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CompletedNCT07821385Post-COVIDUpdated Oct 5, 2026

Interprofessional Rehabilitation for Patients With Post-COVID Condition

An observational study in PostCovid, sponsored by Danderyd Hospital. Completed at 1 site in Sweden. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2026-10-05.

Sponsored by Danderyd Hospital · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
120
Ages
18 Years to 65 Years
Sex
All
01

Study summary

Since 2020, millions of individuals have been infected with SARS-CoV-2 virus and a substantial proportion continue to experience persistent symptoms that impair functional capacity, limit daily activities, and negatively affect quality of life. The terminology and definitions surrounding this condition remain diverse, such as long COVID, post-COVID-19 syndrome or ongoing symptomatic COVID-19 . In October 2021, the World Health Organization (WHO) introduced the term post-COVID condition (PCC) through a Delphi consensus process defined as:

"As the persistence or onset of new symptoms three months after the initial SARS-CoV-2 infection, with symptoms lasting for at least two months and not explained by alternative diagnoses".

PCC is characterized by a wide range of symptoms, most commonly fatigue, cognitive impairments, muscle weakness, respiratory and cardiac symptoms, and pain often occurring alongside anxiety, depression, and sleep disturbances. Research shows that PCC markedly impairs activities of daily living (ADL), work ability, and overall functioning. Qualitative studies further demonstrate that the combination of physical and cognitive symptoms limits individuals' ability to engage in everyday occupations and reduce work capacity. Consequently, PCC is associated with difficulties in maintaining employment, often resulting in prolonged sick leave, reduced working hours, or the need for workplace accommodations. Given the heterogeneous nature of PCC, its impact on everyday life varies between individuals, highlighting the importance of understanding patients´ own experiences and priorities when planning rehabilitation interventions.

Global efforts have focused on understanding and managing PCC, with rehabilitation emerging as a central strategy. Rehabilitation strategies seem to be a key intervention for improving fatigue, cognitive dysfunction, mood disturbances, and decrease overall well-being; however, current evidence is heterogeneous and insufficient to establish standardized interventions. A lack of research on PCC patients would lead to profound consequences for both patients and society. Without such knowledge, patients' risk of being misdiagnosed or receiving inadequate care, rehabilitation efforts may be ineffective, and healthcare systems will struggle to allocate resources properly. This increases long-term disability, reduces work ability, and places an avoidable burden on individuals and society. Therefore, a deeper understanding of the scope and nature of PCC is essential for understanding this patient group better, developing effective rehabilitation approaches and informing public health policy.

The goal of this observational study is to learn more about the impact of post-COVID condition (PCC) on individuals' everyday occupational performance, cognitive functioning, perceived health, and life satisfaction, with the aim of understanding these patient groups better, and to generate evidence to guide rehabilitation strategies. The research focuses on patients diagnosed with post-COVID condition who are receiving an interprofessional rehabilitation program at a specialized Rehabilitation Clinic in Sweden, Danderyds Hospital,

The main questions aim to answer are:

  • Which activities do individuals with PCC identify as most important to improve, and how do they rate these activities in terms of performance and satisfaction?
  • How do individuals with PCC rate their overall health and occupational performance before and after participating in an interprofessional rehabilitation program?
Read the detailed description

This is a prospective clinical cohort study, describing occupational performance, cognitive dysfunction and health aspects within patients with post-COVID condition (PCC), which have participated in an interprofessional rehabilitation program. Data collection began in 2021 and continued through 2025. Participants were recruited prior to initiation of rehabilitation and assessed at baseline, immediately post-intervention, and at six-month follow-up.

Setting The study was conducted at the Stockholm Department of Rehabilitation Medicine, Danderyd University Hospital, within the Cognitive Post-COVID Clinic .

Participants Between August 2021 and December 2025, patients with persistent cognitive symptoms and fatigue following mild COVID-19 infection were assessed for eligibility. A total of approximately 100 patients aged 18-65 years were included.

All patients underwent a comprehensive interdisciplinary assessment to determine the need for and potential benefit from interprofessional multimodal rehabilitation (IMR). Only patients who provided written informed consent were enrolled in the study.

Intervention:

Interprofessional Rehabilitation Program The interprofessional rehabilitation program was initiated in spring 2021 and progressively refined based on expanding clinical knowledge of PCC and neurorehabilitation. The program is grounded in principles of chronic pain rehabilitation and neurorehabilitation.

Rehabilitation was delivered in a group-based, in-person format consisting of half-day sessions once weekly for 10 weeks. Participants attended together with other patients with PCC.

