Brain fog, brain fog, is a common complaint among patients who have had covid-19 – Diário do Sudoeste

Undecipherable in many ways by science, covid-19 gives rise to studies in the most diverse field of neurology, among many others. In Brazil, recent studies by the Faculty of Medicine of the University of São Paulo and the State University of Campinas (Unicamp), among many others, seek a more solid understanding of the increasing referral to neurological consultations of affected and cured patients, by clinicians and intensivists.

The patient describes sensations of memory failure, of being half-airy, slower, sometimes disconnected. Brain Fog is the English name given to the prolonged mental fatigue felt by patients after infection with covid-19. In addition to fatigue and the feeling of mental confusion, slow thinking and difficulty in concentration and memorization are also reported.

It is estimated that just over 30% of these patients have neurological symptoms. However, there is still no more accurate data on those with post-covid cognitive complaints.

In any case, there are already interesting lines of reasoning about the theoretically mild frames of SARS-CoV-2. Preliminary results from the Unicamp study indicate that even mild episodes can alter the brain’s functional connectivity pattern, causing a kind of synaptic “short circuit”.

“We know that SARS-CoV-2 has a tropism for the nervous system, a propensity to infect nerve cells. Other types of coronaviruses do too. Although the search for the virus by PCR in the patient’s CSF is often negative, the insult to the brain happens even in mild cases”, explains Jerusa Smid, neurologist at the Emílio Ribas Institute of Infectious Diseases and the Cognitive and Behavior Neurology Group at HC-FMUSP and coordinator of the Scientific Department of Cognitive Neurology and Aging.

The symptoms of brain fog can appear up to six months after infection with the coronavirus, but its signs are overlooked by the patient because they resemble other problems such as anxiety, depression, stress, jet lag and sleep deprivation.

According to the psychiatrist at the Hospital do Servidor Público Estadual (HSPE) Michel Haddad, the problem is often not identified or ignored by the patient. “The complaints are about physical and mental exhaustion. The person is tired, lacks vigor, has difficulty thinking and performing tasks”, explains the doctor.

Despite the discomfort and setbacks it can cause, the problem usually disappears after a few weeks. The ideal is to seek specialized care when Brain Fog becomes an obstacle in the patient’s routine.

A significant proportion of those who suffer from the problem say they have not resumed activities that were common to everyday life, mainly due to fatigue and memory impairment. “In a normal brain, certain areas are synchronized during activity, while others are at rest. In people who have had covid, there is a serious loss of specificity of the brain network, which probably causes more brain energy expenditure, making it less efficient, at least at first”, ponders Clarissa Yasuda, professor at Unicamp and coordinator of a survey on the subject.

loss of smell

In addition to brain fog, the loss of smell also deserves continued investigation and robust explanations, according to Jerusa Smid, as there is always an invasion of the central nervous system, through the olfactory bulb. There are also studies supporting this invasion of the virus in astrocytes and other cells of the central nervous system.

In more serious cases of covid, secondary damage to the nervous system is observed, associated with the intense inflammatory process with increased production of substances called cytokines, metabolic and clotting disorders, inducing bleeding or cerebral ischemia (stroke).

“Secondary aggressions to the central nervous system are common in ICU patients. Sometimes they become confused, disoriented, with loss of memory and/or attention. These are manifestations that often occur in seriously ill patients, not just in covid. It’s what we call delirium”, argues Jerusa Smid.

This commitment can last beyond the hospital environment and does not only occur associated with covid. Severe bacterial pneumonia, for example, can reverberate in the brain due to decreased oxygenation, exuberant inflammatory activity, or other secondary metabolic complications.

However, what intrigues neurologists are the complaints in mild cases that do not even deserve hospitalization. Several of these patients, after a few weeks, begin to complain of impaired attention and memory. “There is even evidence of interference in executive function, known as our ability to manage cognitive processes, planning and executing a task from beginning to end. Most are mild conditions, but they can lead to a commitment to more complex activities, contextualizes Jerusa.

Which alleviate the symptoms

The practice of games and exercises of concentration, language, memory and logical reasoning helps in alleviating the symptoms of Brain Fog, in addition to physical activities, healthy eating and good nights sleep.

Psychiatrist Haddad reinforces that covid-19 and its neurological manifestations are still being studied and, therefore, there is no specific treatment for its symptoms. “The therapy depends on each case, so taking care of health in an integral way is the most appropriate”, adds the doctor.

* Source: and advisors

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