‘Brain fog’ after COVID may reveal patients have PTSD

LOS ANGELES, Calif. — For the millions of people worldwide who have or are recovering from COVID-19, a new study finds the illness may be just the beginning of their struggles. Researchers believe many coronavirus patients are at higher risk of suffering from post-traumatic stress disorder (PTSD) following their ordeal.

Neuropsychologist Andrew Levine and graduate student Erin Kaseda say previous outbreaks have also resulted in higher risks for PTSD among the survivors. The study finds this was the case when populations were hit by severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).

During the current pandemic, patients recovering from COVID sometimes report having “brain fog.” This can include headaches, anxiety, fatigue, insomnia, and lingering issues with concentration. While these patients may think they are now suffering from a permanent form of brain damage, researchers say it may be a treatable psychological condition instead.

“The idea is to raise awareness among neuropsychologists that PTSD is something you might want to consider when evaluating persistent cognitive and emotional difficulties among COVID-19 survivors,” Dr. Levine of the David Geffen School of Medicine at UCLA says in a university release.

Levine adds it’s best to rule out the possibility that someone is dealing with a treatable disorder before assuming there is something physically wrong with the brain.

“When we see someone for neuropsychological testing, we expect them to be at their best, relatively speaking. If we identify a psychiatric illness during our evaluation, and if we believe that condition’s symptoms are interfering with their ability to perform at their best, we would want that treated first, and then retest them once it’s under control.”

Haunted by the pandemic

Kaseda, from the Rosalind Franklin University of Medicine and Science in Chicago, has been exploring these issues since working with patients recovering from mild traumatic brain injuries like a concussion.

“When these symptoms persist for months or years after the original injury, it’s much more likely to be due to the presence of a psychiatric disorder,” the co-author explains.

The researchers reviewed data on recent SARS and MERS outbreaks, both of which are strains of the coronavirus. Since both groups of patients experienced a heightened risk of PTSD, the study suggests COVID patients needing hospitalization, intubation, or ventilation are also at risk for mental trauma.

Researchers add that delirium can cause patients with COVID-19 to experience hallucinations. The memory of all these disturbing events can continue to haunt patients even after they fully recover from the illness.

COVID patients aren’t the only people at risk for PTSD, mental trauma

Levine and Kaseda say frontline healthcare providers are another group that can’t be forgotten in this pandemic. These workers confront constant stress and fear while treating critically ill patients daily, raising their risks for COVID-related PTSD. The stress of being isolated from friends and protecting against the virus may also be too much for some, even if they have not been infected.

Although being diagnosed with PTSD may not sound great, patients can at least get the help they need. Unfortunately, the researchers caution there is still a lot about COVID-19’s symptoms scientists don’t know.

“Treatment options (for COVID) are still quite a way’s out, because it’s still an evolving situation,” Kaseda says. “We don’t actually know anything yet from survivors of COVID-19. Until we have that data, it’s very hard to say what actual percentage of patients are going to have cognitive complaints because of direct effects of the virus, because of medical intervention, or because of psychiatric concerns.”

The study appears in the journal The Clinical Neuropsychologist.

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