Post-COVID-19 syndrome: Brain fog and mood disorders plaguing patients ‘long after infection’

ROCHESTER, Minn. ­­­— Are you “sick and tired” of feeling sick and tired during the coronavirus pandemic? There’s a chance you may have post-COVID-19 syndrome. Researchers at the Mayo Clinic say PCS, or “COVID-19 long-haul syndrome,” is a very real condition continuing to affect COVID patients long after their recoveries.

The symptoms can include mood disorders, fatigue, and the perception that you’re experiencing cognitive impairment. The study finds these issues can be so impactful that they can prevent patients from returning to work or even resume normal activities in their daily lives.

Researchers studied the first 100 patients to take part in the Mayo Clinic’s COVID-19 Activity Rehabilitation program (CARP). The program is one of the first in the nation focusing on diagnosing and treating coronavirus patients experiencing PCS. These participants, treated between June 1 and Dec. 31, 2020, had an average age of 45 and two-thirds were female. The Mayo Clinic staff evaluated each person for PCS about three months after their infection.

Mild COVID cases actually lead to more post-COVID-19 syndrome diagnoses

It might be logical to think the worse your COVID symptoms are, the more likely you are to develop PCS. However, study authors say many of their patients only had mild cases of the virus. In fact, several did not have any serious symptoms at all.

Researchers say the most common issue leading patients to seek help for PCS was fatigue. Eight out of 10 patients said they experienced unusual levels of fatigue after their illness. Another 59 percent had respiratory issues and nearly the same number had neurologic complaints.

Over a third of the participants added they were having difficulties completing basic tasks in their daily lives. Only one in three had returned to a full work schedule during the study.

“Most patients in the study had no preexisting comorbidities prior to COVID-19 infection, and many did not experience symptoms related to COVID-19 that were severe enough to require hospitalization,” says Greg Vanichkachorn, M.D., medical director of the CARP program, in a media release. “Most of the patients had normal or nondiagnostic lab and imaging results, despite having debilitating symptoms. That’s among the challenges of diagnosing PCS in a timely way and then responding effectively.”

‘Brain fog’ becoming a consistent problem after COVID-19

The Mayo Clinic’s report is not the first to point out the impact of coronavirus infections on the mind. Previous studies have revealed patients dealing with “brain fog” and even symptoms of post-traumatic stress disorder (PTSD) after their illness.

“Most patients with whom we worked required physical therapy, occupational therapy or brain rehabilitation to address the perceived cognitive impairment,” adds Dr. Vanichkachorn. “While many patients had fatigue, more than half also reported troubles with thinking, commonly known as ‘brain fog.’ And more than one-third of patients had trouble with basic activities of life. Many could not resume their normal work life for at least several months.”

One of the services the clinic’s COVID-19 Activity Rehabilitation program includes is psychosocial support for patients reporting feelings of abandonment, guilt, and frustration during their evaluation for PCS. Researchers say COVID-19 is not the first epidemic to lead to similar conditions after a patient’s illness. Given the scope of this pandemic however, the team is expecting many more cases of post-COVID-19 syndrome in the coming months.

“As the pandemic continues, we expect to see more patients who experience symptoms long after infection, and health care providers need to prepare for this, know what to look for, and know how to best provide for their patients’ needs,” Dr. Vanichkachorn concludes.

The team notes that coronavirus patients should not wait to get evaluated if they’re experiencing prolonged symptoms. They caution healthcare providers, however, to be mindful of scheduling expensive diagnostic tests for patients possibly dealing with PCS. These exams are rarely covered by health insurance and provide limited information.

The study appears in the Mayo Clinic Proceedings.

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