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Brain Fog After COVID Infection: Symptoms, Treatment & Care

Written by Beth Holloway, RN, M.Ed
2022-01-28

The information about long COVID can be confusing and is constantly changing. We’re hearing about new symptoms almost every day. Some of them are easy to understand, like tiredness or headaches. One of the most common symptoms is brain fog. So, what exactly is brain fog?

Here's what you need to know:

  1. What is Long COVID Brain Fog?

  2. What are the Effects of Long COVID Brain Fog on Mental Functioning?

  3. How Common is Long COVID Brain Fog?

  4. What are the Risk Factors for Long COVID Brain Fog?

  5. What Causes Long COVID Brain Fog?

  6. What are the Effects of Long COVID on the Brain?

  7. How Does Long COVID Brain Fog Impact a Person's Life?

  8. Does Brain Fog Occur with Other Medical Conditions?

  9. Can Long COVID Brain Fog be Prevented?

  10. How is Long COVID Brain Fog Treated?

  11. How Long Does Long COVID Brain Fog Last?

  12. Does an Integrative Approach Work for Long COVID Brain Fog?

What Is Long COVID Brain Fog?

One of the symptoms of initial COVID-19 infection may be brain fog. It may continue for weeks or months - it then becomes a symptom of long COVID. It’s also possible for brain fog to be a new symptom of long COVID - it may not have been present with the initial COVID-19 infection.

Before explaining brain fog, let’s define long COVID in general.

Long COVID

Long COVID, or long-haul COVID, refers to new, continuing, or recurring symptoms that last at least 4 weeks after the initial COVID-19 infection. The symptoms of long COVID are real - they are not imagined, exaggerated, or caused by anxiety or stress. 

Neurological Symptoms of Long COVID

Brain fog is one of several neurological symptoms of long COVID. Neurological symptoms are those that affect the nervous system - the brain, spinal cord, and nerves. 

In addition to brain fog after COVID-19 infection, other neurological symptoms may include:

  • Headache

  • Numbness and tingling

  • Loss of taste and/or smell

  • Tiredness or fatigue

  • Muscle pain

  • Trouble sleeping

  • Dizziness

Long COVID Brain Fog

Although the term may be new to you, brain fog or mental fog is exactly what the name suggests - a foggy brain or fuzzy thinking. Brain fog can be one of the most frustrating symptoms of long COVID. It refers to impaired cognitive or mental function.

Medical terms for brain fog/mental fog are cognitive dysfunction, cognitive impairment, impaired cognitive function, or impaired mental function

Brain fog is not a medical condition - it is a symptom that may be present during initial COVID-19 infection. It may be one of the symptoms that lingers after COVID-19 and it can be a new symptom of long COVID.

What are the Effects of Long COVID Brain Fog on Mental Functioning?

People with post-COVID brain fog may be impaired in several ways. 

They may have difficulty with:

  • Concentrating

  • Paying attention

  • Remembering

  • Speaking

  • Understanding

  • Planning

  • Problem-solving

  • Completing tasks

How Common is Long COVID Brain Fog?

Experts are still studying the frequency of long COVID symptoms, including brain fog. One review-type study from the United Kingdom concluded the following: 

“It is unknown who is most affected by cognitive complaints induced by COVID-19 and how long they persist; however, patient experiences and published summaries of long COVID have described brain fog to be a common and debilitating symptom.”

What are the Risk Factors for Long COVID Brain Fog?

Studies have looked at the risk of developing post-COVID brain fog. Although there are likely to be others, study data has identified:

  • Patients who are female

  • Patients with respiratory problems at the start of COVID infection

  • Patients with severe illness or that require intensive care unit (ICU) stays during infection

What Causes Long COVID Brain Fog?

Many factors contribute to long COVID brain fog. Experts do not fully understand the cause. There is evidence that the coronavirus directly (through its presence in the brain) and indirectly (through its effect on other body organs) leads to neurological problems like brain fog. 

Other conditions/circumstances are often present in those with long COVID and may contribute to brain fog:

  • Severity of the illness - i.e. severe, acute COVID infection with symptoms leading to decreased oxygen in the brain (hypoxia), etc.

