Have you or someone you know tested positive for COVID-19, and after the illness went away did you continue to have symptoms or develop new ones such as depression, anxiety, short-term memory loss, or “brain fog”? If so, you may be suffering from “long COVID” or Post-Acute COVID-19 Syndrome.
According to Dr. Hector Fabio Bonilla, co-director of the Stanford Hospital COVID-19 Post-Acute Syndrome Clinic (PACS) pointed out that some people, after weeks of suffering from the disease, have presented symptoms such as extreme fatigue, headache, concentration problems, memory loss, and even respiratory or heart problems.
These signs, said the associate clinical professor of medicine and infectious diseases at the Stanford School of Medicine, are classified as Post COVID Syndrome.
These long-term effects have also been defined by the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) as syndrome, after this group of symptoms appeared 28 days after testing positive for the SARS-CoV-2 virus.
While the World Health Organization has defined Post-COVID Syndrome as the presentation of symptoms 5 or 6 months after having the disease.
Dr. Bonilla stated that there are different degrees of severity of this Syndrome, in an interview conducted by Marcos Gutiérrez and Manuel Ortiz on the program Península 360 Radio, on KIQI, through the 1010 AM frequency from San Francisco, California, in collaboration with the program Hecho en California.
Although it is true that the most common symptom in these patients is extreme fatigue, many of them also present "mental fog", a cognitive problem with memory and concentration in which processing information could lead to some difficulties.
"When we look at this problem, this is nothing new. In patients with chronic fatigue syndrome, it is one of the most important symptoms," he said.
He added that this mental fog is a symptom that "has been forgotten due to the negligence of the community and doctors in general. Because the patient looks very well and all the tests are normal, but when more in-depth studies are done with more sophisticated equipment, it has been found that the brain is compromised."
Recent evidence, he said, has shown that the brain is affected in patients with COVID-19. “This may possibly occur secondary to long-term COVID symptoms.”
He added that to reach these conclusions, quite sophisticated studies have been carried out, which measure brain metabolism.
«In patients with chronic fatigue who experience brain fog, inflammation has been found in the brain. Autopsy studies on the brains of patients with COVID have identified that there is an inflammatory response in the brain, in addition to areas of low metabolism. It is something that is happening in the brain in patients with COVID that is not very well defined.»
Identifying mental fog
According to Dr. Bonilla, symptoms of brain fog manifest when the patient says he or she cannot concentrate or starts reading and feels tired and forgets things. “Sometimes they forget people’s names or what to call things. They forget names of things they know and have to find words to explain to people. They have memory problems.”
Post-COVID syndrome is still under study. Experts are still unable to understand why, how and in what ways the various symptoms can be treated.
"It's an area we're still learning about. It's something new. We're still learning, we don't have a completely clear idea of how to give a specific therapy. So far, there isn't one. People empirically use drugs that reduce inflammation."
He also noted that there are anecdotal reports showing that patients have a favorable response to anti-inflammatory drugs.
"We have a clinic at Stanford to evaluate those patients, to find those problems, because patients often do not have brain fog and they have to identify them appropriately in order to propose more appropriate solutions."
In this regard, he suggested that having these symptoms is not necessarily mental fog, as they could be caused by other conditions, including brain tumors.
“The reason we have this clinic at Stanford is to try to evaluate these patients and determine if the symptoms they are experiencing are related to COVID-19. Some people may come in with a headache and forgetfulness, and we may even find a brain tumor. It is important to evaluate patients.”
She explained that Stanford's Post-Acute COVID-19 Syndrome clinic has specialists in internal medicine, infectious diseases, neurology, cardiology, psychiatry, rheumatology, otorhinolaryngology, allergy and immunity, sleep medicine and gastroenterology.
Empathy, part of the solution
For many, it may be difficult to understand and believe patients who suffer from the Syndrome, however, it is necessary to empathize and give comfort to people who go through it.
"The people who know how difficult this disease is are the people who live with it. It is important to feel compassion for them."
Although efforts are being made to find quicker solutions, it has been found that between 80 and 90 percent of patients improve after one or two years post-infection.
However, there are others in which the symptoms persist, and these are the ones on which relief efforts are being focused.
Everyday life seems to be complicated for some patients, as it is quite possible that one day they have severe symptoms and the next they feel fine.
“It’s like a roller coaster, some days are worse, some days are better, but some people experience new symptoms after COVID first appeared. As soon as we have more information and we know more, we will be able to understand the problem much better.”
Finally, Dr. Bonilla called on everyone to get vaccinated, and to get the booster shot for those who have already had their first two doses, or those who have been immunized with the Moderna or Pfizer vaccine, or after a dose of J&J.
“It is important to protect ourselves, vaccination has been found to reduce cases of Long COVID. Please get vaccinated.”
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