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Posted on: November 25, 2020

COVID-19 Long Haulers Lost in a Brain Fog

Throughout the past few months so many of us have spent time worrying about the coronavirus and the long term harm that it could possibly do to our lungs. Unfortunately, respiratory damage is only one of a multitude of possible symptoms that COVID-19 long haulers are continuing to experience weeks or even months after their diagnosis. Concerns are now emerging about how it may affect us cognitively as well. More and more people who have survived COVID-19 are now finding that they are struggling with “brain fog.” This term encompasses a variety of possible symptoms such as “memory loss, confusion, difficulty focusing, dizziness and grasping for everyday words.” This is in addition to other possible long term neurological symptoms, including anxiety, depression, fatigue, muscle weakness, and nerve damage. Not everyone who has survived COVID-19 experiences these symptoms, but it can be debilitating for those who do. It is especially a concern for older individuals who are already at risk for cognitive decline such as dementia.

Research is being done to try to better understand why some survivors experience brain fog. One possible cause is Post-Traumatic Stress Disorder. The experience of having COVID-19, especially (but not exclusively) for those who required intubation and/or ventillation, may have been so horrifying that it resulted in PTSD. This is something that has been seen previously in other coronavirus outbreaks and it is believed that up to 25% of COVID-19 survivors who had been in intensive care experience PTSD. The psychological trauma of being sick can be so severe that it interferes with cognitive functioning. However, brain fog is experienced by many individuals whose cases were not severe enough to require hospitalization.

Other hypotheses focus on possible physical reasons why the coronavirus could interfere with cognitive functioning, especially as these symptoms are not exclusive to those who suffered from severe cases of COVID-19. The hypotheses include inflammation of the body, inflammation of the brain, and damage to the nervous system. The virus can activate a receptor found in the nervous system, potentially causing damage. Some experts have noted the similarities between COVID-19 brain fog and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), which often begins with some sort of infection.

If brain fog has become a concern for you, it is important to speak with your doctor. Keeping track of your symptoms and providing information about how your functioning compares to before you were sick can help to give your doctor a more complete understanding of your situation. It may be recommend that you be evaluated by a neuropsychologist to learn more about your cognitive functioning. A cognitive evaluation can show what your current level of functioning is with regards to areas such as memory, attention, comprehension, and processing. It can be used to determine if you have a true deficit in your abilities. The neuropsychologist can make recommendations for accommodations or changes that could be made while you recover, as well as possible methods to strengthen your abilities.

As there is so much still unknown about COVID-19 brain fog, many professionals are looking at treatments used for other types of cognitive issues. They may make lifestyle recommendations, such as eating a healthy diet, getting enough sleep, and engaging in regular cognitive and physical exercise.  The National Health Service in the UK gives recommendations for managing your daily activities as you recover from COVID.

What we know about the coronavirus is changing all of the time. Research is constantly being done to learn about how it affects us both when when infected and during recovery. The more that is understood, the more that medical professionals are able to help us.

Resources

Managing Daily Activities

References

https://www.theatlantic.com/health/archive/2020/08/long-haulers-covid-19-recognition-support-groups-symptoms/615382/

https://www.nytimes.com/2020/10/11/health/covid-survivors.html

https://blogs.scientificamerican.com/observations/a-tsunami-of-dementia-could-be-on-the-way/

https://www.uclahealth.org/brain-fog-following-covid-19-recovery-may-indicate-ptsd

https://www.theguardian.com/world/2020/oct/09/brain-fog-the-people-struggling-to-think-clearly-months-after-covid

https://www.cuimc.columbia.edu/news/even-mild-cases-can-cause-covid-19-fog

https://www.apa.org/monitor/2020/09/aftermath-covid-19

https://www.psychologytoday.com/us/blog/neuroscience-in-everyday-life/202007/what-after-surviving-covid-19-brain-fog-fatigue-and-pain

https://jamanetwork.com/journals/jama/fullarticle/2771111

https://www.wired.com/story/confused-about-covid-brain-fog-doctors-have-questions-too/
https://covid.joinzoe.com/us-2