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Do you want to have brain fog for at least 7 months?

“Brain fog” is not a medical condition. It’s a term used for certain symptoms that can affect your ability to think. Nobody wants to experience brain fog. 

Early this year, we learned that brain fog is one of the many symptoms of Long COVID – the effects of COVID-19 that continue for weeks or months beyond the initial illness. 

COVID-19 patients who were hospitalized or visited the emergency department (ED) at a New York City hospital still had cognitive impairments an average of 8 months after diagnosis, according to a research letter in JAMA Network Open. Cognitive impairment is when a person has trouble remembering, learning new things, concentrating, or making decisions that affect their everyday life. Cognitive impairment ranges from mild to severe.

Researchers at Icahn School of Medicine at Mount Sinai evaluated 740 COVID-19 inpatients and outpatients using validated neuropsychologic tests in April and May 2021. 

Average time since the COVID-19 diagnosis was 7.6 months. Participants had no history of dementia. The aim was to better characterize the relationship between COVID-19 severity and persistent cognitive problems, often called “brain fog,” because previous studies have had small sample sizes and lacked optimal measurement of cognitive function, the researchers said.

The most prominent cognitive impairments included processing speed (133 [18%] were impaired), executive function (118 [16%]), phonemic fluency (111 [15%]), category fluency (148 [20%]), memory encoding (178 [24%], and memory recall (170 [23%]). 

In analyses adjusted for race, smoking, body mass index, underlying illnesses, and depression, hospitalized patients had higher odds than outpatients of deficits in attention (odds ratio [OR], 2.8), executive function (OR, 1.8), category fluency (OR, 3.0), memory encoding (OR, 2.3), and memory recall (OR, 2.2). 

Patients seen in the ED were more likely than inpatients to have deficits in category fluency (OR, 1.8) and memory encoding (OR, 1.7). There were no differences in impairments in other areas.

While older adults are especially susceptible to cognitive deficits after severe illness, the researchers noted that patients in the study were relatively young (average age, 49 years). The findings, they said, were consistent with those of cognitive and emotional studies of patients who recovered from other viral illnesses such as flu.*

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Dr. Melvin Sanicas (@Vaccinologist) is a physician-scientist specializing in vaccines, infectious diseases, and global health. 

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