Interventions were individually adapted according to participants' energy levels and physical capacity and included:

  • Educational components (theory and lectures)
  • Physical activity
  • Body awareness training
  • Pacing strategies
  • Cognitive and behavioral strategies aimed at improving daily functioning and facilitating return to work when applicable The interdisciplinary rehabilitation team comprised an occupational therapist, psychologist, physiotherapist, physician, and social worker.

Procedures Baseline Assessment

Prior to the start of rehabilitation:

  • All participants completed self-reported questionnaires addressing health, quality of life, and psychological well-being
  • Occupational performance and satisfaction were assessed using the Canadian Occupational Performance Measure (COPM) during occupational therapy evaluation
  • Background variables including age, sex, educational level, and family situation were recorded Follow-Up Assessments

Assessments were conducted:

  1. Immediately after completion of the rehabilitation program
  2. Six months post-rehabilitation At follow-up, participants completed the same outcome measures as at baseline, with additional assessments of fatigue, insomnia, and participation.

Study Objectives

The planned analyses aim to:

  1. Evaluate changes in occupational performance, satisfaction, and self-rated health from baseline to post-intervention and six-month follow-up
  2. How do cognitive functions, such as attention and executive functions, correlate with rehabilitation outcomes?

Statistical Analysis and Sample Size The COPM is the primary outcome measure. The study has 90% power to detect a pre-post difference of 2.2 COPM points, assuming a standard deviation of 2.1, a significance level of 5%, and using non-parametric methods, with a sample size of 10 participants.

Non-parametric statistical methods will be applied due to the nature of the data. Spearman's rank correlation will be used for correlation analyses. Logistic regression analyses will be conducted to investigate factors associated with rehabilitation outcomes, including age, sex, and educational level.

02

Conditions studied

  • PostCovid

Browse trials for

Keywords

  • Rehabilitation
  • Everydays occupations
  • Health
  • Life satisfaction
03

In context

Personal Satisfaction

541 studies on the registry are indexed under Personal Satisfaction; 93 are open to participants now.

This study's enrollment of 120 is below the median of 180 across 115 observational studies indexed under Personal Satisfaction.

Browse Personal Satisfaction studies →

Lead sponsor

Danderyd Hospital is the lead sponsor of 60 studies on the registry; 13 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Patients aged 18-65 with persistent cognitive symptoms and fatigue following confirmed or strongly suspected COVID-19 infection, who have undergone assessment at the Cognitive Post-COVID Clinic at Danderyd Hospital and subsequently completed a team evaluation prior to participation in interdisciplinary rehabilitation. During the assessment, it is determined whether the patient needs and can benefit from rehabilitation.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Individuals aged 18 and older with confirmed COVID-19 or with a very likely prior COVID-19 infection.
  • Newly developed cognitive impairments or cognitive fatigue.

    --A clear temporal link between COVID-19 onset and symptom onset, with symptoms affecting return to previous activities/occupation.

  • The acute phase of illness ended at least 3 months earlier.
  • Basic investigations for specific differential diagnoses must have been completed at the initial clinic visit, according to "COVID-19 - persistent symptoms" (see viss.nu), excluding anemia, thyroid dysfunction, and alcohol overconsumption. Assessment for depression.
  • Medication review and relevant adjustments carried out with regard to the patient's symptoms

Exclusion criteria

Exclusion Criteria:

  • Predominant recurrent and/or fluctuating infectious symptoms, circulatory, respiratory, or cardiac problems.
  • Other symptoms due to organ failure that should primarily be managed by an organ specialist.
  • Severe psychiatric illness, including depression with pronounced cognitive symptoms.
  • Cognitive impairments primarily related to neurodegenerative disease or substance misuse, e.g., alcohol-related dementia, Korsakoff's dementia, or other dementia disorders.
05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
120 participants (actual)
Target follow-up
3 Months
Patient registry
Yes

Groups and cohorts

  • Patients with Post-COVID condition

    The study aims to investigate a cohort of patients with post COVID condition whose primary symptoms are cognitive impairment and fatigue. The patients have undergone a comprehensive assessment by a multiprofessional team and have been deemed both to require and to be capable of participating in an on site interprofessional rehabilitation program conducted one day per week.

    Other: Interprofessional cognitive group rehabilitation

Interventions

  • OtherInterprofessional cognitive group rehabilitation

    The Interprofessional rehabilitation program (IPR) was delivered in a group format, one half day per week over 10 weeks. The interprofessional team comprised an occupational therapist, psychologist, physiotherapist, physician, and social worker. All patients underwent an initial team assessment to determine eligibility for the IRP. Based on this assessment; an individualized rehabilitation plan was developed prior to program initiation. The IPR included lectures, group discussions, and physical activity, with the overall goal of improving daily functioning and facilitating return to work when applicable.

