Post-COVID syndrome: neurocognitive and memtal health implications in adults and the role of metacognitive psychotherapy and neurogymnastics

Abstract

Abstract. This article addresses the long-term consequences of COVID-19, commonly referred to as “post-COVID syndrome,” which encompasses a wide range of neurocognitive and mental health disturbances persisting for weeks or months beyond the acute infection. Prominent among these are memory deficits, attentional impairments, and executive dysfunction, alongside psychiatric manifestations such as anxiety, depression, and post-traumatic stress disorder. The discussion underscores that even so-called “brain fog,” which may not always be verified by objective testing, significantly degrades quality of life and necessitates a comprehensive approach to rehabilitation. The article delves into key factors influencing the trajectory of post-COVID syndrome. These include neuroinflammatory processes, dysregulated immune responses, and vascular complications, as well as psychosocial factors linked to pandemic-related stress and isolation. The authors highlight that prolonged uncertainty about recovery can exacerbate anxiety, fatigue, and cognitive impairments, underscoring the importance of holistic, non-pharmacological strategies in post-COVID care. Metacognitive psychotherapy emerges as a promising intervention aimed at identifying and correcting ineffective cognitive strategies, such as excessive worry or rumination, which can intensify symptom severity. Techniques like Attention Training and Detached Mindfulness help mitigate cognitive load and reduce internal stress. In parallel, the article presents neurogymnastics—a structured set of cognitive and physical exercises—as another key element. By stimulating neuroplasticity and fostering the renewal of disrupted neural pathways, neurogymnastics may strengthen executive functions and enhance overall cognitive resilience in individuals recovering from COVID-19. Emphasis is placed on personalized treatment protocols that account for varying degrees of cognitive impairment, comorbidities, and emotional states. The role of telehealth is also discussed, given that online delivery offers both continuous engagement and flexibility in scheduling, particularly crucial for patients with limited access to healthcare facilities. Finally, the authors call for further research, including long-term, randomized controlled trials, to refine methods of metacognitive psychotherapy and neurogymnastics. Determining the optimal “dose” of such interventions and evaluating their synergy with other recovery measures will be critical for maximizing rehabilitation outcomes. A more integrated, evidence-based model could substantially improve quality of life for those experiencing post-COVID syndrome, offering a multifaceted and dynamic path toward cognitive and emotional restoration.