COVID-19 may have long-term effects on the brain

We are in the third year of the COVID-19 pandemic and we’re learning more about the virus every day. But one aspect that remains a bit of a mystery is long COVID, also referred to as post-COVID conditions.

As society tries to get back to “normal,” for people with long-haul COVID-19, this isn’t a possibility just yet. It’s estimated that long COVID has potentially affected around 24 million people in the U.S. and can include a wide range of ongoing health problems lasting weeks, months or longer beyond the initial viral infection.

“Long COVID is caused initially by COVID-19 infection and is diagnosed clinically based on the full scope of symptoms the patient is experiencing,” says Dr. Jyotu Sandhu, a family medicine doctor with Sharp Rees-Stealy Medical Group. “There is no specific test for it. Patients with long COVID typically report persistent or returning symptoms that last four or more weeks after the initial infection.”

Cognitive impacts of long COVID
So far, long COVID has been associated with more than 50 conditions and 200 symptoms. One of the most common symptoms is “brain fog.” Used as an umbrella term to describe cognitive symptoms, including problems with thinking, memory and concentration, brain fog can make basic cognitive tasks absurdly hard. Brain fog affects executive function which involves cognitive processes and mental skills used for focusing attention, blocking out distractions and maintaining information.

Roughly 20% to 30% of COVID patients have some brain fog that persists or develops during the three months after their initial infection. Many people with long COVID report instances such as difficulty coming up with words and names; trouble multitasking and organizing; and feeling easily confused. These problems affect daily life and can make it challenging and frustrating to perform even the simplest of tasks.

Many cancer patients experience something similar during or after chemotherapy, often called “chemo brain” or “chemo fog.” Chemo fog is related to the inflammation of neurons, and it’s believed that COVID-19 might be causing brain fog in a similar way.

How COVID-19 affects the brain
In a collaborative study, researchers at Yale University and Stanford University found that a heightened state of inflammation during COVID-19 infection can trigger excessive activation of microglial cells — the main immune cells of the central nervous system. Despite existing to protect us, when the microglial cells go haywire, they can cause additional inflammation that disturbs the sensitive microenvironment of the brain and disrupts healthy cognitive function. Even a mild case of COVID-19 could cause long-term changes to the immune system and neurons, the study shows.

The devastating long-term effects of COVID-19 don’t end there. New research published in Nature Medicine found that brain and neurological disorders — including stroke, migraine, and depression and anxiety — occurred 7% more often in people who had COVID-19 compared to those who were never infected. Those who had COVID were 77% more likely to develop memory problems, 80% more likely to have seizures and 43% more likely to have mental health issues.

Tackling a multifaceted condition
Unfortunately, there isn't one single treatment or medication to treat long COVID. There are studies currently underway to better understand it and develop treatments to combat symptoms.

Dr. Sandhu says treatment often includes a comprehensive plan with multiple specialists based on symptoms. “Examples include counseling and support for those dealing with anxiety and depression, diabetic care, medication management, physical therapy and cardiopulmonary rehabilitation,” he explains.

As winter months near, an expected rise in cases coupled with fewer COVID protections could mean millions more will get long COVID. Dr. Sandhu recommends getting vaccinated as the main way to help prevent COVID-19 and possible long-term symptoms.

If you suspect you might have long COVID, talk with your doctor. Your care team can assess and diagnose the condition appropriately to determine if it is long-haul COVID-19 or other related conditions.

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