Many Covid-19 survivors will experience cognitive complications, researchers find

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  • SARS-CoV-2 may play a role in the development of cognitive and psychiatric conditions in Covid-19 patients who were healthy prior to infection
  • These complications, both short- and long-term, are varied and affect a large number of Covid survivors, researchers say
  • They added that robust monitoring of emerging cognitive and psychiatric conditions in Covid survivors is therefore essential

A new research analysis led by psychologists from Oxford Brookes University and a psychiatrist from Oxford Health NHS Foundation Trust revealed that a large number of Covid-19 survivors will be affected by psychiatric and cognitive complications.

In order to understand possible side effects of SARS-CoV-2 (the virus that causes Covid-19 disease) on the brain, as well as the extent people can expect to experience short- and long-term mental health issues, the team reviewed a range of published research papers. Their findings were published in Frontiers in Psychology.

Based on these findings, they stressed the importance of early intervention for emerging cognitive and psychiatric problems, as this will be critical for independent functioning and improved quality of life for many Covid survivors. 

SARS-CoV-2 can enter the brain

In the review, the researchers wrote that neurotropic viruses, such as coronaviruses (including SARS-CoV and MERS), use sensory and motor neuronal pathways to enter the central nervous system. Earlier studies have already shown how SARS-CoV-2 has the ability to enter the brain.

When the virus reaches the brain, it can lead to inflammation, and if the infection is set, it can reach the whole brain and cerebrospinal fluid (surrounding the brain) in less than seven days, they explained.

Although early indication demonstrates that the new coronavirus deviates slightly in the brain compared to SARS-CoV and MERS, the team added that it is still a potential source for causing short- and long-term psychiatric and cognitive complications.

Psychiatric conditions

Their analysis showed that, in the short term, a wide range of psychiatric problems were reported in Covid-19 patients. One study in particular indicated that 95% of clinically stable Covid patients experienced post-traumatic stress disorder (PTSD), while other studies found up to 42% of patients experienced affective disorders, such as depression.

The main short-term cognitive problems noted were impaired attention (45% of patients) and impaired memory (between 13 and 28% of patients).

Mental health disorders

“Understanding the neuropsychiatric and cognitive consequences of Covid-19 is important as millions of people have been affected by the virus, and many cases go undetected,” Dr Sanjay Kumar, senior lecturer in psychology at Oxford Brookes University said in a news release.

Kumar added: “These conditions affect people’s capacity to work effectively, drive, manage finances, make informed decisions and participate in daily family activities. If even just a fraction of patients experience neuropsychiatric complications, the impact on public health services could be significant.”

What’s startlingly worrying is that experts agree on the likelihood of an increase in the number of Covid patients with psychiatric and cognitive problems who were otherwise healthy prior to their infection.

For this reason, Kumar suggested that there should be detailed cognitive evaluation and robust monitoring of Covid-19 patients in order to detect new neurological cases. “This will also enable healthcare providers to plan adequate healthcare and resources, and improve the quality of life for many Covid-19 survivors,” he said.

Long-term effects

The analysis also found that in the long term, neuropsychiatric problems were mostly affective disorders and fatigue, as well as impaired attention (reported by 44% of patients) and memory (reported between 28 and 50% of patients).

Co-author Dr Tina Malhotra, a consultant psychiatrist working in Oxford Health NHS Foundation Trust said: “We are already seeing an impact of Covid-19 on mental health. Patients are presenting with Long Covid syndrome which includes fatigue, cognitive problems and a range of psychiatric problems.

Long Covid is an unofficial medical term to describe the effects of Covid-19 that continue for weeks or months after infection has occurred. These symptoms can include muscle weakness, fatigue, fever, shortness of breath, “brain fog”, anxiety, sleep disorders, gastrointestinal symptoms, and depression.

Psychiatric and cognitive problems are estimated to be experienced by one in five people who have had Covid, said Malhotra, and cautioned that the “management of such patients in Long Covid clinics should involve a multidisciplinary team including psychiatrists”.

Kumar explained that these are all emerging findings, and that medical experts will learn much more about long-term Covid-related complications as the research in the field progresses.

READ | Researchers may have found what causes 'brain fog' in some Covid-19 patients

READ | The evolving science behind long Covid

READ | To what extent is Covid-19 damaging the brain?

Image credit: Pixabay

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