000169378 001__ 169378 000169378 005__ 20260225105429.0 000169378 0247_ $$2doi$$a10.1371/journal.pone.0342908 000169378 0248_ $$2sideral$$a148324 000169378 037__ $$aART-2026-148324 000169378 041__ $$aeng 000169378 100__ $$0(orcid)0000-0003-2082-8115$$aMartínez-Borba, Verónica$$uUniversidad de Zaragoza 000169378 245__ $$aEffectiveness and acceptability of the unified protocol for the transdiagnostic treatment of emotional disorders in people with long COVID-19: Study protocol for a randomized controlled trial 000169378 260__ $$c2026 000169378 5060_ $$aAccess copy available to the general public$$fUnrestricted 000169378 5203_ $$aBackground: Long COVID-19 is a medical condition associated with persistent physical, cognitive, and emotional symptoms. Despite its significant impact, there are still few psychological interventions—especially with transdiagnostic approaches— that have been rigorously tested in this population. The aim of the present protocol is to describe a randomized controlled trial to examine the effectiveness and acceptability of the online, group-delivered Unified Protocol (UP) for improving emotional, and cognitive outcomes in adults with long COVID-19. We expect greater improvements in emotional and cognitive outcomes for the UP group compared to controls. Additionally, exploratory analyses will assess changes in neurocognitive performance and hair cortisol/cortisone levels as potential correlates of treatment response. Methods: 90 individuals diagnosed with long COVID-19 will be randomized to an experimental group or a waiting-list control group (1:1 ratio). Participants in the experimental group will receive the UP across 12 online group sessions. Longitudinal assessments (pre-treatment, post-treatment and 3, 6 and 12 months follow-ups) will include psychological (e.g., anxiety and depressive symptoms) and cognitive outcomes (e.g., memory failures). Participants in the experimental group will also complete neuropsychological tests and will provide hair samples for the assessment of cortisol/cortisone levels. Data analyses: Baseline characteristics will be described using descriptive statistics, and linear mixed-effects models will evaluate the effects of time, group, and their interaction on psychological and cognitive outcomes. Neuropsychological performance and hair cortisol levels will be analyzed over time in the experimental group. Associations between cortisol and psychological or cognitive measures will be explored through correlational analyses. Conclusions: We expect positive outcomes after the intervention in acceptability and in emotional symptoms and cognitive complaints in individuals living with long COVID-19, the maintenance of the benefits in all follow-ups, and statistically significant changes in favor of the UP condition in comparison with the waiting-list control group. If effective, the UP could provide an accessible and evidence-based psychological treatment for this population, improving the quality of healthcare to individuals with long COVID-19. Trial registration: clinicatrials.gov (registration identifier: NCT06928480; May 22, 2025). 000169378 536__ $$9info:eu-repo/grantAgreement/ES/DGA/S31-23R 000169378 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttps://creativecommons.org/licenses/by/4.0/deed.es 000169378 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000169378 700__ $$aRodríguez-Márquez, Andrés E.$$uUniversidad de Zaragoza 000169378 700__ $$0(orcid)0000-0001-6285-8158$$aGarcés-Arilla, Sara$$uUniversidad de Zaragoza 000169378 700__ $$0(orcid)0000-0002-2437-1207$$aPeris-Baquero, Óscar$$uUniversidad de Zaragoza 000169378 700__ $$0(orcid)0000-0001-9726-3250$$aNavarro-Haro, María Vicenta$$uUniversidad de Zaragoza 000169378 700__ $$0(orcid)0000-0001-9815-358X$$adel Corral-Beamonte, Esther$$uUniversidad de Zaragoza 000169378 700__ $$0(orcid)0000-0002-7293-318X$$aOsma, Jorge$$uUniversidad de Zaragoza 000169378 7102_ $$14009$$2620$$aUniversidad de Zaragoza$$bDpto. Psicología y Sociología$$cÁrea Metod.Ciencias Comportam. 000169378 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina 000169378 7102_ $$14009$$2680$$aUniversidad de Zaragoza$$bDpto. Psicología y Sociología$$cÁrea Person.Eval.Trat.Psicoló. 000169378 773__ $$g21, 2 (2026), e0342908 [16 pp.]$$pPLoS One$$tPLoS ONE$$x1932-6203 000169378 8564_ $$s610675$$uhttps://zaguan.unizar.es/record/169378/files/texto_completo.pdf$$yVersión publicada 000169378 8564_ $$s2147770$$uhttps://zaguan.unizar.es/record/169378/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000169378 909CO $$ooai:zaguan.unizar.es:169378$$particulos$$pdriver 000169378 951__ $$a2026-02-24-14:47:52 000169378 980__ $$aARTICLE