Enhanced External Counterpulsation Improves Cognitive Function of Persons with Long COVID

Mohanakrishnan Sathyamoorthy; Rajkumar J Sevak; Juan Cabrera; Marielisa Lopez; Jessie Fox; Sachin A Shah; Monica Verduzco-Gutierrez

doi:10.1097/PHM.0000000000002433

Enhanced External Counterpulsation Improves Cognitive Function of Persons with Long COVID

Am J Phys Med Rehabil. 2024 Jan 3. doi: 10.1097/PHM.0000000000002433. Online ahead of print.

Authors

Mohanakrishnan Sathyamoorthy¹, Rajkumar J Sevak², Juan Cabrera³, Marielisa Lopez³, Jessie Fox⁴, Sachin A Shah, Monica Verduzco-Gutierrez⁵

Affiliations

¹ Department of Internal Medicine, Burnett School of Medicine at Texas Christian University, Fort Worth, TX, USA and Consultants in Cardiovascular Medicine and Science - Fort Worth, Fort Worth, TX, USA.
² Department of Pharmacy Practice, Thomas J Long School of Pharmacy, University of the Pacific, Stockton, CA, USA.
³ Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, TX, USA.
⁴ Flow Therapy, Fort Worth, TX, USA.
⁵ Department of Physical Medicine and Rehabilitation, Joe R. and Teresa Lozano Long School of Medicine, San Antonio, TX, USA.

PMID: 38206585
DOI: 10.1097/PHM.0000000000002433

Abstract

Objective: To determine the effects of Enhanced External Counterpulsation (EECP) in patients with long COVID and objectively assessed cognitive impairment.

Design: A retrospective evaluation of long COVID patients referred for EECP, with cognitive sequela, and having completed an objective digital assessment before and after therapy. Patients had either cognitive impairment (CI) or no cognitive impairment (NCI) at baseline. We assessed changes in composite score using multi-factor ANOVA. Multiple linear and logistic regression analyses were conducted to evaluate several independent variables.

Results: 80 long COVID patients (38 CI vs 42 NCI) were included for analyses. All baseline characteristics were well matched. There was significant improvement in composite score post-EECP in those with objective cognitive impairment at baseline. There were no notable documented safety concerns.

Conclusion: This is the first study showing that EECP led to significant improvement in cognitive functioning of long COVID patients with objectively defined cognitive impairment. Although a lack of a negative control group is a limitation of this study, EECP appears to be highly safe and effective with the potential for widespread application.