COVID-19 and Brain Fog: A Possible Long-Term Effect

Because COVID-19 is a new virus, it is too early to make definitive statements on how it affects the neurological system. New reports are raising concerns about lingering “brain fog” some COVID-19 patients are experiencing.

These reports are shedding light on more short-term and, potentially, longer-term health consequences of COVID-19.

Specifically, researchers are finding lingering cognitive difficulty, like short-term memory trouble, slowed processing speed, trouble with focus and mental fatigue.

This same effect was observed in previous outbreaks of other forms of coronavirus, such as SARS and MERS. The reason for this involves our brain’s substantial need for regular oxygen to function properly. Changes in our brain’s ability to get oxygen can damage brain cells; in turn, this can contribute to cognitive trouble.

While we cannot completely compare SARS/MERS patients to COVID-19 patients, previous studies on patients with acute respiratory distress syndromes (ARDS) show the following patterns:

Hospitalization and intensive care increase the likelihood of cognitive trouble. Fully 70% to 100% of discharged ARDS patients have objective impairment on cognitive tests. Objective impairment means experiencing greater difficulty on cognitive tests when compared with people your own age. Significant cognitive trouble in non-hospitalized patients is much less common.

Favorably, there is usually significant improvement within the first 12-months, with some patients returning back to their normal self.

For those who are still having cognitive symptoms at the one-year mark, studies do show some improvement even in the second and third years after hospitalization.

Aside from cognitive and neurologic complications from COVID-19, it is also quite common for patients to develop psychiatric symptoms (PTSD, anxiety, depression, insomnia). A new paper, co-authored by clinical professor and neuropsychologist Andrew Levine, MD, of the David Geffen School of Medicine at UCLA, and graduate student Erin Kaseda, of Rosalind Franklin University of Medicine and Science, in Chicago, suggests that brain fog and other neurological symptoms present after recovering from COVID-19 might be due to post-traumatic stress disorder (PTSD).

Patients who have recovered from COVID-19 but continue to have cognitive problems, including brain fog, can be evaluated by a neuropsychologist at Ochsner’s Brain Health Center.

Neuropsychological assessments will help you understand whether you are having significant cognitive trouble and the right treatment pathway. (Should you address anxiety, focus on cognitive strategies or something else?)

If you or a family member is starting to display neurological complications, you should contact your medical provider immediately. Continue to take all necessary steps to keep yourself safe from viruses, including wearing face masks and frequently washing your hands.