A recent article in Psychiatric Times (14 August 2023) looked at the similarities between neurocognitive and neuropsychiatric symptoms of long COVID and concussion/mTBI, and wondered if approaches to effectively manage concussion/mTBI may provide some insights to treatment of long COVID.
COVID-19 is known to affect multiple organs beyond the lungs, including the brain and nervous system. Mechanisms of neurological injury include inflammation, blood-brain barrier disruption, hypoxia, and blood clots. Long COVID refers to symptoms persisting more than 12 weeks post-infection, including neurocognitive issues like brain fog and neuropsychiatric symptoms like anxiety.
Studies estimate about 30% of COVID-19 patients develop long COVID. Neuropsychiatric symptoms are very common, with high rates of anxiety, depression, sleep disturbances and PTSD reported. Cognitive deficits in attention, memory, problem-solving and emotional processing are also prevalent, negatively impacting daily function and ability to work.
The cognitive and neuropsychiatric symptoms of long COVID share many similarities with concussion/mild TBI. This suggests concussion management approaches could inform long COVID treatment. Principles like early identification, education about the condition, and optimistic expectations around recovery may be helpful.
Given the range of symptoms, multidisciplinary care with coordination can help address physical, cognitive and mental health issues. This may involve physiatry, neurology, psychiatry, OT, PT, SLP, and counselling. The goal is reducing negative impacts and improving ability to function.
In conclusion, long COVID results in persistent neurocognitive and neuropsychiatric symptoms that can significantly impair quality of life. Applying principles of concussion/mTBI care could benefit long COVID patients. More research is still urgently needed on the causes, mechanisms and treatment of this condition.