06

What researchers measure

Primary outcomes

  1. Canadian Occupational Performance Measure (COPM)

    The COPM assesses an individual's perceived occupational performance in the areas of self-care, productivity and leisure. Semi-structured interview format and structured scoring method. The person rates/ describes which activities are important for them and after that satisfaction. The person rates importance, performance and satisfaction

    Time frame: Before, after and at six months follow-up

Secondary outcomes

  1. EQ5D

    The EuroQol 5D (EQ 5D) is a widely used measure of quality of life, the instrument consists of a health index with five dimensions: mobility, self care, usual activities, pain/discomfort, and anxiety/depression. Responses across these dimensions generate a health profile that can be converted into an EQ 5D index score, ranging from 0 (equivalent to death) to 1 (representing perfect health). In addition, the EQ 5D includes a Visual Analog Scale (VAS), on which respondents rate their perceived health status from 0 (worst imaginable health) to 100 (best imaginable health)

    Time frame: Before, after and at six month follow-up

  2. HADS

    The Hospital Anxiety and Depression Scale (HADS) was developed as a tool for identifying symptoms of anxiety and depression in patients attending hospital medical outpatient clinics, and it has been shown to be reliable for this purpose. Both the anxiety and depression subscales are considered valid indicators of the severity of these emotional disorders.

    Time frame: Before, after and six month follow-up

  3. Rand-36

    The RAND-36 item health survey is a 36-item questionnaire used as a generic measure of health-related quality of life (HRQoL). It assesses eight health domains: physical functioning, bodily pain, role limitations due to physical health problems, role limitations due to emotional problems, mental health, social functioning, vitality (energy/fatigue), and general health perceptions. Subscale scores range from 0 to 100, with higher scores indicating better health status. The RAND-36 has been translated into Swedish and psychometrically validated for use in the Swedish population.

    Time frame: Before, after and a six months follow-up

  4. MFI-20

    The Multidimensional Fatigue Inventory (MFI) is a 20-item self-report questionnaire developed to assess fatigue across five dimensions: General Fatigue, Physical Fatigue, Mental Fatigue, Reduced Motivation, and Reduced Activity (5).

    Time frame: Before, after and at six months follow-up

  5. ISI

    The Insomnia Severity Index (ISI) is a self-report questionnaire that assesses perceived insomnia severity. It evaluates subjective symptoms and consequences of insomnia, as well as the level of concern or distress associated with sleep difficulties. The instrument comprises seven items measuring the severity of sleep-onset and sleep-maintenance problems. Each item is rated on a 5-point scale (0-4), yielding a total score ranging from 0 to 28, with higher scores indicating more severe insomnia

    Time frame: Before, after and at six month follow-up

  6. WHODAS-12

    The World Health Organization Disability Assessment Schedule (WHODAS) is a standardized instrument developed to evaluate disability and activity limitations associated with a wide range of health conditions, including acute and chronic diseases, injuries, mental and emotional disorders, and problems related to alcohol or substance use. WHODAS 12 is the abbreviated version of the 36 item WHODAS 2.0 and is a self administered questionnaire consisting of 12 items. It provides a global assessment of the impact of health conditions on daily functioning over the preceding 30 days

    Time frame: Before, after and at six month follow-up

07

Study locations

1 site
  • Department of Rehabilitaiton Medicine Stockholm
    Stockholm, 18288, Sweden
08

