Brain Fog and Fatigue following COVID-19 Infection: An Exploratory Study of Patient Experiences of Long COVID

Abstract

Post-acute sequelae of SARS-CoV-2 (PASC) is a poorly understood condition with significant impact on quality of life. We aimed to better understand the lived experiences of patients with PASC, focusing on the impact of cognitive complaints (“brain fog”) and fatigue on (1) daily activities, (2) work/employment, and (3) interpersonal relationships. We conducted semi-structured qualitative interviews with 15 patients of a Midwestern academic hospital’s post-COVID-19 clinic. We audio-recorded, transcribed, and analyzed interviews thematically using a combined deductive-inductive approach and collected participants’ characteristics from chart review. Participants frequently used descriptive and metaphorical language to describe symptoms that were relapsing-remitting and unpredictable. Fatigue and brain fog affected all domains and identified subthemes included symptoms’ synergistic effects, difficulty with multitasking, lack of support, poor self-perception, and fear of loss of income and employment. Personal relationships were affected with change of responsibilities, difficulty parenting, social isolation, and guilt due to the burdens placed on family. Furthermore, underlying social stigma contributed to negative emotions, which significantly affected emotional and mental health. Our findings highlight PASC’s negative impact on patients’ daily lives. Providers can better support COVID-19 survivors during their recovery by identifying their needs in a sensitive and timely manner.

Patient Experiences with a Tertiary Care Post-COVID-19 Clinic

“…The qualitative analysis of patient comments adds nuance and context to some of the quantitative results and highlights the profound impact of symptoms on patients’ everyday lives. Our study echoes results from other qualitative studies where patients with PASC expressed interest in care continuity and multidisciplinary rehabilitation and highlighted the importance of attentive listening by medical providers ( 4 , 13 , 38 , 39 ). Therefore, we advocate for adequate appointment time for detailed assessment and counseling ( 40 ).…”

Personalized Computerized Training for Cognitive Dysfunction after COVID-19: A Before-and-After Feasibility Pilot Study

“…This before-and-after study constitutes the first piece of evidence suggesting that a home-based digital therapeutic program could ameliorate cognitive dysfunction in PASC. Given the potential impact of brain fog on individuals who have had COVID-19 [ 12 ], it is important to consider the development of interventions that can help to alleviate these symptoms. The current study suggests that digital therapeutics, which involve the use of software and mobile devices to deliver evidence-based treatments, may offer a promising approach to addressing cognitive dysfunction in the context of Long COVID.…”

“…PASC-related cognitive dysfunction (also known as brain fog) is characterized by a range of cognitive indicators, including difficulty with focusing and maintaining attention and memory problems, as well as a general sense of confusion or disorientation [ 12 , 13 ]. The precise mechanisms underlying the relationship between brain fog and Long COVID are not fully understood yet, and further research is needed to clarify this relationship.…”

Depression and brain fog as long-COVID mental health consequences: Difficult, complex and partially successful treatment of a 72-year-old patient—A case report

“…The most common mental health consequences of long-COVID are fatigue, cognitive impairment, depression, and anxiety symptoms (5). While the etiology and pathogenesis of long COVID neurological syndrome (6) has not been well defined, the social consequences (such as relationship issues, fear of economic problems, and social stigma) can create additional difficulties (7).…”