Now that we’ve entered the third year of a global pandemic, you’d think doctors would have symptoms and related conditions down to a science—including long haul COVID-19, a collection of new, returning, or ongoing health issues reported four or more weeks after first being infected, according to the CDC. But the truth is, we’re all still learning, says Dr. Tae Chung, MD, assistant professor of physical medicine and rehabilitation and neurology and director of the Postural Orthostatic Tachycardia Syndrome (POTS) Program at Johns Hopkins Medicine. Many of us are also still languishing, meaning we’re prone to chalking up any and all ailments to being sick and tired of pandemic life. This, Dr. Chung says, could be a big mistake. After all, while shortness of breath, changes in smell or taste, headaches, heart palpitations, fash, fever, dizziness, chronic nausea and vomiting, or alternating constipation and diarrhea could all be related to long COVID, it’s chronic fatigue and brain fog that you should really be looking out for, he says.
What you need to know about chronic fatigue
“Almost everyone who has long COVID has this kind of extreme fatigue—it’s the exhaustion that makes you feel like your energy is completely gone,” Dr. Chung says, insisting it’s actually quite easy to distinguish between the long haul symptom and run-of-the-mill lethargy: “Assume you typically wake up feeling fully charged and end the day with a 70% battery. People with long COVID wake up with 5% battery and quickly run out of energy.” The chronic fatigue experienced by so many long COVID patients, he continues, is often accompanied by sleep disturbance, anxiety, excessive sweating, and another oft-dismissed but very real symptom: Brain fog.
What you need to know about brain fog
Patients who report it say they struggle to think clearly—and forget about creativity, says Dr. Caroline Leaf, PhD, a communication pathologist, cognitive neuroscientist, and author of Switch on Your Brain. Their short- and long-term memory is shot, they have trouble transitioning between home and work or school, and focusing becomes a pipe dream.
What’s known about long COVID’s effects on the brain and body
How can a virus affect your body and brain functioning so profoundly well after infection? “Ask 10 different doctors and you’ll get 10 different answers,” Dr. Chung says. “At this point, it’s just speculation. It feels like we’ve been living with COVID forever but it takes more than two years for doctors to scientifically prove pathology—it can take years and years.” Some theories suggest that these long COVID symptoms are caused by underlying neurological dysfunction; others suggest the culprit is an autoimmune condition. Either way, those who think the infection is chronic—that symptoms result from a lingering infection—are wrong, according to Dr. Chung: “It’s not plausible scientifically,” he says. When it comes to fatigue and brain fog, specifically, reduced blood flow to the brain could be a contributor: “One thought is that the COVID virus has a molecular structure that’s similar to the nerve structure that regulates blood flow,” Dr. Chung says. “This confuses the immune system and results in inflammation of the nerve structures after COVID-19 is out of the body, leading to blood flow problems.”
How to mitigate chronic fatigue and brain fog
While this sounds pretty serious, there are plenty of ways to reduce inflammation, expand blood volume, and prevent blood vessels from becoming clogged or collapsing; in fact, intervention can be as simple as doubling down on water and salt or slipping on a pair of compression tights. Medication is also available—which is to say you shouldn’t be suffering in silence if brain fog and chronic fatigue plague you after a known or suspected COVID-19 infection, even if it was asymptomatic. “If you’re young and otherwise healthy without a medical history and experience new symptoms after COVID-19 infection, it’s pretty easy to see there’s a connection,” says Dr. Chung. His medical advice is clear: If you’re experiencing the kind of fatigue that makes it hard to get out of bed or brain fog that’s taking a toll on your everyday life, see a doctor. Really, though: This isn’t the time to play doctor and self-diagnose or prescribe. Your primary care physician can run tests specific to your symptoms to rule out probable causes, which could include POTS, a blood circulation disorder that presents similarly to long COVID; blood clots in the lungs; nerve inflammation; and other esoteric diagnoses. In the worst-case scenario, your doctor sends you home and you continue to languish. Best case scenario? You’ll feel better sooner. Next up: How Walking for 15 Minutes Could Reduce the Side Effects of Long COVID
Sources
Dr. Tae Chung, MD, Johns Hopkins MedicineCaroline Leaf, PhD, cognitive neuroscientistPost-COVID Conditions, CDC
