Long-Covid "mental fog" can last for months, even in less severe patients

Long-Covid "mental fog" can last for months

The results from an American study: a quarter of them would have memory problems and impaired executive functions. Symptoms also present in non-hospitalized patients

Photo: Nik Shuliahin | Unsplash Memory problems, confusion, difficulty in processing thoughts: it is called "mental fog" and is one of the main symptoms of long-Covid, the set of syndromes that can follow a Sars-cov-2 infection. Cognitive impairment can be a big problem for those who have recovered from Covid-19, and not just for those who have developed the disease in a more serious way: the mental fog can last months after recovery and can occur in all patients. even the less serious ones. This is what emerges from a study conducted by a team of doctors from the Icahn School of Medicine at Mount Sinai Hospital, in New York. The research shows that about a quarter of people cured of Covid-19 had some cognitive problems, especially related to memory and executive functions, which lasted long after the infection (for about eight months) and which affected both hospitalized patients and those who received outpatient care, albeit to a lesser extent. The results were published in Jama Network Open magazine.

Mental fog and long-Covid

Although most people with Covid-19 improve their condition and recover from infection in a few weeks, the disease often leaves numerous aftermaths, a set of syndromes known as long-Covid. As we read on the US Center of Disease Control and Prevention website, long-Covid consists of a wide range of new, recurring or persistent health problems that people can experience four or more weeks after being first infected with SARS-CoV-2 . The most common symptoms of long-Covid are breathing difficulties, fatigue, prolonged loss of taste and smell, but not only: often those who are cured of the disease complain of cognitive problems, which are called "mental fog" from Covid-19.

It is a cognitive deterioration that mainly involves memory functions, but also attention and the ability to act intentionally (known as executive skills). According to a study published in Lancet Psychiatry, up to one in three people who have had Covid-19 have developed long-term mental health problems or neurological symptoms. Despite the growing evidence on the existence of Covid-19 mental fog, however, it is still unclear whether and to what extent the severity of coronavirus disease may affect cognitive symptoms.

The study

This is why the doctors at Mount Sinai Hospital, in New York, decided to study the frequency of symptoms of cognitive impairment in patients recovered from Covid-19 hospitalized, admitted to the emergency room or treated in an outpatient clinic, registered in their database. The new study included data, collected from April 2020 to May 2021, from 740 patients with no history of dementia prior to Covid-19 disease. To prevent the symptoms of long-Covid from being confused with those of cognitive impairment due to aging, the average age of the patient cohort was 49 years. The researchers evaluated the cognitive functioning for each patient, and found a relatively high frequency of deterioration in a good number of them, which also developed for a long time - about 8 months - after Sars-cov-2 infection.

The set of disorders would take the name of disexecutive syndrome, that is the alteration of the skills necessary for an intentional activity aimed at achieving objectives. Among these, difficulties in speaking (which affected about 15% of patients) and executive difficulties (16%). About a fifth of the total patients, then, had difficulty processing thoughts and categorizing them (18% and 20%, respectively), and about a quarter reported problems with recalling and decoding their memory (23% and 24% of patients).

As the authors point out in the article, executive dysfunction has significant implications for a person's quality of life, involving his or her functioning, psychological and occupational dimensions. Although cognitive symptoms were highlighted in all patients, the study found that hospitalized patients were more likely to have dysfunction in attention, executive functioning, category fluency and memory than those who received outpatient care.

"In this study, we found a relatively high frequency of cognitive impairment several months after patients developed Covid-19," the researchers, led by Jacqueline Becker, wrote in the study: "The association of Covid-19 with executive functioning raises key questions regarding the long-term treatment of patients. Future studies are needed to identify the risk factors and mechanisms underlying cognitive dysfunction, as well as options for rehabilitation ".


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