Integrated Cognitive Rehabilitation and Cognitive Behavioral Therapy Intervention for patients with Post-COVID-19 Cognitive Impairment and Depression

PROJECT SUMMARY/ABSTRACT Research: The post-acute sequelae of SARS-CoV-2 infection (PASC) continues to pose an unprecedented public health burden, and cognitive impairment (CI) and depression are among the most common symptoms, which profoundly impacts functioning and quality of life. The purpose of this study is to develop and pilot a novel intervention to treat post-COVID CI and depression in patients with PASC by integrating two evidence-based interventions, cognitive rehabilitation (CR) based on Goal Management Training (GMT) and cognitive behavior therapy (CBT), and adapting the intervention specifically for ethnoculturally diverse patients with PASC. The specific aims are to: 1) Develop a manualized intervention for diverse patients with post- COVID CI and depression by adapting and enhancing a GMT CR+CBT approach and 2) Determine the feasibility and preliminary efficacy of the intervention on diverse patients with post- COVID CI and depression. To accomplish these aims, we will employ a mixed methods, design. Qualitative findings from focus groups with patients with PASC will guide the development of the intervention, which will be iteratively refined through additional semi-structured individual interviews and evaluated for feasibility and preliminary impact in a pilot randomized controlled trial (RCT). Candidate: The primary objective of this application is to support Dr. Jacqueline Becker's career development into an independent investigator studying the bidirectional impact of cognitive and mental health on chronic illnesses. Dr. Becker's proposed training activities are: 1) qualitative methodology; 2) psychosocial intervention development; and 3) RCT design, implementation, and evaluation. To achieve these goals, she has assembled a multidisciplinary mentoring team. Dr. Wisnivesky, her primary mentor, is a health services researcher with expertise in PASC, health disparities research, biostatistics, and RCT design and implementation. Her co-mentors include Dr. Lin, a clinician-investigator with expertise in qualitative research and chronic disease self- management in diverse adults, Dr. Feldman, a psychologist and expert in behavioral medicine psychosocial interventions, Dr. Murrough, a world-renowned psychiatrist with expertise in clinical trials for depression, and Dr. Bagiella, an expert in biostatistics and RCT design and evaluation. Environment: The Icahn School of Medicine at Mount Sinai has a strong tradition of outstanding research and the Department of Medicine is ranked 12th nationwide in NIH funding. The Division of General Internal Medicine has a well-established research infrastructure with an exceptionally strong record of successful and well-funded, mentored and independent investigators.