As we move further from the first wave of the COVID-19 pandemic, research has shown significant long-term effects for some patients who contract COVID-19. These effects, commonly referred to as long COVID or Post-Acute Sequelae of SARS-CoV-2 infection (PASC), can have an impact on various systems in your body and be debilitating.
Neurocognitive Long-Term Effects of COVID-19
One of the most common long-term impacts found by neuropsychologists involves cognitive, behavioral, and emotional changes after some COVID-19 infections. This means that for some people getting COVID-19 can cause changes in your brain that impact the way you think, your behavior, and your emotions.
Even though treatments have improved over the last few years many people continue to experience persistent cognitive changes. In other words, even though treatments are better some people continue to have long-term effects on how their brains function because of a COVID-19 infection. These effects include:
- Attention and Concentration: You might have difficulty staying focused and concentrating.
- Processing Speed: There might be a noticeable decrease in the speed at which you process information.
- Executive Functioning: Complex planning and organization of information can be challenging.
- Word-Finding Problems: Difficulty finding the right words quickly.
- Short-Term Memory: Problems remembering information. This is usually related to issues with attention and processing speed.
These changes reflect alterations of functioning in what is called the frontal subcortical circuitry of your brain. This can cause difficulties with high-level thinking tasks at work or at home.
Behavioral and Emotional Changes: Long-Term Effects of COVID-19
Research has shown that individuals with long COVID are at higher risk for developing mood and anxiety disorders like depression. anxiety, and panic attacks. For some, these are new and triggered by the COVID infection. For others, preexisting mood and anxiety issues are exacerbated by the infection.
These mood changes can happen to people of any age and are believed to come from both the biological impacts of the virus and the psychological strain of dealing with persistent symptoms.
Post-Exertional Malaise (PEM)
Another concern gaining increased attention in the research literature is the development of a condition called post-exertional malaise (PEM). PEM can lead to high levels of physical, cognitive, and emotional exhaustion after doing routine activities. This phenomenon, often described as “hitting a wall,” can incapacitate you and requires significant rest. In other words, day-to-day tasks can feel so exhausting that you need to rest for hours or even days.
- Unpredictable Fatigue: Extreme fatigue can come on very suddenly which is frustrating and creates a feeling of uncertainty.
- Adapted Exercise Routines: Typical recovery recommendations, like moderate exercise, can worsen the condition. Patients often need to adjust the frequency, intensity, and type of physical activity to prevent PEM.
Risk Factors for Developing Long COVID
Certain risk factors increase the likelihood of developing long COVID or PASC:
- Severe Initial Infection: Patients who required hospitalization or intubation.
- Thrombolytic Events: Blood clotting events such as strokes or deep vein thrombosis.
- Prolonged Hypoxia: Low oxygen levels during the acute infection.
- Delirium: Acute changes in thinking and disorientation during the infection.
- End Organ Dysfunction: Reduced cardiopulmonary function or issues with liver and kidney function.
Neuropsychological Assessments
Neuropsychological evaluations can play a critical role in measuring and understanding the extent of cognitive, behavioral, and emotional changes due to long COVID. These assessments can:
- Characterize Cognitive Changes: Identify and measure changes in thinking, attention, and memory.
- Guide Treatment Plans: Provide a detailed assessment to help create personalized treatment strategies.
- Additional Support: Determine what additional resources and support systems are needed, such as counseling, psychiatric medication management, and behavioral coaching.
Managing Long COVID
Managing long COVID requires a comprehensive approach that includes medical intervention, lifestyle changes, and psychological support. Recommendations include:
- Medical Care: Regular follow-ups with healthcare providers to address ongoing physical symptoms.
- Mental Health Support: Access to counseling, therapy, or psychiatric care for managing mood and anxiety disorders.
- Lifestyle Adjustments: Modifying activities to manage PEM and using tools to aid memory and executive functioning.
Local Resources
Here are some additional recommended reading and local links:
- St. Luke’s COVID Recovery Clinic
- St. Alphonsus STARS Clinic
- Nature Reviews Article: Long COVID: Major Findings, Mechanisms and Recommendations (2023)
- CDC: Long COVID Basics
Long-Term Effects of COVID-19
Early recognition of symptoms, comprehensive assessments, and appropriate support can significantly improve the quality of life for individuals experiencing long COVID and any neurocognitive and behavioral health concerns.
If you or a loved one are concerned about long COVID symptoms, contact Idaho Neuropsychology. We offer expert guidance and compassionate support to help you navigate the challenges of long COVID.