Two years into a global pandemic, feeling forgetful, easily distracted, and even a little bit loopy is pretty much the norm. But sometimes brain fog, which is not a medical term but a descriptor many use to report reduced mental clarity, memory issues, and/or trouble transitioning between activities, could be a sign of post-acute sequelae of SARS-CoV-2 (PASC), colloquially known as long COVID. The tricky part is distinguishing whether brain fog is indeed a relic of COVID-19, being caused by an entirely unrelated medical condition, or simply a symptom of the times. Here’s how to figure it out.
What to know about long COVID
Also referred to as long-haul COVID or post-COVID syndrome, PASC covers any number of mental and physical symptoms reported four or more weeks after a COVID-19 infection, according to the Centers for Disease Control (CDC). The symptoms can linger after the initial infection or pop up seemingly of nowhere—and they don’t just affect those who suffered from severe COVID-19. In fact, long COVID can afflict just about anyone, whether you had a super mild case of COVID-19 or no symptoms (or positive COVID-19 test) at all. If this whole thing sounds mysterious, it is. “The symptoms can be very non-specific,” says Dr. Tae Chung, MD, assistant professor of physical medicine, rehabilitation, and neurology, and director of the Postural Orthostatic Tachycardia Syndrome (POTS) Program at Johns Hopkins Medicine. “Doctors who don’t know much about post-COVID-19 syndrome might dismiss them.” To complicate medical matters further, because it can take many years to confirm pathology and the pandemic is just two years old, experts can only speculate how COVID-19 leads to PASC symptoms such as brain fog. “There are still a lot of questions around brain fog’s actual causes,” says Dr. Caroline Leaf, PhD,a communication pathologist, cognitive neuroscientist, and author of Switch on Your Brain. Theories include underlying neurological issues, autoimmune conditions, and reduced blood flow to the brain caused by nerve inflammation, says Dr. Chung. A broader theory is that COVID-19 causes permanent organ damage to the heart, kidneys, or lungs, which can in turn take a toll on the ability to remember things and think clearly. Alternatively, lingering physical symptoms themselves could be distracting and interfere with cognitive functioning.
How to tell if your brain fog is a long COIVD symptom
Seemingly, medical murkiness would make it difficult for the layperson to determine whether long COVID is to blame for brain fog. But Dr. Chung says that’s not necessarily so. “In most cases, if you’re young and otherwise healthy without a medical history and experience new symptoms after a COVID-19 infection, there’s a connection,” he says. Here are some telltale signs your brain fog may be linked to long COVID:
Typically, you’ll feel better for a few days or weeks after a COVID-19 infection before brain fog sets in. This timing is integral to a long COVID diagnosis. It’s often accompanied by chronic fatigue and other symptoms. These symptoms can guide diagnostic testing and in some cases, uncover conditions POTS, a blood circulation disorder, or as lung clots, which can become dangerous if left untreated.It’s all-encompassing, not localized to vision or trouble remembering things. Symptoms of brain fog tied to COVID-19 tend to be very different from other brain dysfunctions, Dr. Chung says. In the case of a brain tumor or stroke, you might have a memory or vision problem. “You’ll see effects on a certain area of the brain, not the entire brain at the same time,” he explains. When long COVID is at play, you’ll see broader cognitive dysfunction and attention issues.
While it can be tempting to play doctor, it’s still smart to see a real MD if you think you’re feeling foggy. “Early intervention is always best. Your symptoms may get worse if you ignore them, which will make them harder to manage,” Leaf says. Only a medical professional can rule out the alternative diagnosis, which is the best way to identify long haul COVID to date, Dr. Chung says. Depending on your unique collection of symptoms, your primary care doctor can run numerous diagnostic tests ranging from blood testing for tumors to a chest CT scan to detect potential blood clots. Next, they’ll prescribe appropriate interventions, which may include physical therapy, medication, and/or increased water intake and compression garments in the case of blood volume issues, Dr. Chung says. In many cases, psychological intervention can quicken recovery, too. “Unresolved toxic issues, constant demands, not resting enough, how we age, and how we manage hormonal changes can all impact our mental clarity,” says Leaf. A psychologist can help you work through this. Brain-building activities that call for deep thinking and learning, regular exercise, and a healthy diet may also help sharpen your thinking. After all, brain fog shouldn’t last forever. Help may be just a doctor’s visit away. Next up: What Are the Long-Term Effects of COVID-19?
Sources
Dr. Tae Chung, MD, Johns Hopkins MedicineCaroline Leaf, PhD, cognitive neuroscientistPost-COVID Conditions, CDCCOVID ‘Long Haulers’: Long-Term Effects of COVID-19, John Hopkins MedicineWhat is COVID-19 brain fog — and how can you clear it? Harvard Health Blog