References and documents

Publications

  • Bastien CH, Vallieres A, Morin CM. Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med. 2001 Jul;2(4):297-307. doi: 10.1016/s1389-9457(00)00065-4. PubMed 11438246 ↗
  • Smets EM, Garssen B, Bonke B, De Haes JC. The Multidimensional Fatigue Inventory (MFI) psychometric qualities of an instrument to assess fatigue. J Psychosom Res. 1995 Apr;39(3):315-25. doi: 10.1016/0022-3999(94)00125-o. PubMed 7636775 ↗
  • Hays RD, Morales LS. The RAND-36 measure of health-related quality of life. Ann Med. 2001 Jul;33(5):350-7. doi: 10.3109/07853890109002089. PubMed 11491194 ↗
  • Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361-70. doi: 10.1111/j.1600-0447.1983.tb09716.x. PubMed 6880820 ↗
  • Balestroni G, Bertolotti G. [EuroQol-5D (EQ-5D): an instrument for measuring quality of life]. Monaldi Arch Chest Dis. 2012 Sep;78(3):155-9. doi: 10.4081/monaldi.2012.121. Italian. PubMed 23614330 ↗
  • Pollini E, Lazzarini SG, Cordani C, Del Furia MJ, Kiekens C, Negrini S, Arienti C. Effectiveness of Rehabilitation Interventions on Adults With COVID-19 and Post-COVID-19 Condition. A Systematic Review With Meta-analysis. Arch Phys Med Rehabil. 2024 Jan;105(1):138-149. doi: 10.1016/j.apmr.2023.08.023. Epub 2023 Oct 5. PubMed 37802177 ↗
  • Zeraatkar D, Ling M, Kirsh S, Jassal T, Shahab M, Movahed H, Talukdar JR, Walch A, Chakraborty S, Turner T, Turkstra L, McIntyre RS, Izcovich A, Mbuagbaw L, Agoritsas T, Flottorp SA, Garner P, Pitre T, Couban RJ, Busse JW. Interventions for the management of long covid (post-covid condition): living systematic review. BMJ. 2024 Nov 27;387:e081318. doi: 10.1136/bmj-2024-081318. PubMed 39603702 ↗
  • Ballouz T, Kerksieck P, Haile SR, Dressel H, Hammig O, Bauer GF, Fehr JS, Puhan MA, Menges D. Work ability trajectories and sick leave in individuals with post COVID-19 condition: 3-year follow-up of a population-based cohort. Lancet Reg Health Eur. 2025 Nov 20;61:101536. doi: 10.1016/j.lanepe.2025.101536. eCollection 2026 Feb. PubMed 41362299 ↗
  • Kerksieck P, Ballouz T, Haile SR, Schumacher C, Lacy J, Domenghino A, Fehr JS, Bauer GF, Dressel H, Puhan MA, Menges D. Post COVID-19 condition, work ability and occupational changes in a population-based cohort. Lancet Reg Health Eur. 2023 Jun 23;31:100671. doi: 10.1016/j.lanepe.2023.100671. Online ahead of print. PubMed 37366496 ↗
  • MacEwan SR, Rahurkar S, Tarver WL, Eiterman LP, Melnyk H, Olvera RG, Eramo JL, Teuschler L, Gaughan AA, Rush LJ, Stanwick S, Burpee SB, McConnell E, Schamess A, McAlearney AS. The Impact of Long COVID on Employment and Well-Being: A Qualitative Study of Patient Perspectives. J Gen Intern Med. 2025 Apr;40(5):1070-1077. doi: 10.1007/s11606-024-09062-5. Epub 2024 Oct 8. PubMed 39379779 ↗
  • Hawke LD, Nguyen ATP, Sheikhan NY, Strudwick G, Rossell SL, Soklaridis S, Kloiber S, Shields R, Ski CF, Thompson DR, Castle D. Swept under the carpet: a qualitative study of patient perspectives on Long COVID, treatments, services, and mental health. BMC Health Serv Res. 2023 Oct 11;23(1):1088. doi: 10.1186/s12913-023-10091-9. PubMed 37821939 ↗
  • Rosenstein J, Lemhofer C, Loudovici-Krug D, Sturm C, Bokel A. Impact of post-COVID symptoms on activity and participation of women and men. Sci Rep. 2024 Oct 17;14(1):24379. doi: 10.1038/s41598-024-74568-1. PubMed 39420197 ↗
  • Ottiger M, Poppele I, Sperling N, Schlesinger T, Muller K. Work ability and return-to-work of patients with post-COVID-19: a systematic review and meta-analysis. BMC Public Health. 2024 Jul 7;24(1):1811. doi: 10.1186/s12889-024-19328-6. PubMed 38973011 ↗
  • Pizarro-Pennarolli C, Sanchez-Rojas C, Torres-Castro R, Vera-Uribe R, Sanchez-Ramirez DC, Vasconcello-Castillo L, Solis-Navarro L, Rivera-Lillo G. Assessment of activities of daily living in patients post COVID-19: a systematic review. PeerJ. 2021 Apr 6;9:e11026. doi: 10.7717/peerj.11026. eCollection 2021. PubMed 33868804 ↗
  • Zakia H, Pradana K, Iskandar S. Risk factors for psychiatric symptoms in patients with long COVID: A systematic review. PLoS One. 2023 Apr 7;18(4):e0284075. doi: 10.1371/journal.pone.0284075. eCollection 2023. PubMed 37027455 ↗
