Thursday, June 16, 2022

How Long Does Brain Fog Last After Covid

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What Cdc Is Doing

Battling brain fog after COVID-19

CDC continues to work to identify how common post-COVID conditions are, who is most likely to get them, and why some symptoms eventually improve for some people and may last longer for other people. Rapid and multi-year studies are underway to further investigate post-COVID conditions in more detail. These studies will help us better understand post-COVID conditions and how to treat patients with these longer-term effects.

What Causes Long Covid

The Northwestern study did not look at why some of the symptoms persist and others fade away or why they occur in the first place.

The next step for this is finding out what causes long COVID in the first place and why some people get it and others dont, Koralnik said.

Avindra Nath, the clinical director of the National Institute of Neurological Disorders and Stroke at the National Institutes of Health, who was not involved with the new research, said one hypothesis is that the symptoms in long COVID patients are the result of damage from the bodys inflammatory response to the coronavirus.

Any viral infection activates inflammatory cells throughout the body, including in the brain. The inflammation is meant to attack the invading virus, but it also damages brain cells and neurons in the process.

SARS-CoV-2, the virus that causes COVID, triggers a particularly strong inflammatory response, he said.

COVID is probably the most severe respiratory illness we have ever had, so its no surprise that we are seeing long-term effects from it, Nath said.

Theories About How Neuro

Many hypotheses seek to explain the pathological pathways for the long-term neurological effects of COVID-19. Generic explanations include fatigue post-illness, but these do not explain the changes in brain scans of individuals who have contracted SARS-CoV-2.

Another explanation focuses on post ITU syndrome, but studies show that these symptoms occur in people who have not spent time in the hospital.

Another suggestion for cognitive dysfunction is that microthrombi damage the brain when oxygen levels are low during the acute phase of the illness. However, while this may contribute to the risk, it does not explain the waxing and waning nature of the symptoms nor the ongoing signs of neuroinflammation.

Similarly, residual brain damage from an inflammatory response in the acute phase does not account for the pattern of symptoms and ongoing signs of inflammatory response in the brain.

Prof. de Erausquin and Dr. Visvabharathy discussed the two leading key hypotheses:

  • neurotropism direct infection of the brain with the virus, potentially precipitating protein misfolding and clumping of proteins similar to the pathological process that occurs in Alzheimers disease
  • an inflammatory response possibly with an autoimmune or hyper-inflammatory component.

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/6how Do You Spot Brain Fog

When you struggle with cognitive functioning, you can be sure of brain fog. You may find it difficult to focus or concentrate on your work. At times, it will also be difficult to bring the brain to its normal functioning.

One example that can demonstrate this is when you are talking to someone and lose the train of thought after a few minutes and are unable to keep up with the conversation. Other examples can be getting absent-minded while doing some important work like reading, writing or any household chores.

New Study Offers Clues Into Who Could Get ‘long Covid’

COVID

At first, your doctor might say it’s too early to know if your symptoms are due to COVID-19 and ask you to keep an eye on things for a few months, Becker said. “But I think that a lot of doctors who do their due diligence will say, ‘Let’s do some blood work. Let’s try to figure out what else might be going on.'”

If blood work and screening tests rule out other possible causes, your doctor may recommend you speak to a neuropsychologist for a thorough evaluation, Becker added.

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For the follow-up, the team continued to survey 52 of the original participants, who were patients at the universitys Neuro COVID-19 Clinic – a long COVID clinic – for up to 18 months.

The cohort was three-quarters female, and the average age was 43. Almost 80 per cent were vaccinated, and all had mild COVID symptoms that did not require hospitalisation.

Most neurological symptoms persisted after an average of 15 months, the study found.

While most patients did report improvements in their cognitive function and fatigue, the symptoms had not gone away completely and still affected their quality of life.

A lot of those patients still have difficulties with their cognition that prevent them from working like they used to, study co-leader Igor Koralnik said. Koralnik is the chief of neuro-infectious diseases and global neurology at Northwestern Medicine, and oversees the Neuro COVID-19 Clinic.

