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April 19, 2022

Brain fog is common among long COVID sufferers, but there are ways to treat it

Inflammation caused by an overactive immune response may be to blame for cognitive difficulties, experts say

Adult Health COVID-19
COVID brain fog Engin Akyurt/Pixabay

Brain fog isn't a medical term, but it is often used to describe a lack of mental clarity or fuzzy thinking.

One of the most common issues people experience when dealing with long COVID-19 is a lingering brain fog that can make daily activities more challenging to carry out.

Nearly 40% of those who recover from COVID-19 infections suffer from the debilitating syndrome. While it's not life-threatening, there currently is no cure or exact treatment, but experts say that there are some ways to help reduce the severity of symptoms. 

What is brain fog?

Some people with long COVID struggle for weeks or even months with cognitive difficulties, including short-term memory loss and concentration issues.

Brain fog isn't a medical term. It is used to describe fuzzy thinking or when a person feels a lack of mental clarity. People who report having it say they experience confusion, memory loss, and difficulties focusing and recalling words. They are also often easily distracted.

In severe cases, it can affect a person's ability to do their job and complete simple daily tasks.

Comparing long COVID to other conditions causing cognitive difficulties

COVID0-19 brain fog is one of the most common complaints by long-haul sufferers of the coronavirus. In a survey published in the July 2021 issue of The Lancet's EClinical Medicine, 85% of the 3,762 participants with COVID-19 experienced brain fog.

As more data is available about patients with cognitive symptoms, investigators are beginning to put together a picture of what might be causing them.

One new study by researchers at the University of California, San Francisco, found that people with post-recovery brain fog have abnormalities in their cerebrospinal fluid, which surrounds the brain inside the skull.

These abnormalities were present in study participants of all ages and among patients who had varying degrees of infection severity. The participants were all unvaccinated before they developed the cognitive impairment. Individuals with more health risk factors were more likely to experience COVID brain fog than those who had fewer.

Serena Spudich, a professor of neurology at the Yale University School of Medicine who has treated patients at Yale’s neuroCOVID-19 clinic, told Everyday Health that inflammation caused by an overactive immune response may be to blame. The same mechanism is thought to be behind other COVID symptoms, including breathing difficulties.

Although more research is needed to confirm the exact mechanism behind COVID brain fog, Spudich says some studies have shown the presence of autoantibodies – which are created when the immune system attacks itself – in the cerebrospinal fluid of COVID-19 patients with neurological symptoms.

Other researchers have been comparing COVID brain fog to conditions that cause similar cognitive difficulties. Comparable changes in specialized cells, called the microglia, that serve as the brain's surveillance and defense system have been found in cancer patients being treated with chemotherapy and among people with Alzheimer's disease. The microglia also are affected in other post-viral syndromes related to infections like influenza, Epstein-Barr, HIV and Ebola, the Washington Post reported.

Stanford University neuroscientist Michelle Monje told The Post that studying these other conditions could lead to treatments for people suffering from severe COVID brain fog.

Tips for improving mental clarity

Patients with COVID brain fog may benefit from cognitive rehabilitation, which is like physical therapy for the brain. It is regularly used to help patients recover from traumatic brain injuries, strokes and concussions.

Cognitive rehab gives patients strategies to improve the specific issues they are having. For example, in treating a person with memory issues, a therapist may help build a memory support system that includes a calendar for recording important appointments and activities.

And if someone is easily distracted or struggling with concentration, a therapist can help the patient develop ways to mark where they are in current tasks before moving on to another, so that it's easier to return to the initial activity.

Harvard Health recommends some other activities people can do on their own, which have been proven to strengthen cognitive function. These include:

Aerobic exercise. Start slow if you need to, but try to build up to 30 minutes a day, five days a week.
Follow a Mediterranean-style diet that includes olive oil, fruits, vegetables, nuts, beans and whole grains.
• Don't drink alcohol or take drugs in order to give your brain a chance to heal.
• Make sure you are getting enough sleep which helps the brain and body clear out toxins.
 Spend time with family and friends. Social activities can improve thinking and memory
• Engage in other activities that stimulate the brain such as reading, listening to music and practicing mindfulness.

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