Written by Dr. Inez Van Roy on
May 8, 2022
Reading Time: 5 minutes

Medically Reviewed by our Medical Affairs Team

Written by Dr. Inez Van Roy on:

While most people recover from coronavirus within weeks, the Mayo Clinic reports that brain fog symptoms can linger more than four or 12 weeks. Covid brain fog symptoms are some of the more impactful symptoms. They impact your thinking ability and your confidence. You might not be able to concentrate on tasks that were easier before.

What is covid brain fog?

Covid brain fog usually refers to the neurocognitive symptoms felt after suffering from COVID-19.

Cognitive impairments affects attention, executive function, language, and memory. Patients usually describe difficulty in thinking and reasoning. They can’t concentrate, remember things, process information, learn, speak and understand.

Others might refer to the issue as ‘clinical or profound brain dysfunction’, ‘neurocognitive fatigue’, or ‘brain impairment’.

On top of this, people also suffer from physical symptoms and fatigue, after initial recovery.

About ten percent of patients feel impedes in their daily and professional life up until 12 weeks after infection.

Outside of the impact on their daily life and occupation, long haul covid also comes with guilt and shame. Patients feel anxious about their abilities or self-worth.

What about brain health for the uninfected?

If not tested positive, you can still suffer from a lack of mental clarity. A research study from the Massachusetts General Hospital found that the lockdown might affect some people. Those who interpret the lockdown as a stressor might suffer from more brain fog. 

Stress is known to negatively impact brain health, and as such contribute to inflammation. Positive health adaptations, such as exercise, might aid your symptoms

Covid Brain Fog Symptoms

The NHS.scot confirms in March 2022 that brain fog is not a diagnosis. As described above, the symptoms would look like this:

  • poor concentration
  • feeling confused
  • thinking slower
  • fuzzy thoughts
  • forgetfulness
  • Difficulty finding words
  • mental fatigue.

They make the comparison of how people feel with a lack of sleep, or when they are drunk, highly stressed, or suffer from depression or anxiety. Our brain doesn’t work optimally.

Covid Mental Fog Diagnosis

There is no official way to diagnose covid mental fog at this point. If you show mental fog after initial recovery from COVID-19, you should contact your doctor. They will exclude other causes and refer you to a specialist (e.g., a neuropsychologist) so they can assess your cognitive functioning.

Most people show deficits in executive functioning, memory, and language. Experts most likely will focus on assessing the functions related to the symptoms you show.

Pandemic Mental Fog Remedies

Usually, the pandemic mental fog will reside on its own, after you are healed from COVID.

If your mental clarity stays low, we would recommend:

  • Drinking enough water.
  • Sleeping around 8 hours daily.
  • Exercising regularly.
  • Choosing a healthy and balanced diet, a Mediterranean diet could be a good example.
  • Meditating and taking breaks when needed.
  • Stop smoking, drinking alcohol, and consuming illegal drugs.
  • Spending time with your hobbies.
  • Spending time with friends, and family.
  • Using neuropsychological strategies to implement structure in your life and thinking tasks.

How COVID-19 Affects the Brain

COVID-19 is associated with neural damage. There seem to be functional and structural changes occurring in the brain.

What seems to be common is:

  • loss of gray matter
  • neuro-inflammation

Post-mortem research showed proof of structural changes. There was proof of ischemic lesions and neuro-inflammation. Other studies also showed structural changes in:

  • the orbitofrontal cortex
  • the medial temporal lobe
  • the hippocampus
  • the thalamus
  • and sub-insular regions.

These regions, or those connected with the olfactory system, lose gray matter. The left hemisphere seems to be the most affected.

Knowing this information, there are two possible causes of COVID brain fog:

  • COVID enters the brain through the olfactory system (the nose), and wreaks havoc. It attacks the brain through an asymmetrical connection.
  • COVID interacts with our immune system. Those with obvious brain fog show a different or overactive immune response. Their system attacks their own cells, causing a lack of mental clarity. More information on this hypothesis can be found under the cerebrospinal fluid headline of this article.

Irrelevant of the cause is the fact that some people experience brain fog, in our brain this looks like inflammation. The areas most affected are regions connected through the nose and further down that stream. These interconnected areas are mostly associated with memory and executive thinking. This could explain foggy thinking. More research is needed to understand what is happening.

Another risk regarding COVID is abnormal blood clotting and increased risk for CVAs or strokes. Mostly hospitalized patients seem at risk.

How common is it for COVID-19 patients to experience persistent neurological symptoms?

Most people recover within weeks from SARS-CoV-2 infection. Those with persistent neurological issues mostly have long COVID.

Long haulers show symptoms longer than 4 weeks. Other guidelines might indicate long COVID as 12 weeks of symptoms. Other words used for this group of people are: “post-COVID syndrome” or “post-acute sequelae SARS-CoV-2” (PASC).

While research is still ongoing, the CDC estimates at this date that 13.3% of the infected show symptoms for longer than one month, and 2.5% for longer than 3 months.

About 10 to 25% of those with post COVID syndrome experience persistent neurological symptoms. Cognitive performance seems altered in line with their self-reported fatigue or neurological symptoms.

People with mild (initial) COVID can also suffer from long-term symptoms. Previously hospitalized patients form a big chunk of those still suffering after six months (30%).

What to do if you suspect lingering symptoms, after recovering from the infection?

If you suspect ongoing neurological symptoms due to COVID you should contact your doctor. They can give clear advice on testing and treatment options.

They might first test your blood to exclude other biological causes. After they might send you for a neuropsychological assessment to get a better idea of what is going on.

These psychologists can work with you on a rehabilitation plan. This plan could provide tools and coping strategies to make your life easier.

Call 911 if your cognitive symptoms are combined with: 

  • numbness or tingling,
  • changes of vision, or speech.

These are signs of a possible stroke.

Can this virus cause lasting changes to the brain?

It is not clear yet if the virus causes lasting damage to the brain. At this point, we can observe that those who develop long covid show symptoms that last for months. For these people, the cognitive challenges seem stable. They also might be at higher risk for later neurodegeneration.

The cause of post-COVID conditions could be found in Cerebrospinal Fluid.

As mentioned before, COVID 19 might cause inflammation in the brain. Long haulers with cognitive symptoms show difference in their cerebrospinal fluid. They show inflammatory bodies, such as elevated amounts of protein. This indicates a systemic inflammatory response.

Researchers also found specific antibodies in the blood and cerebrospinal fluids. This again confirms inflammation. However, what seems to happen is that these antibodies also seem to attack our system. In other words, our immune system gets activated and seems to confuse our cells as the attacker.

Those with pre-existing conditions and executive misfunctioning, (e.g., ADHD, diabetes, hypertension, learning disabilities, mood disorders) are at higher risk.

Conclusion

If you are experiencing any post covid conditions or cognitive impairment, know that you are not alone. Don’t hesitate to reach out for healthcare providers to help if needed. 

People report experiencing cognitive impairments for up to 12 weeks. If that is the case for you, know that brain fog usually fades out when you recover from the coronavirus. If that is not the case for you, or you want some more help then you can try the above remedies. 

Check out these resources for more information on brain fog and overall brain health. Join our online community for support groups and ideas on how others manage their challenges. And please don’t hesitate to reach out for help.

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