  • Fernandez-de-Las-Penas C, Notarte KI, Macasaet R, Velasco JV, Catahay JA, Ver AT, Chung W, Valera-Calero JA, Navarro-Santana M. Persistence of post-COVID symptoms in the general population two years after SARS-CoV-2 infection: A systematic review and meta-analysis. J Infect. 2024 Feb;88(2):77-88. doi: 10.1016/j.jinf.2023.12.004. Epub 2023 Dec 13. PubMed 38101521 ↗
  • Talkington GM, Kolluru P, Gressett TE, Ismael S, Meenakshi U, Acquarone M, Solch-Ottaiano RJ, White A, Ouvrier B, Pare K, Parker N, Watters A, Siddeeque N, Sullivan B, Ganguli N, Calero-Hernandez V, Hall G, Longo M, Bix GJ. Neurological sequelae of long COVID: a comprehensive review of diagnostic imaging, underlying mechanisms, and potential therapeutics. Front Neurol. 2025 Feb 7;15:1465787. doi: 10.3389/fneur.2024.1465787. eCollection 2024. PubMed 40046430 ↗
  • Elboraay T, Ebada MA, Elsayed M, Aboeldahab HA, Salamah HM, Rageh O, Elmallahy M, AboElfarh HE, Mansour LS, Nabil Y, Eltawab AKA, Atwan H, Alkanj S. Long-term neurological and cognitive impact of COVID-19: a systematic review and meta-analysis in over 4 million patients. BMC Neurol. 2025 Jun 14;25(1):250. doi: 10.1186/s12883-025-04174-9. PubMed 40514644 ↗
  • Santoro A, Bai F, Greco MF, Rovito R, Sala M, Borghi L, Piscopo K, Vegni E, de Morais Caporali JF, Marinho CC, Leite AS, Santoro MM, Silberstein FC, Iannetta M, Juozapaite D, Strumiliene E, Almeida A, Toscano C, Quinones JAR, Carioti L, Mommo C, Fanti I, Incardona F, Marchetti G; EuCARE POSTCOVID study. Short and long-term trajectories of the post COVID-19 condition: Results from the EuCARE POSTCOVID study. BMC Infect Dis. 2025 Apr 29;25(1):625. doi: 10.1186/s12879-025-10805-w. PubMed 40301791 ↗
  • Soriano JB, Murthy S, Marshall JC, Relan P, Diaz JV; WHO Clinical Case Definition Working Group on Post-COVID-19 Condition. A clinical case definition of post-COVID-19 condition by a Delphi consensus. Lancet Infect Dis. 2022 Apr;22(4):e102-e107. doi: 10.1016/S1473-3099(21)00703-9. Epub 2021 Dec 21. PubMed 34951953 ↗
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  • Norrefalk JR, Borg K, Bileviciute-Ljungar I. Self-scored impairments in functioning and disability in post-COVID syndrome following mild COVID-19 infection. J Rehabil Med. 2021 Nov 23;53(11 (November)):jrm00239. doi: 10.2340/jrm.v53.188. PubMed 34643243 ↗
  • Greenhalgh T, Sivan M, Perlowski A, Nikolich JZ. Long COVID: a clinical update. Lancet. 2024 Aug 17;404(10453):707-724. doi: 10.1016/S0140-6736(24)01136-X. Epub 2024 Jul 31. PubMed 39096925 ↗
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Individual participant data

Plan to share: No — Data might be shared on request.

09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Aug 2021 to primary completion in Jan 2026, 52 months.

Of 36 non-industry observational studies under Personal Satisfaction, half reached primary completion within 10 months of starting (the median), counting those still running; a quarter within 3 and three quarters within 28. This study's 52 months is above that.

Counting every sponsor, half of 44 studies reached it within 14 months; a quarter within 4 and three quarters within 29.

How these figures are worked out, and which studies are left out of them.

Registered
Sep 10, 2026
First posted
Sep 15, 2026
StartActual
Aug 20, 2021
Primary completionActual
Jan 15, 2026
CompletionActual
Jan 15, 2026
Last update
Oct 5, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Minor edits
Nothing that changes what the study is or who can join. Edited: conditions
1 update, last Oct 5, 2026
Show all 1 update
  1. Oct 5, 2026
    Minor edits only
    + 1 other change: conditions

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT07821385
Lead sponsor
Danderyd Hospital
Responsible party
Sponsor
First posted
Sep 15, 2026
Start date
Aug 20, 2021
Primary completion
Jan 15, 2026
Completion
Jan 15, 2026
Last update
Oct 5, 2026

Study contacts

Monika Löfgren, Assoc Prof
principal investigator · Karolinska Institutet

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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