COVID-19 and Brain

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  • About 1/3 of COVID-19 survivors suffer from a variety of symptoms long after they were first infected.

  • Brain fog is one of the symptoms that persist for weeks and months after the disease and significantly affects survivors' everyday functioning.

  • Neuropsychological evaluation can help identify the symptoms of such cognitive problems and provide remediation.

There is a consensus in the medical field that COVID-19 invades and infects brains. According to the University of Washington study published in JAMA in February, 2021, about 1/3 of Covid-19 patients experience symptoms of brain fog, fatigue, exhaustion, shortness of breath, muscle pain and weakness, headaches, insomnia, etc., weeks and months after the disease. The symptoms just do not seem to go away. These patients are called “long haulers”. What is interesting and also puzzling is that there is no pattern to these “long haulers”. Some were very sick, hospitalized and on ventilators and some just had mild symptoms, mostly loss of smell and taste for a while and tiredness. However, most of these patients seem to be in theirs 40ties. So far, medical scientists and practitioners do not have a definite answer as to how this virus is causing long lasting problems. Unfortunately, there is also no consensus upon treatment for “long haulers”.

The good news is that the brain can repair some or most of the damage with time and treatment. How much and how long does it take? This is very individual. Being a brain damage specialist for over 30 years, I have seen patients with quite severe brain trauma who recovered quite well and were able to return to their normal level of functioning. I have also seen patients with mild brain trauma that had long lasting symptoms and were unable to return to their normal level of functioning. I suspect that this will be the case with COVID-19 as well.

What Brain Fog Usually Consists of?

As was mentioned above, brain fog is one of the most difficult symptoms for COVID-19 survivors to deal with in their everyday life. However, brain fog is not a medical terminology. It is rather a description patients use for a variety of symptoms related to difficulty in thinking and daily cognitive functioning. These may include: searching for words, problems with memory, concentration, problem solving, decision making and slowed thoughts. What this means is that brain fog may mean different things for different people or a combination of different symptoms. Also, depression and anxiety affect brain functioning and need to be taken into consideration in the diagnostic process. Different treatment approaches need be used for different symptoms or combination of symptoms. If you are experiencing brain fog, the most important question to answer is what brain fog means for you? What kind of cognitive problems do you have and how much your cognitive functioning has been affected by the disease. When these important questions are answered, the individual and comprehensive treatment program can be designed to treat and/or manage those symptoms.

How to Find Help?

In order to find out what brain fog means for you, find a neuropsychologist who is a provider for your insurance (you can call your insurance or do an internet search) and complete a neuropsychological evaluation. This will help you understand what cognitive processes (memory, attention/concentration, information processing etc.) have been affected in your case and how much (mild, moderate, severe). After the evaluation is completed, you will have an idea which of your cognitive functions are still working quite well and which have been affected by the disease and how much and what is most important, what to do about it? How to improve and/or maintain your cognitive functioning. Also, if you suffer from anxiety and depression, this should be included in your treatment plan. You may be referred to therapy and/or medication management, if necessary. Neuropsychological evaluation is not an answer for every question, but it is the first and a necessary step to understand how your brain has changed after COVID-19 and what you can do to improve your brain functioning.

P.S. Reading about brain and COVID-19 is difficult, especially if you are a “long hauler”; therefore, I want to dedicate a picture of the rose from my garden that is called “Peace Rose” to all my readers with the hope that it will help them find the “peace within”. Good Luck!

Barbara Koltuska-Haskin, Ph.D.