Neurocognitive symptoms persist 6 months post-infection with long COVID

By Susha Cheriyedath, M.Sc.May 26 2021

According to the World Health Organization (WHO), COVID-19 long-haulers are people who experience symptoms such as body ache, fatigue, shortness of breath, headache, difficulty concentrating, loss of taste or smell, or other health issues long after they test negative for the virus. It can be defined as having serious and prolonged symptoms three months after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Comparing long-haul COVID-19 symptoms to that of myalgic encephalomyelitis / chronic fatigue syndrome

Researchers at DePaul University recently reported that individuals with long-haul COVID-19 might experience neurocognitive symptoms worsening over time, as they continue to recover from COVID-19.  Psychologist Leonard A. Jason led the study, which compared people with long-haul COVID-19 to patients with myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS).

By comparing long-haul COVID-19 with another chronic illness, the researchers tried to uncover the root causes of long-term illness after COVID-19 and inform their approach to care. Several other symptoms of long-haul COVID-19 seem to improve over time, which is not the same as the experience with ME/CFS. The study is published in the journal "Fatigue: Biomedicine, Health & Behavior."

Study: COVID-19 symptoms over time: comparing long-haulers to ME/CFS. Image Credit: create jobs 51 / Shutterstock

"The symptoms hanging on most for COVID-19 long-haulers are sometimes referred to as 'brain fog.' People have trouble problem solving, or they get in the car and forget where they're supposed to be going,"

The researchers surveyed 278 long-haul COVID-19 patients on their symptoms at 2 points - six months apart. A total of 502 ME/CFS patients were also surveyed about their symptoms, which overlapped significantly with that of COVID-19. They used the DePaul Symptom Questionnaire, a self-report measuring tool originally developed for use among ME/CFS patients.

Neurocognitive symptoms with long-haul COVID-19 are less severe than those seen in ME/CFS

The results showed that at the 6-month mark, people with long-haul COVID-19 reported worse neurocognitive symptoms compared to those at the beginning of their illness. The neurocognitive symptoms included difficulty focusing, trouble forming words, and absent-mindedness. These symptoms were still ranked as less severe than those seen in ME/CFS.

Many other symptoms such as immune-related issues, sleep problems, gastrointestinal issues, and pain seem to improve over time in COVID-19 long-haulers. The most severe symptom for patients with long-haul COVID-19 and ME/CFS alike was post-exertional malaise, making the patients feel physically and mentally drained.

Literature shows that past epidemics also caused long-term fatigue in patients

The researchers believe that the study's findings may offer other researchers valuable insights into the pathophysiology of the nervous system, including that found in ME/CFS patients. While ME/CFS has many triggers, including the Epstein-Barr virus, some patients do not know what caused their illness. However, in the case of patients with long-haul COVID-19, it is clear that the initial cause of their symptoms is a single virus. Both these patient groups face similar challenges because their family members or health care workers may not fully understand the persisting symptom patterns.

The researchers estimated that about 10% of COVID-19 patients become long-haulers. Data from literature shows that even past epidemics such as the 1918 pandemic have also led to much long-term fatigue in patients.

"These types of serious neurocognitive complications are incredible given that millions of people have been infected,"