The study also found some symptoms, including heart rate and blood pressure variation, as well as gastrointestinal problems, increased over time, while loss of taste and smell tended to improve.

COVID vaccination did not alleviate symptoms, but it also did not make long COVID any worse.

Who Is Most At Risk Of Neuro

Prof. de Erausquin described two groups of patients from his clinics who showed different forms of neuro-COVID. The first group of younger individuals had a more severe respiratory illness in the acute phase. Over time, these patients tended to improve.

A second group he describes as more worrying. They tend to be over 60 years of age and have developed a dementia-like syndrome:

And its a much more dense memory impairment, with a component of also executive dysfunction and language impairment. That is very reminiscent of Alzheimers disease.

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What Kind Of Treatments Are Available

If your cognitive symptoms are due to the lingering effects of COVID-19, both Becker and Jackson recommend asking your doctor about cognitive rehabilitation, a set of treatment options often used to help patients after traumatic brain injuries or to help with issues like “chemo brain.”

Cognitive rehabilitation won’t necessarily cure your post-COVID issues, but “you’re going to learn strategies and work-around solutions to minimize the impact of your cognitive impairment,” Jackson said. He also recommends people pursue computerized cognitive training on their own. And he said that puzzle games like Wordle and sudoku, while certainly not cures, can “promote brain health and be helpful to people with long COVID.”

It’s not clear yet how long these cognitive deficits typically last, Becker said, adding that longer-term studies are sorely needed. In a study published this past October in JAMA Network Open, Becker and her colleagues found that many patients still had issues with things like memory and processing speed more than seven months after their diagnoses. So although these symptoms do seem to improve within a year for a small number of patients, “about a year after COVID, we’re still seeing a large subset of people who are complaining of cognitive deficits,” she said.

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Whats The Link Between Covid

LA research shows post-covid brain fog is due to damaging enzyms

When it comes to the cognitive dysfunction that many survivors of COVID-19 experience, theres still a great deal of uncertainty.

Because this is all a relatively new phenomena the overall understanding continues to evolve, says Scott Kaiser, MD, board certified geriatrician and Director of Geriatric Cognitive Health for the Pacific Neuroscience Institute at Providence Saint Johns Health Center in Santa Monica, California.

According to Dr. Kaiser, there are many potential pathwaysreduced oxygen delivery, reduced blood flow, an attack by the immune system on healthy brain cells, an actual invasion of infectious cells into the brain, or inflammation affecting brain cells. A combination of multiple factors may actually be at play, plus additional factors associated with having COVID-19 may indirectly contribute as well, like increased stress and anxiety, depressed mood, changes in diet, medications, decreased physical activity, poor sleep quality, or even social isolation and feelings of loneliness, he explains.

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What This Means For You

Prolonged COVID-19 symptoms make recovery more difficult, particularly if you previously lived an active life or have existing health conditions that have been exacerbated. Support from family, friends, health care providers, and community organizations can all help you manage your symptoms.

Check out the nonprofit organizations Body Politic and Survivor Corps for online advice and support.

If you think you might benefit from a formal cognitive rehabilitation program, ask your provider to make a referral.

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Recent research has shown that people with mild COVID had a greater decline in executive function — notably in their ability to perform complex tasks — that dovetailed with brain changes seen before and after COVID-19 on an MRI. In a U.K. Biobank study, 401 COVID-19 patients showed a greater loss of gray matter volume and more brain tissue damage an average of 4.5 months after infection compared with people who never were infected.

“The U.K. Biobank study shows the first truly compelling data of a measurable change in the brain structure in people with COVID-19,” said Dr. Serena Spudich, a Yale University neurologist specializing in nervous system infections, who wasn’t involved with the research.

“A key aspect of this study is its focus on people with mild COVID-19,” Spudich told MedPage Today. “Only 4% of patients were hospitalized during their bout of acute COVID-19, so the findings come from a population that parallels the experience of most people worldwide who’ve been infected.”

