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More than a year into the novel coronavirus pandemic, researchers are still working tirelessly to better understand the virus behind COVID-19 and its short- and long-term health implications.
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The most commonly reported symptoms include fatigue, shortness of breath, coughing and joint and chest pain, per the Centers for Disease Control and Prevention (CDC), but long-term effects may include difficulty thinking and concentrating, aka "brain fog."
These brain symptoms have been identified in many "long-hauler" patients who continue to suffer lingering symptoms six months or more after being initially diagnosed with COVID-19, as shown in one September 2020 medical review in JAMA.
Here, we'll take a look at what we know so far about COVID's affect on the brain and what you can do to support your brain health after infection.
How COVID Can Affect the Brain
Not everyone who has COVID ends up with brain symptoms, but there are a few to look out for:
1. COVID Encephalitis
Among the more severe effects is something coming to be known as COVID encephalitis, or inflammation of the brain.
Early data from an October 2020 study in the Journal of the Neurological Sciences suggests that up to 13 percent of people who have COVID-19 and who have neurological complications may go on to experience some form of encephalitis.
Although not very common, "We know from experience that encephalitis caused by other viruses can lead to long-term issues, such as early dementia or stroke, so the concern is that a COVID-19-induced encephalitis might have the same consequences," Stephen Hurlbut, MD, a neurologist with Texas Health Harris Methodist Hospital, tells LIVESTRONG.com.
2. Mental Health Issues
Psychiatric symptoms have also been reported in people suffering from "long COVID." A February 2021 study in JAMA Psychiatry found that an estimated 24 percent of patients recovering from severe COVID-19 infections met the criteria for depression and/or generalized anxiety disorder. (The number is closer to 11 percent in the general adult population, per the CDC.)
The same study also found an association between patients recovering from severe COVID-19 and post-traumatic stress disorder (PTSD).
"PTSD not only includes depression and anxiety, but also produces problems with sleeping that further reduce cognitive function," explains neuropsychologist Paul Schulz, MD, professor of neurology and director of the Memory Disorders and Dementia Clinic at McGovern Medical School.
3. Chronic Fatigue Syndrome
A number of post-viral syndromes involving the brain have also been seen with COVID-19, such as chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), a disorder marked by extreme fatigue or tiredness that can also cause memory issues and difficulty concentrating.
"It has been very difficult to figure out why some people get CFS/ME, but we do see lots of people with [the disorder] after any viral illness, and the same seems to apply to COVID," Dr. Schulz says.
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9 Ways to Support Brain Health Post-COVID
Beyond working with your doctor, here are some of the ways you can work to rebuild your neurological health as your body recovers from COVID.
1. Engage in Mentally Stimulating Activities
In the same way that exercising the muscles in your body improves its strength, exercising the brain through mental stimulation, or mental exercises, improves its health, notes Eva Feldman, MD, PhD, professor of neurology at Michigan Medicine.
Research, including one December 2016 study in Brain Imaging and Behavior, has shown that mentally challenging your brain creates new connections that protect against future memory loss.
When it comes to selecting these activities, start with things you enjoy, such as crosswords or Sudoku puzzles.
"Try to find things that make you use your brain in a way that you find enjoyable and a little challenging," Dr. Hurlbut says.
2. Eat Brain-Friendly Foods
A healthy diet benefits every organ in your body, including your brain.
"Consuming a diet consisting of green leafy vegetables, fish, legumes and whole grains will improve the health of blood vessels of the brain and help prevent cerebrovascular disorders like stroke," says Vinit Mehrotra, MD, a neurologist with Texas Health Harris Methodist Hospital Fort Worth.
Dr. Mehrotra further breaks down the best brain foods like this:
1. Green leafy vegetables are rich in brain-healthy nutrients like vitamin K, folate and beta carotene. Healthy picks include:
- Spinach
- Kale
- Collard greens
- Lettuces
- Microgreens
2. Fatty fish are a source of omega-3 fatty acids, which have been linked to lower blood levels of beta amyloid, a protein found in Alzheimer's and dementia. Good picks include:
- Salmon
- Tuna
- Mackerel
- Trout
- Shellfish
3. Berries are also brain-boosting, as they contain flavonoids, which can help improve memory, per a June 2019 study in Frontiers in Aging Neuroscience. Think:
- Blackberries
- Blueberries
- Raspberries
- Strawberries
3. Fit in Some Form of Fitness Daily
Exercise benefits almost every facet of your health, from reducing your risk of heart disease to strengthening your muscles and bones. It also boosts your brain health.
"Daily exercise will keep the blood vessels open and improve brain oxygenation, as bloodflow through the blood vessels is how the brain is oxygenated," says Dr. Mehrotra. "This will prevent slow damage and the death of brain cells, which in turn will improve the overall function of the brain."
While any type of exercise can yield brain-boosting benefits, research, including one April 2013 study in PLOS One, has shown tai chi to be especially effective.