Question: I am a Covid-19 survivor and my doctor cautioned me to expect a "cloudy mind". I wonder whether this may be some kind of mental illness in future. Might you have what this condition is all about?
Let me confirm that “brain fog” is a real medical condition that has been described in relation to Covid-19 infections. In the circumstances, your doctor was right in warning you that this is a possibility. Sadly, that the time it takes for the symptoms to affect you is not known, and the duration of the symptoms is also uncertain.
Any person reading this article who is not vaccinated must get to a vaccination centre as soon as possible because, for now, the only way out of this problem, is to get prevention measures in place. Without vaccination, brain fog is staring at you in the face.
Additionally, the so-called symptoms of “long Covid” are interesting in a few ways. First, they are not related to the severity of the Covid-19 infection, meaning that those with mild symptoms are also at risk of long Covid. Secondly, because Covid is a relatively new condition, our knowledge is increasing as the pandemic evolves. Thirdly and relevant to your question is the fact that the symptoms of long Covid are both mental and physical and often occur together.
The most common physical symptoms are shortness of breath, fatigue, cough, chest pain, headache, to name just a few. One of the most distressing symptoms, however, is extreme exhaustion after mild or moderate effort, which might lead to a misdiagnosis of depression.
Brain fog as you allude to, is a condition in which after the infection, the patient experiences difficulties in thinking, is unable to concentrate on mental tasks, and finds the process of thinking almost impossible. Some people with this condition are so impaired that they are unable to go back to work for months.
Early in the pandemic, we saw a middle-aged woman who had experienced mild symptoms of the virus and who was sent to us by her employer because she had either become lazy or was in the view of the employer, very depressed. Having been away from the office for a few days during the acute infection, the lady had initially gone back to work, but two weeks later she became progressively withdrawn.
She was unable to focus her mind on the tasks at hand and kept saying that her brain was ‘stuck’. As her work piled up, she became progressively more frustrated, and her employer was on the verge of sacking her.
Following evaluation, the diagnosis of long Covid was made. After months of supportive care, she is finally back to her job and continues to make steady progress.
Her concentration and her ability to make decisions are slowly coming back. Other long Covid symptoms such as loss of smell and taste are also getting better.
In yet another instance, we had a young woman who presented to us four weeks after the onset of the infection. The infection had been severe enough to warrant oxygen and hospitalisation. The psychosis was diagnosed after discharge from hospital. She was brought by her husband who had noted increasing paranoia.
She claimed that plots had been hatched to eliminate her family and cited the fact that there was a power blackout in the home area on the day of her discharge as evidence. Her husband was confused and let the matter rest for a day or two.
When he got home in the rain, that was the sign for her that her enemies had found a woman for him. The fact that it was raining that day was all the evidence that she needed for this conclusion. He was confused because none of this was making sense to him. There was no history of mental illness.
He brought her to hospital when she tried to stop him from turning on the TV because the waves coming through would damage the baby in some way. A diagnosis of post-Covid psychosis was made and on treatment, she eventually got better.
In yet another Covid related case, the problem was that of Post-Traumatic Stress Disorder (PTSD). Our patient was in a ward where several patients died in his presence, and as far as he could tell, he was next in line, because there was not enough oxygen to go round.
Happily, he lived. Several weeks after discharge, he kept fearing that death was close to him. The flashbacks of death in the ward came back to him daily, as well as the sounds and smells of the hospital. Medication and psychotherapy got him better.
Covid-19 is a whole-body disease with many types of symptoms.