Covid & the brain: How to deal with post-Covid brain fog and when to seek medical attention

By Dr PN Renjen & Dr Dinesh Chaudhari

Is brain fog real in a neurological sense as a post-Covid complication or is it just a result of stress?

Yes, post-Covid brain fog is for real. Brain fog, a term used to describe slow or sluggish thinking, can occur under many different circumstances—for example, when someone is sleep-deprived or feeling unwell, or due to side effects from medicines that cause drowsiness. Brain fog can also occur following chemotherapy or a concussion. There are many ways that Covid-19 can damage the brain. Some of the neurological complications of Covid can be devastating, such as encephalitis, strokes, and lack of oxygen to the brain. But other effects may be subtler, such as the persistent impairment in sustained attention. People struggling with the effects of long Covid may have noticeable problems with attention, memory, and executive function.

In addition to direct effects on the brain, can Covid-19 also have long-term effects on other organ systems?
Most people think of Covid-19 as a respiratory disease, which it is, but part of the body’s defence against the disease is an immune response. According to the CDC, the most common lasting symptoms are fatigue, shortness of breath, cough, joint pain and chest pain. Other issues include cognitive problems, difficulty concentrating, depression, muscle pain, headache, rapid heartbeat and intermittent fever. Long-term effects of Covid are also seen on the kidney and heart.

Can you share some medical breakthroughs and theories on this to enlighten the common person?
There have been a lot of such studies. A recent analysis by Sandra Lopez-Leon, et al, “More than 50 long-term effects of COVID-19: A systematic review and meta-analysis”, throws light on the same. The studies defined long-Covid as ranging from 14 to 110 days’ post-viral infection. It was estimated that 80% of the infected patients with SARS-CoV-2 developed one or more long-term symptoms. The five most common symptoms were fatigue (58%), headache (44%), attention disorder (27%), hair loss (25%) and shortness of breath (24%).

How worried should patients be? Can it signify any serious issues?
Patients need not worry and be stressed about brain fog. However, it must be discussed with the treating doctor at the earliest. Instead of worrying about the loss of concentration or getting embarrassed about it, visit a doctor.
You should know that many people are experiencing this after recovery from Covid infection. Therefore, getting timely medical assistance will only help you get back to normal. Conditions related to brain dysfunction should be dealt with carefully because, if left uncared, these conditions will aggravate further.

Under what conditions should patients seek medical advice?
Long-term Covid-19 symptoms can be similar to signs of another disease, so it is important to see your doctor and rule out other problems, such as cardiac issues or lung disease. Don’t ignore the loss of smell, depression, anxiety or insomnia, or write these off as unimportant or “all in your head.” Any symptom that interferes with your daily life is worth a call to your doctor, who can help you address these problems and improve the quality of your life.

Are there any lifestyle changes that can help?
To help clear the brain fog one should pursue all of the activities that we know help everyone’s thinking and memory:
Regular exercises: Generally recommended exercise for 30 minutes a day, five days a week.
Eat healthy meals: A healthy diet including olive oil, fruits and vegetables, nuts and beans and whole grains has been proven to improve thinking, memory and brain health.
Sleep well: Sleep is a time when the brain and body can clear out toxins and work toward healing. Make sure you give your body the sleep it needs.
Be active: Pursue other beneficial activities, including engaging in the novel, cognitively stimulating activities; listening to music; practising mindfulness; and keeping a positive mental attitude.

Dr PN Renjen & Dr Dinesh Chaudhari are neurologists at Indraprastha Apollo Hospital, New Delhi