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Writer's pictureDr Ilene Naomi Rusk

Can COVID-19 Lead to Long-Haul Cognitive Decline? How can you Help?

Updated: Sep 26, 2023




The COVID-19 pandemic presented the entire globe with numerous unpredictabilities. From not knowing when it was safe to go outside again, to not coming within six feet of dear friends and family, to mourning millions of COVID-related deaths, the pandemic taught us all the value of adaptability in the face of terrifying uncertainties.


As we get on with our lives after the global pandemic, there are still many uncertainties that remain relating to the long-term impact of this relentless virus. One of the uncertainties we are still working to understand is the nature of post-COVID-19 cognitive impairment, as well as the impact of different strains of COVID-19 that are still being spread today.


What is Post-COVID-19 Brain Fog?

Cognitive problems and cognitive decline are some of the most commonly reported long-term symptoms that reside after being infected by SARS-CoV-2. Findings from in-depth clinical studies on patients infected with COVID-19 report symptoms such as deficits in attention, executive functioning, language, processing speed, and memory for twelve or more weeks following their initial diagnosis.


In addition to symptoms of cognitive impairment, patients have also frequently reported an increase in mental health problems after COVID, such as a spike in anxiety and depression. These lingering symptoms have been collectively referred to as “brain fog”, while the patients experiencing these symptoms are often called “COVID-19 long haulers”.


Additionally, long-COVID is often associated with an autonomic nervous system disorder called dysautonomia. This disorder takes place when the nervous system, or the “automatic" nervous system is not functioning properly, which long-COVID can induce. It allows for some very basic physiological symptoms like breathing and heart rate can go awry. This condition often mimics syndromes like post viral fatigue syndrome and chronic fatigue syndrome. However, it is an independent disorder. Fatigue and mitochondrial health are often issues in long-COVID, but inflammation in the body and the brain is the more concerning repercussion.


What Causes Post-COVID Cognitive Changes?

It is challenging to directly identify the exact cause of long COVID brain fog, as psychologists and neuroscientists cannot directly separate COVID-related cognitive problems from other reasons an individual may be experiencing mental symptoms. In addition to the SARS-CoV-2 virus itself, the pandemic also brought about a stark increase in social, economic, and interpersonal stressors for millions, which could also be connected to residual mental issues.


While correlation does not always directly equal causation, recent data does tend toward a solid connection between COVID-19 and fatigue / cognitive impairment. A study done by The Lancet Discovery Science found that COVID patients had a more than two-fold higher rate of fatigue when compared to the non-infected control group in the study. Additionally, a recent meta-analysis done by the Brain, Behavior, and Immunity Journal concluded that one-third of patients previously impacted by COVID-19 have experienced persisting symptoms of fatigue after being infected. These numbers signify that long COVID is likely a crucial public health crisis, impacting millions of previously infected patients across the globe.


An additional study conducted by neuroscientist Fernández-Castañeda and their team presented the neuroscience community with a more conclusive understanding of the possible reasons for COVID’s residual mental impact. Castañeda’s team used mice to test the ways that mild-respiratory infections (as seen with SARS-CoV-2) can induce neurological inflammation and lead to successive brain damage.


These neuroscientists injected the viral-entry receptor for SARS-CoV-2 into the mice through the nose, and quickly observed signs of neuroinflammation and increased levels of chemokines in cerebrospinal fluid and serum, without actually observing SARS-CoV-2 in the brain itself. The increase in chemokines, cytokines, and other cellular factors is where scientists predict the problem might lie.


This spike in chemokines and cytokines led to the activation of microglia in the brain’s white matter. While microglia typically aid the homeostasis of the nervous system, they can also flip into a toxic state, which is what occurred with Castañeda’s mice model. The activation of toxic microglia in the hippocampus hindered the formation of new neurons in the brains of these mice. This study predicts that this might be the catalyst for post-COVID brain fog.


How to Help your Mind When Experiencing Long-COVID Brain Fog

As we collectively recover from all the repercussions of the COVID-19 pandemic, it’s important to remember that you aren’t alone in the way this challenging virus may be impacting you still. It’s okay to feel as if things aren’t fully back to the way they were before 2020. It’s okay to still be experiencing mental struggles that keep you from springing right back to your pre-COVID self.


Don’t let COVID brain fog scare you. If you or a friend or family member is experiencing symptoms of long-COVID brain fog or an increase in anxiety and depression, there are many ways you can work to mitigate these lasting effects. You deserve to feel holistically better about your daily post-pandemic life.


Simple Ways to Help with COVID Brain Fog:

  1. Increase the amount of sleep you get each night

  2. Try various forms of meditation and gratitude recognition

  3. Increase endorphins by moving your body each day

  4. Introduce talk-therapy into your week

  5. Prioritize activities that bring you genuine peace and joy

  6. Refresh your diet to be nutrient rich

  7. Make it a priority to stay hydrated

  8. Integrate activities into your life that increase neuroplasticity

  9. Work on emotional resilience to decrease worry and fear

  10. Prioritize time with family, friends, and loved ones

  11. Spend time in nature

It’s also encouraging to note that the increase in medical explanations surrounding long COVID could lead to potential medications, cures, and other medically supported symptom alleviations. In the meantime, it’s important to prioritize your emotional wellness as best you can, while keeping in mind that hope for even more healing after COVID-19 is just around the corner.

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