Cognitive Rehabilitation Therapy for COVID-19 (CCT-COVID)

July 13, 2026 updated by: VA Office of Research and Development

Cognitive Rehabilitation to Improve Functioning in Veterans Following COVID-19

Cognitive dysfunction, psychiatric symptoms, functional impairment, and disability following COVID-19 negatively impact Veterans' community functioning and quality of life, contribute to significant human suffering, and are costly to VHA. Rehabilitation is a critical priority for Veterans with long COVID. One promising treatment to improve functioning in Veterans with post-COVID-19 cognitive symptoms is Compensatory Cognitive Training (CCT). Previous studies have found that CCT is feasible, acceptable, and efficacious in Veteran populations with multiple sources of cognitive dysfunction. This randomized controlled trial aims to address important RR&D priorities by examining feasibility, acceptability, and preliminary efficacy of a COVID-19-specific rehabilitation intervention, CCT for long COVID (CCT-C) compared to a robust control condition. The proposed study has the potential to improve cognitive function, functional independence, and quality of life for Veterans with late or delayed effects of secondary conditions related to COVID-19 infections.

Study Overview

Status

Enrolling by invitation

Conditions

Intervention / Treatment

Detailed Description

2-8% of the US population report "long COVID" symptoms - including "brain fog," thinking difficulties, memory problems, and psychiatric symptoms such as sleep disturbance, anxiety, and depression. Rates of post-COVID-19 symptoms are nearly double in the Veteran population. These cognitive symptoms contribute to functional impairments, reduced quality of life, poorer self-reported health status, psychological distress, delayed return to work, new onset disability, reduced community integration, and increased healthcare utilization. One promising treatment to improve both everyday functioning and cognition secondary to post-COVID-19 symptoms is Compensatory Cognitive Training (CCT). Previous studies have found that CCT is feasible, acceptable, and efficacious in Veteran populations with multiple sources of cognitive dysfunction. The proposed CDA provides a golden opportunity to evaluate CCT for Veterans with prolonged COVID-19 symptoms (CCT-C), compared with a robust control condition, Holistic Cognitive Education (HCE). The project closely aligns with current RR&D priorities, by "examining COVID-19-specific rehabilitation interventions and responses to treatment" and by addressing "late or delayed effects of secondary conditions related to COVID-19 infections on impairment and disability." Specific aims are 1) to conduct a pilot randomized controlled trial of remote CCT-C with 70 Veterans (35 CCT-C, 35 HCE) with post-COVID-19 cognitive symptoms to examine feasibility, acceptability, and initial efficacy; 2) to examine the preliminary efficacy of CCT-C in this population on overall functioning, as measured by the World Health Organization's Disability Assessment Schedule (WHODAS 2.0), performance-based measures of functional capacity, and secondary outcomes (cognitive performance, quality of life, self-reported cognitive problems, psychiatric symptoms, sleep disturbance, and engagement in work/community activities); and 3) to explore moderators of outcome (e.g., age, initial COVID-19 severity, baseline cognitive functioning, presence of PTSD/mTBI history; biomarkers related to COVID-19 infection).

Study Type

Interventional

Enrollment (Estimated)

70

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • California
      • San Diego, California, United States, 92161-0002
        • VA San Diego Healthcare System, San Diego, CA

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Veterans > 18 years old who are able to provide informed consent
  • Prior participation in SF Parent Study or LA Parent Study
  • Report of cognitive symptoms that Veteran attributes to COVID-19 infection

Exclusion Criteria:

  • Current substance abuse disorder, psychotic disorder, dementia, etc.
  • History of moderate to severe brain injury with loss of consciousness > 30 minutes
  • Auditory or visual impairments that would prevent the ability to participate in assessment procedures
  • Invalid performance on one or more embedded performance validity tests (PVTs)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: CCT-C
10-week Compensatory Cognitive Training Group
Behavioral: Compensatory Cognitive Training for COVID-19
CCT-C is a manualized group-based behavioral intervention (10 weeks, 2 hours per week, 20 hours total) designed to improve cognition and everyday functioning in patients with prolonged COVID-19 symptoms
Other Names:
  • CCT-C
Active Comparator: HCE
10-week Holistic Cognitive Education Group
Behavioral: Holistic Cognitive Education
HCE provides the same frequency and amount of therapist and other group member contact as CCT-C, but does not provide training in cognitive or lifestyle strategies addressed in CCT-C. The HCE intervention provides information and discussion regarding common causes of and treatments for cognitive impairment.
Other Names:
  • HCE

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in World Health Organization - Disability Assessment Schedule (WHODAS 2.0)
Time Frame: baseline, 8 weeks
Change in average total score
baseline, 8 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in objective cognitive performance z score
Time Frame: baseline, 8 weeks
Change in composite z score
baseline, 8 weeks
Change in functional capacity performance z score
Time Frame: baseline, 8 weeks
Change in composite z score
baseline, 8 weeks
Change in Patient Health Questionnaire 9 (PHQ-9)
Time Frame: baseline, 8 weeks
Change in total score
baseline, 8 weeks
Change in Generalized Anxiety Disorder 7 (GAD-7)
Time Frame: baseline, 8 weeks
Change in total score
baseline, 8 weeks
Change in PTSD Checklist for DSM-5 (PCL-5)
Time Frame: baseline, 8 weeks
Change in total score
baseline, 8 weeks
Change in Cognitive Failures Questionnaire (CFQ)
Time Frame: baseline, 8 weeks
Change in total score
baseline, 8 weeks
Change in Neuro-QOL: Applied Cognition General Concerns
Time Frame: baseline, 8 weeks
Change in total score
baseline, 8 weeks
Change in Neuro-QOL: Applied Cognition Executive Functioning
Time Frame: baseline, 8 weeks
Change in total score
baseline, 8 weeks
Change in Neuro-QOL: Fatigue
Time Frame: baseline, 8 weeks
Change in total score
baseline, 8 weeks
Change in World Health Organization - Quality of Life (WHOQOL-BREF)
Time Frame: baseline, 8 weeks
Change in total score
baseline, 8 weeks
Change in Insomnia Severity Index (ISI)
Time Frame: baseline, 8 weeks
Change in total score
baseline, 8 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

VA Office of Research and Development

Investigators

  • Principal Investigator: Tara A Austin, AA, VA San Diego Healthcare System, San Diego, CA

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

July 1, 2024

Primary Completion (Estimated)

June 30, 2027

Study Completion (Estimated)

March 31, 2029

Study Registration Dates

First Submitted

October 13, 2023

First Submitted That Met QC Criteria

October 13, 2023

First Posted (Actual)

October 17, 2023

Study Record Updates

Last Update Posted (Actual)

July 15, 2026

Last Update Submitted That Met QC Criteria

July 13, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • E4764-W

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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