  • Long hospital stays and, in some cases, complex medical treatments (e.g. use of mechanical ventilation  - i.e. “vent”)

  • Depression, anxiety, and post-traumatic stress disorder - PTSD (in some cases  it occurs with serious illness, long hospitalization, etc.)

What are the Effects of Long COVID on the Brain?

There is evidence that coronavirus impacts brain function. For example, it may actually damage structures in the brain, as well as cause inflammation of the nervous system. Organ dysfunction (i.e. liver, kidneys, and lungs) and blood flow/blood vessel changes may also contribute to brain impairment.

How Does Long COVID Brain Fog Impact a Person’s Life?

A person with long COVID brain fog may have difficulties with concentration, attention, memory, speech, comprehension, etc. Depending on the severity of the symptoms, and whether or not other long COVID symptoms are present, brain fog has the potential to interfere with every aspect of life. 

An online survey of one thousand adults looked at cognitive impairment and quality of life associated with long COVID. The survey included people who had been infected with COVID-19, people with long COVID, and for comparison, people who had neither. The results clearly showed the impact of long COVID on quality of life. 

  • Those with COVID, particularly long COVID, had higher rates of cognitive dysfunction. 

  • Those with long COVID had greater challenges with work and household responsibilities. They also had higher rates of unemployment and less financial security.

Does Brain Fog Occur with Other Medical Conditions?

In addition to long COVID, brain fog or mental fog is a symptom in many other medical conditions and situations. These include patients with chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) and patients receiving chemotherapy for cancer (it’s known as chemofog or chemobrain). In fact, some treatments for long COVID brain fog are based on treatment for brain fog in these two groups.

In some cases, brain fog/mental fog is also a symptom in patients with diabetes, heart failure, multiple sclerosis (MS), lupus (SLE), etc.

Can Long COVID Brain Fog Be Prevented?

Once you have an initial COVID-19 infection, with or without symptoms, long COVID symptoms such as brain fog cannot currently be prevented. You can, however, do many things to prevent initial COVID-19 infection. 

You’re probably well-acquainted with the following:

  • Get the recommended vaccines and boosters.

  • Wear a mask. It should be one of the safest types available.

  • Stay at least 6 feet apart from others.

  • Avoid crowds.

  • If you’re sick or around someone who’s sick, isolate and test.

  • Wash your hands. Cover your mouth and nose when coughing or sneezing.

How Is Long COVID Brain Fog Treated?

The treatment for brain fog is supportive - it addresses the symptoms as well as factors that may cause the symptoms to worsen. It includes cognitive support techniques, healthy lifestyle measures, and treating other medical problems.

Cognitive Support Techniques and Long COVID Brain Fog

Cognitive support techniques help you cope with impaired mental functioning. Some of the following can help you with the day-to-day challenges of mental and physical fatigue; memory; focus and attention; task completion:problem-solving; organization; and goal management.

Cognitive Support Techniques

Mental and Physical Fatigue
  • Pay attention to your fatigue

  • Plan for rest throughout the day to help prevent fatigue

  • Change positions to help decrease muscle fatigue (e.g. sit, then stand, then lie down)

  • Take your time, slow down, and take some deep breaths

  • Change your environment (e.g. spend time outdoors)

  • Include enjoyable activities every day (e.g. Zoom with a friend, pet your cat or dog, go for a walk, listen to music, etc.)

Memory
  • Use reminders or alarms (e.g. app, phone/watch, computer, post-it paper note)

  • Plan your day

  • Use a checklist, marking tasks as you complete them

  • Record meetings, lectures, etc.

  • Take notes using voice-to-text, phone, computer, or paper

  • Mentally practice or think through activities

  • Play brain games (e.g. apps, crossword, sudoku, word search, puzzles)

  • Try something new (e.g. research a topic that interests you; explore a new hobby, etc.)

Focus/Attention
  • Avoid distractions (e.g. choose a quiet space, turn off the television)

  • Use earbuds, headphones, or white noise app/device

  • Keep things simple (e.g. remove clutter)

  • Organize your work, kitchen, and living environment

Completing Tasks/Problem-solving
  • Work on one task/problem at a time

  • Break projects into smaller parts

  • Think through the task before you begin

  • Gather and organize what you’ll need for a task (e.g. to prepare a meal, assemble ingredients, utensils, bowls, pans, etc.)

