Long COVID: Brain Fog

Brain Fog

There are dozens of symptoms in people with long COVID - brain fog is one of them.  The severity, number of symptoms, and how long they last vary from person to person.

The symptoms of long COVID are real - they are not imagined or exaggerated or caused by anxiety or stress. 

Brain fog is a symptom for some people with long COVID. It refers to impaired cognitive or mental function. You might describe it as trouble thinking or feeling fuzzy. It may include difficulty with:

  • Concentrating

  • Paying attention

  • Remembering

  • Speaking

  • Understanding

  • Planning

  • Problem-solving

  • Completing task

How Common is Long COVID Brain Fog?

Many studies have examined groups of people with long COVID (cohorts) to determine the frequency of symptoms, including brain fog.  

“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 Causes Long COVID Brain Fog?

There are many possibilities, however, the exact cause is unknown.

Brain fog is a symptom of long COVID, as well as of other conditions and circumstances. For example, it is also associated with chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME), and chemotherapy to treat cancer (called chemofog and chemobrain).

The coronavirus may impact brain function. For example, it may actually damage structures in the brain, as well as cause inflammation of the nervous system.

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

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

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

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

What are the Risk Factors for Long COVID Brain Fog?

Studies have looked at the risk of developing long-COVID brain fog. Although there are likely to be others, those they’ve identified include:

  • Female sex

  • Respiratory problems at the start of COVID infection

  • Severe illness/intensive care unit (ICU) stay

What is the Treatment for Long COVID Brain Fog?

There isn’t a cure for brain fog. The treatment is supportive - it includes implementing cognitive support techniques, having a healthy lifestyle, and treating other existing medical problems.

Cognitive Support

There are numerous techniques that can help with brain fog. Many of them have been used to treat brain fog associated with other conditions like chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME), chemobrain, stroke, traumatic brain injury (TBI), etc.

The techniques can help you deal with brain fog. You are very likely using some of them already. 

Think about activities and tasks that are particularly challenging. What might help? Try one or two techniques to begin. Do the best you can  - they’re intended to help, not to add anxiety and stress.

Healthy Lifestyle

The activities and habits that are critical to your overall health may also help lessen your brain fog. In other words, being as healthy as possible helps your body, including your brain, heal.  

Your Goodpath coach can help you with lifestyle changes such as diet, exercise, activity planning, stress reduction, etc.

Your Diet

Consider following a Mediterranean diet, or one similar to it. It is an overall healthy diet and has been shown to support 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 and minimal red meat and refined sugar. 

Your program includes diet information and support.

Fluids

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

Smoking

It’s simple - if you smoke, consider quitting. In addition to all of the other health risks, it is harmful to the brain. 

Alcohol

An occasional drink is unlikely to cause harm. However, it’s best to avoid drinking alcohol  - even in small amounts - as it may have a worsening effect on your brain fog. It may also cause drowsiness and interrupt sleep. 

Exercise and Physical Activity

Appropriate exercise and physical activity are part of long COVID recovery and play a role in reducing brain fog. 

It may take time until you’re able to be more active. Start slow with the idea that you’re working towards regular activity and exercise.

Caution: Breathlessness, Fatigue, and Post-Exertional Malaise (PEM)

The presence of other long COVID symptoms like breathlessness, fatigue, and PEM (when even small amounts of mental and physical activity may cause severe fatigue) are likely to impact exercise and activity.  

Your Goodpath program includes solutions that help with these symptoms, should they be present. For example, you may have breathing exercises for breathlessness and activity planning for severe fatigue/PEM.

If you have fatigue and/or breathing problems, be very careful about doing too much.

Reducing Stress

Dealing with long COVID, including brain fog, is very stressful. Anxiety and stress impact your cognitive health. Mind-body activities and social support may help with reducing stress and improving mood.

Mind-body

Breathing techniques, meditation, journaling, and yoga can help you relax and improve mental clarity (reduce feeling fuzzy).

Your Goodpath program will include mind-body solutions as part of your care.

Support

Your family and friends can provide support. They may help with emotional support, e.g. being present and listening, and with challenging daily tasks, e.g. shopping, cooking, etc. 

They may also help you with issues specific to brain fog. For example, planning or organizing, e.g. setting up a schedule, removing clutter, etc. 

Your coach can also provide support, etc. Counseling or therapy may also help you cope with cognitive issues and long COVID, in general.

Treating Other Problems

Some conditions may worsen long COVID brain fog. They include:

  • Mood disorders (depression, anxiety, PTSD). Treatment may be antidepressant or anti-anxiety medications, supplements, mind-body techniques, therapy, etc.

  • Trouble sleeping. Treatment may be changing sleep habits, supplements and over-the-counter (OTC) medicines, and mind-body techniques. Your doctor may also prescribe medications to help with sleep.

  • Endocrine, autoimmune, etc. conditions. Some conditions, if untreated, may contribute to brain fog

Some of the conditions, and some of the medicines used to treat them (see below), may worsen your brain fog. Your doctor will work with you to balance the benefit of taking medicines vs. the risk of contributing to long COVID brain fog.

Medicines

Certain medicines in these categories may cause drowsiness and/or confusion and may worsen your brain fog:

  • Antidepressants

  • Antihistamines

  • Anti-nausea medications

  • Muscle relaxants

  • Sedatives, sleeping pills

Don’t stop taking any of your medicines without checking with your doctor. 

How Long Does Long COVID Brain Fog Last?

As with the other symptoms of long COVID, experts don’t know how long it will last. And, just like research on COVID and long COVID overall, studies are ongoing.

Goodpath’s Long COVID Program

To help with brain fog, your program may include supplements, OTC medicines, cognitive and mind-body techniques, nutritional support, etc.