Assessing Attention Process Training Efficacy in Improving Brain Fog Symptoms in Individuals with Long Covid: A Study Protocol for a Randomized Controlled Trial

BackgroundLong Covid, also referred to as post-acute sequelae of SARS-CoV-2 infection (PASC), is characterized by symptoms that persist or emerge weeks to months following acute COVID-19 illness. Cognitive impairments affecting attention, memory, and executive functioning--commonly described as "brain fog"--are frequently reported. Currently, limited evidence-based cognitive rehabilitation interventions specifically target these impairments. ObjectivesThis pilot randomized controlled trial aims to evaluate the feasibility and acceptability, and to develop preliminary data regarding efficacy of Attention Process Training-3 (APT-3), a computerized attention training program, for individuals with Long Covid-related brain fog. MethodsThis study uses a three-arm randomized controlled design. Participants are randomized to (1) Immediate Attention Training, (2) Delayed Attention Training, or (3) Music Activity. Participants complete comprehensive cognitive assessments at baseline, post-intervention, and one-month follow-up. The Immediate Attention Training group completes a 4-week APT-3 intervention, while the Music Activity group engages in a 4-week music-based listening activity. The Delayed Attention Training group dont receive any intervention for 4 weeks. Following completion of the final assessment, participants in the Music Activity and Delayed Attention Training groups are offered the APT-3 intervention. Feasibility and acceptability outcomes include recruitment, retention, and adherence numbers, and participant satisfaction. Preliminary data regarding efficacy will be determined using objective cognitive tests and subjective self-report measures. ConclusionsThis pilot trial will inform the feasibility and acceptability of APT-3 and generate preliminary efficacy data to guide the design of a future fully powered randomized controlled trial targeting brain fog associated with Long Covid.