.

Do not assume this treatment works for all long COVID patients. The study only included people with measurable cognitive impairment on the MoCA, excluding those whose brain fog is primarily subjective or who have severe depression. Additionally, the large effects seen here may be exaggerated by the lack of blinding and the small sample size.