Over one year into the coronavirus pandemic, scientists are still learning about COVID-19, particularly its long-term effects on the brain. Recent findings suggest that a previous infection with COVID-19 is associated with a higher risk of mental health and neurological symptoms within six months following the initial infection. In fact, it appears one third of COVID-19 survivors experience lingering side-effects. These patients, often referred to as “long-haulers,” experience post-COVID mental health symptoms long after they first contracted virus.
COVID-19 Long-Term Effects
Although most people with COVID-19 get better within weeks of illness, some people a range of new, returning, or ongoing health problems. Even people who did not have symptoms when they were infected can have post-COVID, or long COVID, conditions. These conditions can have different types and combinations of health problems for different lengths of time. People with long COVID may experience combinations of the following symptoms:
- Tiredness or fatigue
- Difficulty thinking or concentrating (sometimes referred to as “brain fog”)
- Headache
- Loss of smell or taste
- Dizziness on standing
- Fast-beating or pounding heart (also known as heart palpitations)
- Chest pain
- Difficulty breathing or shortness of breath
- Cough
- Joint or muscle pain
- Depression or anxiety
- Fever
- Symptoms that get worse after physical or mental activities
Problems with Mood and Fatigue
Anxiety and mood disorders, such as depression, were the most common brain-related diagnoses of those who contracted the virus. In total, researchers have identified 14 different psychiatric and neurological diagnoses in COVID long-haulers. These diagnoses included neurological events such as strokes, brain hemorrhages and much more rarely, dementia.
While several studies have shown a relationship between COVID-19 infection and lingering effects on the brain, researchers have not yet concluded that the virus is causing these effects directly. However, recent findings suggest a few possibilities of how the coronavirus could impact the brain.
Blood Clots and Blood Vessel Problems
After finding no trace of the virus in the brains of people who had COVID-19, a team of neurologists realized that the virus may be affecting the brain in other ways. By examining COVID-19 infected, post-mortem brains with an MRI machine too powerful for clinical use in living people, researchers found small clots within the blood vessels. They also noticed that the walls of the vessels were unusually thick and inflamed and there appeared to be bleeding into the surrounding brain tissue. The clots, inflamed linings and blood leaks in the barriers that ordinarily keep blood and harmful substances out of the brain may be contributing to covid-related brain damage.
Inflammation and COVID-19
Another hypothesis to explain how COVID-19 affects the brain involves inflammation. When the body experiences an injury, the brain uses neurotransmitters that help cells communicate. When there’s a lot of inflammation, serotonin, norepinephrine and dopamine molecules can get scrambled. Similar effects can be seen when one experiences a traumatic brain injury, for example, athletes who experience repeated hits to the head. With excessive inflammation, neural messages can be interrupted, resulting in mental illness. Because COVID-19 causes inflammation, there is a possibility that the inflammation is disrupting neurotransmission, particularly in the case of depression.
Many Long-Term COVID-19 Effects Still Unknown
While both of these hypotheses could explain the lingering brain effects of COVID-19, there are still several unknowns. What does the COVID-19 virus actually do to the brain? Which patients are more likely to experience lingering symptoms? How long will these lingering effects last? All these and more remain unanswered. In the meantime, many clinicians are focused on ways in which they can help, by designing longer and larger studies and with the help of emerging of “post-covid” clinics.
Coping with Post-COVID Symptoms
It can take months for “long-haulers” to recover from the long-term effects of COVID-19. Having to endure these symptoms can result in a number of challenges and interrupt daily life. While there is no medical standard of treatment for these post-COVID patients, there are several treatments that may help relieve specific symptoms.
If you are experiencing symptoms such as anxiety or depression, ask your doctor for a referral to a psychiatrist, psychologist, or therapist. A mental health professional can help you cope with your symptoms with healthy strategies, support groups, antidepressants, or other treatment options including transcranial magnetic stimulation (TMS). TMS is a safe and effective treatment for depression and anxiety that is non-invasive and non-systemic.
Since COVID-19 increases inflammation, it can also be helpful to reduce and avoid additional sources of inflammation. Not getting enough sleep or lacking certain vitamins and nutrients can trigger inflammation throughout the body. By enjoying nutrient-rich foods and getting an adequate amount of sleep, you can reduce inflammation. When stress, poor food choices or travel deplete the body of key nutrients, vitamin supplements or even IV nutrition infusion, such as NAD+ infusions, can help.
Studies have also shown that just 20 minutes of movement can reduce inflammatory blood markers. Physical activity is known to be as effective as medications on mood and anxiety. While your symptoms may prevent you from your normal high-intensity workout, you can still do some light activities to get your blood flowing. This can be as simple as moving during commercials, going for a walk around your neighborhood or even completing chores at a fast pace like vacuuming or dusting the house.
As researchers and clinicians learn more about the COVID-19 virus, it appears we should anticipate the impact of the virus to be with us for many years. However, there are many safe and effective treatment options that can help. It’s important to remember that most people who have COVID-19 recover quickly. But the potentially long-lasting problems from COVID-19 make it even more important to reduce the spread of COVID-19 by following infection prevention guidelines.
