![]() ![]() ![]() Prior to the COVID-19 pandemic, brain fog was most often associated with chronic fatigue syndrome and fibromyalgia (known as “fibro fog”).Ĭhronic fatigue is a debilitating and complex disorder characterized by intense fatigue that is not improved by bed rest and that may be worsened by exercise or mental stress. This early precursor to what we now identify as brain fog was included in the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition) as a “culture-bound” syndrome associated with excessive academic strain. He described it as a type of mental exhaustion experienced by lawyers, writers, teachers, students and other “brainworkers” as a consequence of “overworking mental facilities without sufficient bodily fatigue.” One of the first mentions of brain fog was in 1850 by British physician James Tunstall. “There are no FDA-approved treatments for long COVID–related brain fog,” she says, “but current strategies target guidance on techniques to compensate and cognitive pacing by avoiding overburdening cognitive loads.” Walker says there is concern that COVID-19 can result in neurodegeneration, which is currently under investigation. “There are high rates of depression and anxiety in long COVID, and these illnesses can lead to brain fog as well, but it is important to note that brain fog certainly occurs independent of mood disorders and should not be entirely attributed when they exist concurrently.” “Unfortunately, we have found that even some COVID-19 survivors that do not notice symptoms of brain fog actually have evidence of cognitive impairment on comprehensive neurocognitive testing,” she says. She is also current co-principal investigator of an Emory subsite for the RECOVER (Researching COVID to Enhance Recovery) initiative of the National Institutes of Health. Walker co-founded the Grady post-COVID clinic and co-established a multisite long COVID registry and biorepository. “Brain fog is one of the primary symptoms of long COVID, often persists and can be quite debilitating for some,” says Tiffany Walker, assistant professor of medicine at Emory, who practices internal medicine at Grady Hospital in Atlanta.edicine at Emory who practices internal medicine at Grady Hospital in Atlanta. And the symptoms and their severity often get worse as the day goes on. Subjects say they have “muddled or fuzzy thoughts,” that their brain feels like it has “a bad wi-fi connection to a router,” that their thoughts are “in slow motion” or disappear like “smoke” or a “dream.”īrain fog, they say, has impacted their abilities to work at their job, do household chores, recall facts, read, write, focus, multitask, drive safely or even put together a coherent sentence. The patient interviews have resulted in vivid descriptions of brain fog. Multiple studies are being conducted on postacute sequelae, the medical term for lingering symptoms of a SARS-CoV-2 infection. Research will provide some of these answers through better testing mechanisms and treatments, so we will have more to offer people.” “When there are no lab tests to confirm it, some patients are less likely to be believed. “I worry that a lot of the symptoms are subjective: brain fog, shortness of breath, fatigue,” says Zanthia Wiley, Emory associate professor of infectious diseases. But long COVID and brain fog are still sometimes met with skepticism and impatience, whether by doctors, employers, friends or family. Some patients experience severe enough cognitive difficulties and fatigue that they have had to quit work or go on a leave of absence. Most of the time, patients are complaining that their brain fog and fatigue are the biggest limiters of their activities of daily living - their ability to get back to work, the ability to go back to school or take care of their kids.” “It’s very rare that someone comes in with a singular issue. “A lot of our patients come in with very, very similar symptoms of brain fog, fatigue and shortness of breath,” says Truong. Nearly one out of every five adults who have had COVID develop long COVID, defined as symptoms lasting three months or more, according to the Centers for Disease Control and Prevention’s National Center for Health Statistics.Īlex Truong, Emory assistant professor of pulmonology, works with patients at Emory’s Executive Park post-COVID clinic. While most people recover from mild COVID-19 symptoms over the course of one to two weeks, long COVID patients can suffer from lingering symptoms, including cognitive complaints and brain fog, for months or even years.
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