Most people infected with the new coronavirus will survive COVID-19. Some will be asymptomatic and may not even realize they have been infected. Others will need hospitalization for more severe forms of the disease. But surviving COVID-19, or eliminating the virus from the system, does not mean that a person will have an immediate recovery. COVID-19 lasts about two weeks in most cases, at which point the virus disappears from the body. But many people continue to experience symptoms for several weeks after that. Many survivors continue to deal with COVID-19 several months after the virus disappears, and doctors are unable to accurately explain what causes this type of chronic COVID-19 disease, which is often called “long COVID”.
Long COVID symptoms can mimic COVID-19 symptoms, such as fatigue, shortness of breath, headaches and cognitive problems such as memory loss and “brain fog”. The psychological side effects after infection can also be quite serious, doctors warn, with many patients with COVID-19 likely to experience some type of psychiatric disorder, including long-term problems that may need treatment.
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Researchers at Oxford Brookes University analyzed some of the available data on the psychiatric and cognitive consequences of COVID-19, publishing their work on Frontiers in psychology.
The authors explain that patients with COVID-19 have neurological symptoms, including headache, altered consciousness and paresthesia (pins and needles sensation). Autopsies revealed cerebral edema and neurodegeneration. These are indications that the virus can lead to the development of “acute psychiatric symptoms and long-term neuropsychiatric sequelae of COVID-19”, similar to what happens with other viral respiratory diseases such as SARS and MERS.
The scientists analyzed several studies, identifying potential acute and long-term neuropsychiatric symptoms in COVID-19, as detailed in other studies. Here are some of the acute symptoms:
- 20-40% of patients may experience headache, dizziness, encephalopathies, anosmia (loss of smell), ageusia (loss of taste) and mood swings
- 65-69% of intensive care unit patients experience confusion and agitation
- 33% of patients had disexecutive syndromes (emotional, motivational and behavioral symptoms) at discharge
The authors also point out that studies have shown that some patients may develop a new diagnosable psychiatric disorder after infection. The new virus can directly impact brain structure, with a study showing brain abnormalities “in the bilateral thalamic, medial temporal lobes, hippocampus and island regions”.
Some patients develop encephalopathy and reduced blood flow in the frontotemporal region of the brain after an infection. Encephalitis (inflammation of the brain) alone is associated with an increased risk of long-term neuropsychiatric symptoms, including epilepsy, bipolar disorders, psychotic disorders, anxiety disorders, cognitive problems and dementia. The authors claim that “the long-term neuropsychiatric sequelae of COVID-19 are currently unknown”, but the SARS and MERS studies may provide some information on psychiatric disorders that can arise after infection with the new coronavirus.
Post-traumatic stress disorder or PTSD (55% of cases), depression (39%), pain disorder (36.4%), panic disorder (32.5%) and obsessive-compulsive disorder (15.6% ) appeared in patients who survived SARS, according to one of the studies cited. Other long-term neuropsychiatric consequences of SARS and MERS included “depressed mood, insomnia, anxiety, irritability, impaired memory and fatigue”, which appeared in 10% to 20% of patients in a different study.
The authors point out that it is also “important to understand that neuropsychiatric manifestations, such as PTSD, depression or anxiety, after COVID-19 infection can also be a psychological reaction to being infected, being in an intensive care unit or experiencing the stigma of contracting the infection. If similar proportions of long-term neuropsychiatric complications arise after COVID-19, then we can expect a wave of neuropsychiatric sequelae, which will have huge implications for the management of limited health resources in all countries. “
According to previous data, “the cognitive domains of executive functions, attention and memory appear to be affected by COVID-19”. The authors indicated that long-term neuropsychiatric and cognitive sequelae may include affective disorders, anxiety, fatigue and PTSD.
PTSD was seen in 96% of patients in a COVID-March 19, 2020 study.
The authors of this latest study say that neuropsychiatric symptoms may be the direct result of the virus’s impact on regular brain pathophysiology, or “the psychological reactions of having contracted COVID-19 and undergoing associated medical interventions.” Doctors should perform additional tests to determine the nature of these problems. “Early detection and prevention of neuropsychiatric and cognitive problems should be the long-term goal of health services and governments around the world, as this could present itself as a ‘third wave’ of the pandemic,” wrote the authors.
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Chris Smith started writing about gadgets as a hobby and, before he knew it, was sharing his views on technology with readers around the world. Whenever he’s not writing about gadgets, he fails miserably to stay away from them, although he tries desperately. But this is not necessarily a bad thing.