Study may hold key for COVID-19 long-haulers experiencing brain fog


A study from the University of California, Los Angeles, recently suggested that brain fog — a series of cognitive impairments reported by many COVID-19 long-haulers — may be fueled by posttraumatic stress disorder. Now survivors of COVID-19 who report struggling with brain fog are starting to speak out about the mental health issues they’re battling as well.

“Anxiety was an issue from day one,” Saudia Nagamootoo, a 44-year-old personal trainer from Valley Stream, N.Y., tells Yahoo Life. “Sleeping for [two hours] a night and feeling so heavy and fatigued that your body just doesn’t hold itself up. Mood swings were in the form of depression. The irritability came when people would tell you you’ll be OK and you feel like you’re dying slowly.”

Nagamootoo is one of tens of thousands of COVID long-haulers, individuals who report symptoms and side effects from COVID-19 long after testing negative for the virus. Fatigue, muscle pain and shortness of breath were the three most common side effects in an Indiana University study of more than 1,000 long-haulers, but dizziness, memory loss and difficulty concentrating — all hallmark symptoms of brain fog — all landed in the top 10.

Brain fog, while not an official diagnosis, is used by the medical world to capture a collection of neurological symptoms that range from mild to severe. The National Institutes of Health defines brain fog as “slow thinking, difficulty focusing, confusion, lack of concentration, forgetfulness, or haziness in thought processes.”

Ed Hornick, a New York-based journalist (and senior editor at Yahoo News, which is also owned by Verizon Media), describes brain fog as similar to “being woken up in the middle of a dead sleep and asked, ‘Where are the car keys?’ You’ll eventually get to the answer — it will just take a few beats.” Hornick, who first noticed the symptoms of brain fog in early May, a week after his COVID-19 symptoms disappeared, says it’s one of many side effects he’s still living with — but in some ways, the most difficult.

Brain fog, a side effect affecting may COVID long haulers, may be linked to PTSD. (Photo: Getty Images)
COVID long-haulers say brain fog is like "being woken up in the middle of a dead sleep and asked, 'Where are the car keys?'" Now expert say the cognitive impairment could be tied to PTSD. (Photo: Getty Images)

“It takes me longer than normal to comprehend language and words. I often have to read a sentence two or three times before I fully understand it,” Hornick tells Yahoo Life. “When a person asks me a question, it takes about five to 10 seconds for it to compute in my brain — and even then, I often have to ask, ‘Say that again?’”

Experts have found that certain physical conditions such as an underactive thyroid or low vitamin B12 can trigger brain fog, but psychological issues, like anxiety, depression and PTSD, can too. It’s the last one that Andrew Levine, a neurology professor at UCLA, and Erin Kaseda, a graduate student at Rosalind Franklin University of Medicine and Science, believe may be fueling brain fog among long-haulers, and may be the key to treating it.

Their paper on the link between brain fog and PTSD in COVID-19 survivors encourages doctors to discuss any psychological changes that long-haulers are experiencing. “With MERS and with SARS, there was a higher incidence of PTSD among survivors and even among the workers,” Levine tells Yahoo Life. “So there’s certainly precedent to expect that with SARS-CoV-2, we’re going to see higher rates of PTSD.”

Levine says the coronavirus, which spread rapidly across the globe and prompted an illness that science is still yet to fully comprehend, has created a traumatic environment. “Early in the pandemic, lots of people were going to the hospital, and the media coverage was showing people on ventilators and really highlighting the worst cases of infection of COVID-19,” says Levine. “And so when somebody would get infected or they start showing any kind of symptoms and they thought they might’ve been infected, you can imagine the anxiety that that would provoke.”

Levine says that this feeling of being out of control is often what triggers PTSD. “The death rate at first was somewhere between 5 percent and 10 percent, although it was pretty unclear. But there’s certainly the fear that one’s going to die,” he says. “And so that kind of near-death experience or the perception of a near-death experience can certainly lead to psychological trauma and PTSD.”

Nagamootoo relates to this firsthand. “The worst for me was watching and hearing about people dying around you from issues you have also,” Nagamootoo says. “Not being able to breathe and not knowing if you will wake up the next morning. The stigma that comes with having COVID and people even being negative, people still avoid you and are scared to be around you. It messes with you psychologically. You become wrapped up in your own self-contained illness and you feel like you’re in a box alone.”

Hornick says he’s definitely experiencing symptoms of PTSD, including anxiety, insomnia and irritability — which may be contributing to his brain fog. “My mind races with thoughts and worries and to-do lists,” says Hornick. “Long-term memories come back extremely easy, while I find it hard to even remember what I had for breakfast. I am just not the same sharp, quick-witted person I was before COVID-19. Now I struggle to remember even the most basic of words.”

Levine hopes that stories like these will lead doctors to focus on the mental health of long-haulers, which may in turn alleviate these symptoms. “If research over time reveals that this virus is not quite as neuroviral as some of us feared, and there’s no real biological reason for there to be lasting cognitive symptoms, then we’d need to focus on the psychological and say, ‘OK, this might just be more anxiety,’” says Levine. “That would help dictate what type of treatment there would be.”

For the latest coronavirus news and updates, follow along at According to experts, people over 60 and those who are immunocompromised continue to be the most at risk. If you have questions, please reference the CDC’s and WHO’s resource guides.

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