Long COVID and Brain Fog

by Adam Brown   BScPT   MClScPT   FCAMPT
Registered Physiotherapist
updated July 26, 2021

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Long COVID is quickly becoming the next major health crisis that the international medical community will face. A recent study from the United Kingdom identified 200 different symptoms that long hauler were experiencing. These symptoms spanned 10 of the body’s organ systems showing how widely this virus can impact humans.

One of the most reported symptoms is called brain fog.

 

What is Brain Fog?

Brain fog can take several different forms and each patient’s description and experience is unique. It involves an alteration in the person’s capacity for cognition or in lay terms, difficulty with concentration, attention and thinking tasks. Environments with complex stimuli such as a moving car, or watching a fast moving action film can be very difficult to process and may make symptoms worse.

Symptoms Of Brain Fog:

• Difficulty with concentration
• Irritability
• Slower reaction times
• Speech difficulties
• Fatigue

 

What Causes Brain Fog?

The exact physiological changes that cause brain fog are still being researched and may be different for different patients.

Research on COVID-19 has shown that the virus can have a direct effect on neural and brain tissue. This can cause relatively mild symptoms, like the widely reported loss of smell. It can also become quite severe leading to encephalitis or inflammation of the brain itself.

Some COVID-19 patients experience a condition called a cytokine storm. This is a widespread exaggerated immune response that can impact the brain and other important tissues of the body.

Some other factors that have been identified that may contribute to brain fog are:

• Insomnia
• Concurrent depression
• Decreased physical activity
• High levels of anxiety and stress
• Some medications

 

Who Is At Risk of Having Brain Fog?

At this point it’s not clear why some patients experience brain fog and others do not. Recent studies (found here and here) have suggested that between 7-69% of people infected with COVID-19 may experience some degree of brain impairment.

It is thought that the degree of brain fog is determined by a combination of the severity of COVID-19 infection and the resilience of the person’s brain to adapt and compensate for damage.

However it’s important to note that this problem is still being investigated and the understanding is incomplete. It would not be appropriate to make judgements or statements about why a particular patient is experiencing more brain fog.

 

How Long Does Brain Fog Last After COVID-19?

This is the big question that many patients would like answered. Unfortunately we have not been dealing with this problem long enough to be able to answer with certainty. With other similar neurological conditions approximately two thirds of patients will recover within 6-12 months, while one third may have longer lasting or permanent symptoms. Brain fog related to COVID-19 seems to be following a similar pattern.

 

How are Brain Fog Symptoms Reduced?

While the most powerful factor in the recovery of brain fog symptoms is time. There are some strategies and best practices that can be implemented in an attempt to help the brain recover.

When recovering from an illness, good health hygiene is key to recovering efficiently. The following are steps that patients can take to ensure they are providing the best chance of recovery.

• Avoid smoking and alcohol
• Treat any other neurological or mental health conditions
• Keep other metabolic conditions like high blood pressure and diabetes under control
• Eat a healthy diet, and eat plenty of calories to support recovery.
• Try to get plenty of sleep (Long COVID can also cause insomnia which can make this a challenge)
• If you are able to tolerate some exercise it may help with recovery. Keeping in mind any limitations from post-exertional malaise (PEM).

 

With Long COVID, no single symptom can be treated in isolation. As you can see insomnia, PEM, fatigue and pain conditions all impact recovery from brain fog. If possible, connect with a great team of medical professionals who are studying this condition to help you navigate your recovery.