What drives cognitive symptoms?

What drives post-COVID cognitive changes is still a mystery.

“The mechanisms have not been very well studied,” Nath said. “The indications are that there’s at least a subset of persistent immune activation. Now the question is, what type of immune activation are we seeing?”

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Brain Fog Can Persist 8 Months After Covid: Study

Oct. 25, 2021 â Patients treated for COVID-19 still had high rates of brain fog an average of more than 7 months after diagnosis, a new study finds.

Jacqueline H. Becker, PhD, with the Icahn School of Medicine at Mount Sinai in New York City, led the study, which was online Friday in JAMA Network Open.

The study of 740 people with no prior history of memory problems included people treated as outpatients as well as those who were admitted to a hospital or treated in emergency departments.

The authors say that although older populations are well known to be susceptible to cognitive impairment after a serious illness, this study has implications for younger people as well.

“Many people believe that they will survive COVID and they’ll be just fine and for the majority of the population I think that’s true,â says Becker, a clinical neuropsychologist. âBut I think our paper suggests there are long-term cognitive repercussions from COVID that may impact individuals across various age groups and the spectrum of disease severity.”

Helen Lavretsky, MD, professor in the Department of Psychiatry at UCLA, and a geriatric psychiatrist, says she is seeing similar problems in her patients.

“It is devastating for young people, especially, who were in their best health up until they got COVID,â she says. âSome improve right after COVID, but then lapse and brain fog or cognitive impairment is one of the top three most common symptoms. Others include fatigue and anxiety.”

Who Is At Risk Of Developing Brain Fog

One

Sarah A. Kremen, MD

Scientists don’t yet know who is likely to suffer from post-COVID-19 brain fog. However, there may be a link between the condition and anosmia during active infection.

“A virus can enter the nasal passages where it can then access nerves that lead into the brain. When these neurons are affected, the resulting conditionfrom coronavirus or any other virusis anosmia,” says Dr. Sarah A. Kremen, director of the Neurobehavior Program at the Jona Goldrich Center for Alzheimer’s and Memory Disorders. “Once the virus that causes COVID-19 reaches the olfactory bulb, it can travel long the olfactory pathways to other places in the brain.

While early studies don’t show any correlation between severity of disease and long-hauler symptoms such as brain fog, it makes sense that a brain starving for oxygen is likely to become compromised. Everything from poor heart and lung function to the social isolation caused by COVID-19 can affect cognitive processes. Treatments for COVID-19, including sedation, intubation and various medications, may also come with cognitive side effects.

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“But plenty of patients get COVID-19, recover well and then a month or two later develop cognitive symptoms, such as slow thinking, difficulty concentrating and fatigue,” says Dr. Kremen. So, even patients who had mild disease and recovered seamlessly may still develop post-COVID-19 brain fog.

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Other Medical Problems And Long Covid Brain Fog

Other medical conditions may worsen long COVID brain fog. They include depression, anxiety, PTSD, trouble sleeping, etc. So, part of your treatment for long COVID brain fog may include treating those problems.

The Goodpath Long COVID program and your doctor can address other medical problems. For example, supplements and mind-body therapies from Goodpath may be combined with other treatments provided by your doctor.

You may be taking medication for different medical conditions. Some medications may worsen brain fog. For example, certain antidepressants, allergy medications, etc. Your doctor may review, and possibly change your medications.

How Prevalent Is Long Covid

For most patients, COVID-19 infections are mild or even asymptomatic, and whatever symptoms are present completely resolve within a few weeks. A considerable number of patients, however, struggle to fully recover from this infectious disease. They experience a wide range of symptoms for much longer than expected, especially if they only had a mild case of COVID-19 in the first place.

