Cognitive Changes and Post-COVID

Nov 22, 2021 | Greg Vanichkachorn, M.D., M.P.H. | @drvan | Comments (3)

Troubles with anxiety and depression are common symptoms in long haul COVID.

34% of patients seen in the COVID Activity Rehabilitation Program at Mayo Clinic report having troubles with their mood.  This occurs even if patients have not had any mental health problems in their past. Unfortunately, many patients have been told that all of their symptoms are due to depression and anxiety, which can amplify the stresses people feel after having COVID-19 during a global pandemic.

For some medical providers and patients though, these symptoms lead to questions about how SARS-COV-2 can affect the brain. Fortunately, there is some new research that sheds light on what may be going on inside the brain. Researchers in Italy performed brain magnetic resonance imaging on 50 patients with Post COVID Syndrome. What they found is that many patients showed changes, such as decreased volume of brain gray matter and changes in microstructure. These findings were similar to the brains of patients suffering anxiety and depression. Not surprisingly, the extent of changes seen on imaging were found to be related to the patient’s reported severity of anxiety and depression.

What is surprising is that the brain changes were also found to be directly related to the amount of inflammation a patient had during their acute SARS-COV-2 infection. In other words, patients that had increased markers of inflammation while they were initially sick had worse changes on the brain MRI and worse mental health symptoms.

As we have already discussed, every piece of research has its limitations, even the Nobel prize winning type. The authors noted that they had a small study population of 50. In addition, patients in the study had a wide variety of treatments, although none were in the ICU or had brain findings prior to having SARS-COV-2.

Many patients may blame themselves for not only having long haul COVID, but also for feeling anxious and depressed about their symptoms.  This new research indicates that perhaps it is the infection itself that causes real changes in the brain and mental health symptoms, rather than a patient’s response to their illness and the stresses of the pandemic.  Hopefully more research will further explain this possible connection and offer new treatments and preventive tools.

If you are suffering from depression or anxiety, please don’t be afraid to seek treatment. Taking care of your mental health is just as important as taking care of your physical health. Ultimately, the mind and body work together to maintain your health.  As you continue to recover, your evaluation and treatments should address both.

If you need help managing your mental health, there are many resources you can turn to. At Mayo, Psychiatry and Psychology Services offer comprehensive care to anyone who is struggling with mental illness. Likewise you can find other mental health resources through the National Institute of Mental Health. Your primary care physician can also help connect you with the best mental health services for you. Finally,  practicing mindfulness and other methods of coping with stress can also be very beneficial.

At the end of the day, it’s important to remember that just because someone is experiencing mental health symptoms does not mean all their symptoms are due to mental health problemsYour physical health greatly impacts your mental health. As you recover physically, you may find that your depression or anxiety symptoms will lessen. Though we can’t say if or how quickly that will happen for you, there is hope. Things will get better. Continue to lean on your support system and seek treatment for your symptoms, and improvement is sure to come.

To discuss the latest on Post-COVID Syndrome, head over to the Post-COVID Recovery discussion group.

Interested in more newsfeed posts like this? Go to the Post-COVID Recovery blog.

Thanks for this! I completely relate but have an opposite story:-). In the past 3 months I moved and started a new high stress job. 2 months ago came all the symptoms of Long COVID (including depression). Dealing with symptoms for 2 months not going away, I attribute them to have 2 huge life-stressors happening at once so being familiar with Mental Health (much therapy and family history) diagnosed myself with anxiety & depression and stated back on Bupropion that I had leftover. I was desperate and needed to do something until I could see my doc! Well…. 10 minutes in, he told me 1) EVERYONE is depressed right now; 2) depression can set in when we don’t feel well a.k.a other health issues; 3) he just really did not believe I was a clinically depressed person. Ok, so now what? Wait for it…. He said he is almost sure I had COVID and never knew I did…ran the antibody test and it was positive! Therefore I have Long COVID which depression is a symptom. The point is I finally have doctors (including Mayo) that did not take the easy route and blame it all on depression… they actually took the time to properly diagnose. This is a huge shift from even 5 years ago, but for me, entire life I’ve dealt with underlying chronic health issues and have been on about 25 different medications that did not work! I’ve become my own health advocate finally and am getting answers instead of “try this pill and see if it works”. Mind you, I am on numerous RXs but they are for my chronic health issues, not just depression. I will now seek out support for Long COVID and am glad to see the medical community taking it seriously (not so with my Post-Lyme….which presents almost identical symptoms (after all they are both pathogens that are unwanted guests:-) 🤞🌻🙏

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Thank you for sharing and validating we truly are the “experts” when we seriously seek accurate information and need objective, thorough examination before any conclusions are drawn. Keep getting better! Licia Rogers

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I suffer from prolonged (close to a year and a half) PICU symptoms. Of 11 members of our immediate family (parents, children and grandchildren) 5 have proven auto-immune disease. My symptoms are almost identical to those of the long-haul Covid. patients.
Is there no interest in this? Certainly, this is no co-incidence.
Charles

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