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COVID-19's Potential Impact on Neurological Function and Mental Health

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Key Takeaways

  • Mental health is at an all-time low due to the long-term effects of pandemic anxiety, isolation, social distancing, job loss, and other related concerns.
  • But can contracting COVID-19 itself have residual mental or neurological health effects? There is growing evidence it could impact cognitive function even after recovery.

The ongoing stress and uncertainty of a pandemic has provided collective stress for many, resulting in a sharp decline of mental health across the United States and the world. There are many factors, including changes in job responsibilities, sick friends or family, fear of illness, and general uncertainty for the future. 

Between the lack of control that impacts our wellness to the chronic Zoom fatigue that has plagued many working from home since March, the changes in our mental health have been documented. But what about the mental and neurological health of those actually infected with the disease? This is where the broader psychological implications of COVID get a little bit trickier.

Shaheen E. Lakhan, MD, PhD, FAAN, neurologist, and Senior Vice President of Research and Development at Click Therapeutics, explains, "COVID-19 wreaks havoc on our bodies, including our brain. The verdict is out whether the brain is directly infected or is responsive to body-wide inflammation. Infection with COVID-19 in hospitalized patients has been associated with altered mental status, seizures, and stroke. Even after the infection stabilizes and clears, residual symptoms remain in the form of persistent brain fog, dizziness, and headaches in so-called COVID long haulers."

Cognitive Impact

COVID-19 is most widely known to damage the respiratory system, but research has shown that the nervous system is also affected, which could have lasting neurological consequences. A study done at Northwestern Medicine Healthcare System showed that 42% of admitted COVID-19 patients presented neurological symptoms at the onset of the disease, and 82% showed neurological symptoms overall. Nearly 32% had cognitive dysfunction (encephalopathy).

While the causes of dysfunction vary, there is always the potential for long-term complications, as the brain damage observed in COVID-19 survivors has caused cognitive, behavioral, and psychological changes. Lack of oxygen and encephalitis, or swelling of the brain, seem to be two of the leading causes of this damage and could ultimately lead to stroke.

Shaheen E Lakhan, MD, PhD, FAAN

Infection with COVID-19 in hospitalized patients has been associated with altered mental status, seizures, and stroke. Even after the infection stabilizes and clears, residual symptoms remain in the form of persistent brain fog, dizziness, and headaches in so-called COVID long haulers.

— Shaheen E Lakhan, MD, PhD, FAAN

The insidious side of these potential complications is that they are not always linked to the severity of the disease. Researchers in China evaluated patients that seemingly recovered from the virus and found that cognitive issues like difficulty in paying attention for long periods of time prevailed. In addition to causing serious daily complications, those that have had a stroke are at higher risk of developing dementia later in life.

Mental Health Impact

Another long-term consideration is mental health. ICU patients often deal with high rates of PTSD, anxiety, and depression, and some experts fear the same will be true for COVID-19 survivors. Some research has already shown high prevalence of these issues in COVID-19 survivors, and long-term effects from these conditions are likely.

Dr. Roseann Capanna-Hodge, Integrative and Pediatric Mental Health Expert and author of Teletherapy Toolkit, says, “Just about every member of our world community is feeling stressed, overwhelmed, and uncertain. People are taxed out, and there is a general loss of courteousness and civility as individuals struggle to cope with stress.”

The mental health of those that are pushing through this pandemic has gotten a majority of the attention, while researchers work to learn more about the physical effects of those who contracted COVID-19. However, it is important to consider the ways in which contracting and surviving a novel virus impacts a person’s mental health as well, especially considering possible connections between the two.

Dr. Roseann Capanna-Hodge, LPC

Contracting COVID not only affects us physically but [also] affects our mental health in so many ways. The toll of stress and accompanying isolation of contracting COVID can be quite detrimental in and of itself.

— Dr. Roseann Capanna-Hodge, LPC

“Contracting COVID not only affects us physically but [also] affects our mental health in so many ways. The toll of stress and accompanying isolation of contracting COVID can be quite detrimental in and of itself, but COVID can also produce lingering effects due to inflammation of the brain and body that will have an adverse effect on cognitive and psychological functioning,” says Capanna-Hodge.

There is still a lot we are learning about the disease, but the severity of after-effects increase depending upon the individual’s case of COVID-19. Coping with severe illness, especially over a long period of time, can have damaging effects on the individual afterwards.

Capanna-Hodge says, “Of course, the greater severity of COVID, the greater likelihood that there will be both lingering psychological and physical effects. COVID is not only hard on the body, but we are seeing individuals who are struggling with mood, anxiety, and cognitive functioning for weeks and months after physical recovery. Any infectious disease can impact the brain and interfere with things like word retrieval, how one copes with stress, and can even affect one’s personality.”

The Importance of a Support System

Similar to other hard and potentially traumatic situations, varied responses are normal. Living through a potentially deadly illness, especially in situations where the illness was severe or required hospitalization, can provide some people with a renewed outlook on life, while others may struggle to cope.

Capanna-Hodge says, “Some COVID survivors have a heart filled with gratitude after getting through; others may be struggling with returning to their day-to-day lives as they are overwhelmed with different feelings. Some survivors have the added sting of being shunned by fearful people."

Experts suggest creating safety plans and being intentional about surrounding yourself with community during this time, even if you have to do it virtually. This advice applies to those pushing through this time as well as those who have dealt with the virus firsthand. Because of the collective fear and uncertainty around COVID-19, the potential for isolation increases.

Isolation and depression have a direct relationship, and it is important to combat these potential outcomes before they inflict more damage. "Anxiety, depression and isolation are all things we are all facing, but those who have survived COVID may experience these issues at an even higher rate, especially if they are being shunned by their community.” says Capanna-Hodge. 

Once you have been clinically cleared, make plans to get fresh air and to engage with others in safe ways. This could look like socially-distanced outdoor hangouts, or it could be recurring Zoom happy hours with a group of close friends. Sickness can provide an easy reason to self-isolate, but your health will benefit from intentional socializing.

What This Means For You

It is important for everyone to recognize that this time is unprecedented and extremely stressful for most people for varying reasons. COVID-19 has the potential to inflict devastating physical symptoms, but dealing with and surviving the virus can have negative effects on mental health as well.

Regardless of your circumstances, support is available. Teletherapy is widely available, and this in tandem with reaching out to your support system as often as necessary are useful tools in making it through this time.

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