Brain fog caused by long Covid is real. These doctors have advice for managing it

According to doctors, one of the ways long COVID manifests itself, commonly known as “brain fog,” is particularly devastating to those suffering from it.

According to the U.S. Census Bureau, more Americans say they have memory, decision-making, and other cognitive issues than at any time in the last 15 years, according to the New York Times.

It’s as common as other long COVID symptoms, and it’s still showing up in adults in their 30s and 40s, where it’s been reported to keep people from working.

“If you take the example of an engineer who works with computers and has to process the information, write down the data, do all kinds of mental calculations, and make decisions, they cannot do that because they cannot process the information,” said Dr. Naheed Van de Walle, a rehabilitation physician with Hartford HealthCare.

“I had a patient who had to give up the practice of law because of these brain fog symptoms,” she told me. “And I have physician patients who obviously have a lot of problems if they have brain fog.” So it basically affects everyone, even if you’re not working.”

Related: UConn study to test cognition training games to improve Covid-related’brain fog’

Van de Walle stated that she hasn’t seen the problem as much in older people.

“I don’t see it.” “I see younger people, mostly in their 30s to 60s, with some in their 20s,” she explained. “And I don’t see a lot of it in the elderly.” So I think that’s something we need to revisit and look at again, because it’s not always older people in their 80s.”

Brain fog, or a loss of cognitive ability, is “very debilitating,” according to Van de Walle.

It includes “memory deficits, word-finding difficulties, and information processing problems.” Short-term memory is the most damaging, as I see in my 30-something patients. It’s not all of them. These are extremely productive individuals. “They’re working, and this symptom has completely devastated them,” she explained.

According to Van de Walle, scientists believe that brain fog is caused by a loss of serotonin caused by the coronavirus, including a decrease in the precursor of serotonin in the gut. According to her, serotonin deficiency impairs communication between the brain and the vagus nerve, which regulates bodily functions such as digestion, heart rate, and the immune system.

According to her, this can result in decreased brain function, particularly in the hippocampus.

According to Van de Walle, people suffering from brain fog frequently do not have their complaints taken seriously.

“One thing they’ll say is, ‘Thank you so much for listening to us and acknowledging our symptoms,’ because they’ve been dismissed so many times by so many different providers that they feel so invalidated.” They do not feel validated in any way. “These symptoms are real,” she added.

She added that brain fog can occur in conjunction with other diseases such as fibromyalgia, depression, chronic fatigue syndrome, and general cognitive decline.

According to Dr. Lindsay McAlpine, director of Yale Neurology’s NeuroCOVID-19 Clinic, brain fog can be associated with chronic fatigue syndrome or postural orthostatic tachycardia syndrome (POTS), which causes an increased heart rate after rising from a sitting or lying position.

Patients with these issues account for a sizable proportion of those seen by McAlpine in her clinic, she claims.

“I’ve seen a lot of very high-functioning people, busy moms who used to do 10 things at once, who now … can’t do that, have to prioritize,” she said.

“I had this conversation with my wife yesterday, and she gets so frustrated with me,” others will say. “I just don’t remember the conversation at all today,” she explained. “Interestingly, the severity really varies a lot. Some people, most people, are able to work through it and simply adapt, but they are frustrated.”

Others were forced to change jobs or retire, she explained.

While brain fog cannot be cured and can last anywhere from 12 weeks to six months or even years, Van de Walle does teach her patients how to cope with it.

She first refers them to a speech pathologist.

“Speech pathologists are very well trained to do cognitive screening,” she went on to say. “If it’s just mild brain fog, I’ll refer them to a speech pathologist to see what the deficiencies are.” They can carry out specific tests. These are standardized tests to determine the source of the problem and then provide recommendations and remedial techniques.”

She also advises her patients to avoid multitasking.

“You’re going to cause more confusion and more problems and will not be able to complete any task,” she went on to say. “So always do one thing at a time.”

She also advises people to take it slowly.

Hydration is critical, as is avoiding physical fatigue, according to Van de Walle.

McAlpine said she checks to make sure she hasn’t overlooked another cause because “long COVID to me is the diagnosis of exclusion.”

“Then, one of the main things I concentrate on is sleep.” So we’re discovering that people with long COVID are much more sensitive to sleep loss, sleep deprivation, and sleep interruption.”

Anyone who has trouble sleeping is given a sleep study. Exercise is also advised for patients who are physically capable of doing so because it improves brain health.

“And then making sure we’re not missing other things like … migraine disorders,” McAlpine went on to say. “Migraines have an effect on function, making sure we’re treating new mood disorders after COVID or mood issues, because anxiety and depression has a huge effect on cognitive function.”

It’s a holistic approach, she says, with medications like guanfacine and N-acetyl cysteine included, “and patients respond well to that.”