Organization
  • Use a calendar (e.g. phone, computer, paper)

  • Create a filing system for emails, documents, etc.

  • Try to have a daily routine, but know it may change (e.g. an unscheduled event)

  • Place items in or at the same place (e.g. car keys, phone, glasses, etc.)

Goal Management
  • Use this: 1. Set a simple goal; 2. Make a plan: 3. Do it; 4. Review it

  • Set achievable/small goals ( e.g. “I’ll get ready for bed between 9:30 - 10:00 PM”) Set reachable goals

  • Imagine reaching the goal (How does it make you feel?)

Diet and Long COVID Brain Fog

A Mediterranean diet is very healthy in general.  Studies show it supports cognitive health.

The diet emphasizes plant-based foods like fruits and vegetables; whole grains; legumes, nuts, and seeds; and healthy fats (olive oil). It also includes some chicken and fish with minimal amounts of red meat and refined sugar. 

It is very similar to the healthy diet recommended in the U.S. Department of Agriculture (USDA) Dietary Guidelines for Americans, 2020-2025. Both focus on nutrient-dense foods described as follows:

“Nutrient-dense foods and beverages provide vitamins, minerals, and other health-promoting components and have little added sugars, saturated fat, and sodium. 

Vegetables, fruits, whole grains, seafood, eggs, beans, peas, and lentils, unsalted nuts and seeds, fat-free and low-fat dairy products, and lean meats and poultry—when prepared with no or little added sugars, saturated fat, and sodium— are nutrient-dense foods.”

Goodpath’s Long COVID program includes diet information and support.

Fluids

Make sure to stay hydrated. The best choice is water. Dehydration itself often results in cognitive impairment and can add to brain fog.

Stress, Mind-Body Techniques, Support, and Long COVID Brain Fog

Dealing with long COVID, including brain fog, is very stressful. Stress impacts your cognitive health.

There are many types of mind-body techniques, including deep breathing, guided imagery, progressive muscle relaxation, journaling, etc. Various methods can help you relax and improve mental clarity (reduce feeling fuzzy).

Family and friends. may help with emotional support, e.g. being present and listening. Our Goodpath coaches also provide support. You might ask a family member or friend to help with challenging daily tasks, like shopping, cooking, etc. 

Some types of counseling or therapy may also help you cope with cognitive issues and long COVID in general.

Lifestyle Changes and Long COVID Brain Fog

Changing diet and reducing stress are part of your long COVID brain fog treatment and a healthy lifestyle. The same is true with exercise and physical activity.

You may have challenges trying to exercise or participate in other activities due to long COVID symptoms. This is particularly true if you have breathing problems and/or fatigue. 

Balancing activity with rest throughout the day may be necessary. Watch for worsening symptoms with activity and slow down, if needed. It may take time until you can be as active as you’d like.

Be aware that smoking and alcohol use may impact your cognitive health - these are two habits that you may need to change. Eliminate, or at least greatly reduce, both of them.  

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 Long Does Long COVID Brain Fog Last?

The length of time a person has long COVID brain fog varies from person to person. It has been reported to last for weeks or months in some people. It may last even longer, but long COVID symptoms like brain fog are too new for experts to know.

Does an Integrative Approach Work for Long COVID Brain Fog?

An integrative approach for long COVID brain fog can work very well. The approach combines the best of conventional and complementary medicine. It puts the person at the center of care and addresses all of their needs (e.g. physical, emotional, cognitive, etc.). 

Long COVID guidance from the Centers for Disease Control (CDC) guidance recommends a whole-person approach. It includes exercise therapy, activity pacing, cognitive support, OTC medicines, and lifestyle changes for underlying conditions.

Goodpath and Long-haul COVID

Goodpath provides a program for people with long COVID. We use an integrative approach that includes specific exercises and activity guidance, mind-body techniques, nutritional supplements, OTC medicines, and diet support. Take our assessment to get started.