This is such a new condition that, up until now, there was no formal definition. Using the term post-COVID-19 condition, the World Health Organization announced its official definition of what constitutes Long COVID. According to this organization, Long COVID occurs in individuals with a history of probable or confirmed SARS-CoV-2 infection, usually three months from the onset of COVID-19, with symptoms that last for at least two months and cannot be explained by an alternative diagnosis.

Reports of Long COVID started appearing quite early in the pandemic. Initial values were alarming, with more than 70% of patients who had been hospitalized with a severe COVID infection still reporting symptoms months after the initial infection. Among those who stayed at home, initial studies suggested lower values, with around 30% of patients reporting at least one symptom nine months later.

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How To Cope With Post

    Angela Underwood’s extensive local, state, and federal healthcare and environmental news coverage includes 911 first-responder compensation policy to the Ciba-Geigy water contamination case in Toms River, NJ. Her additional health-related coverage includes death and dying, skin care, and autism spectrum disorder.

      If I Tested Positive For Covid

      What is COVID-19 âbrain fogâ? and why should we be concerned?

      The short answer is likely, yes, said Dr. Sanghavi, adding that there were a significant number of patients who were initially asymptomatic but then they subsequently developed symptoms, which are particular to COVID long haulers or long COVID.

      And thats why COVID-19 is a very intriguing disease. It’s not just a simple virus affecting the body, there are immune and inflammatory mechanisms which affect the patient’s body, he added. Additionally, the patient may be initially asymptomatic, but subsequently develops symptoms like anxiety, depression, fatigue and so on.

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      What Are Some Neurological Symptoms Of Covid

      About 1 in 7 people who’ve had the COVID-19 virus have developed neurological side effects, or symptoms that affected their brain function. While the virus doesn’t directly attack your brain tissue or nerves, it can cause problems that range from temporary confusion to strokes and seizures in severe situations.

      Therapy Used Around The World

      There are no current treatments for brain fog attributed to COVID-19. But a new clinical trial at UAB is testing a proven rehabilitation method with a record of success in restoring lost function. Known as Constraint-Induced Therapy , it was developed by Edward Taub, Ph.D., University Professor in the Department of Psychology and director of the CI Therapy Research Group, in collaboration with colleagues at UAB. CI is used around the world to help patients regain limb function and language abilities after stroke.

      Studies in France and the United States reveal that a third of patients hospitalized with COVID-19 have experienced memory loss and other cognitive difficulties in the months after their recovery. This brain fog can be debilitating. It feels as though I am under anesthesia, one patient said.

      CI Therapy also is used to treat patients with traumatic brain injury, multiple sclerosis and cerebral palsy, and with anoxial and other brain damage in pediatric patients.

      Individuals who think they can benefit are welcome to contact the project directly at 205-934-9768 or learn more about the study at uab.edu/citherapy.

      Some 97% of the thousands of stroke patients who have taken part in CI Therapy have seen meaningful improvement, and the average patient uses his or her affected limb five times more post-therapy than pre-therapy.

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      How Acute Covid Infection Affects The Brain

      An acute infection is a sudden and active infection. According to NINDS, COVID probably does not infect the brain or nerves directly. Inflammation and damage are caused by proteins called antibodies that the immune system makes in response to the infection. These antibodies may cause a severe immune system reaction that could cause brain or nerve swelling. There are also other ways COVID can cause neurological symptoms:

      • COVID mainly affects the lungs and causes oxygen levels to drop. The brain and spinal cord require oxygen to function. Low oxygen levels can cause damage to the central nervous system. Without oxygen brain cells start to die.
      • Some research shows that COVID viruses can attack the cells in the walls of blood vessels and make them weak. This can cause microbleeds. In the brain, these microbleeds lead to mini-strokes.
      • COVID may also increase the risk for blood clots. A blood clot in a blood vessel that supplies part of the brain can also cause a mini-stroke.
      • A large bleed or large blood vessel clot in the brain can cause a full-blown stroke with permanent brain damage.

        Common COVID symptoms dont typically include neurological symptoms, but brain fog and memory loss can occur because of long COVID.

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