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Covid-19 and long Covid: Your questions answered Main Image

Covid-19 and long Covid: Your questions answered

Thu 26 Aug 2021

Dr Aravinthan Varatharaj, Clinical Lecturer in Neurology at the University of Southampton, answers some of the common questions about Covid-19 and its impact on the brain.

When the outbreak of Covid-19 first struck the world in 2020 causing a global pandemic, scientists were desperately attempting to undertake investigations into the impact of the viral infection.

Now, just over a year on, we are beginning to better understand what the virus is and how it affects the body, both in the acute stage and on a longer-term basis.

Find answers to some frequently asked questions on Covid-19, long Covid and the impact on the brain here...

What do the terms Coronavirus and Covid-19 mean?

Coronavirus is a type of virus that has been around for a while and causes various illnesses, including the common cold. Covid-19 is a disease caused by a new strain of Coronavirus which has spread rapidly around the world. 

What are the usual symptoms of Covid-19?

The most important symptoms are a new continuous cough, a change in sense of taste or smell, or a high temperature. In many people Covid-19 causes few or no symptoms and recovery happens within a few weeks.

Other people may become very unwell and need hospital care.

Does Covid-19 affect the brain?

All infections can affect the brain. If you have had a cold and felt tired, irritable, or headachy, these effects were probably caused by your body’s immune system trying to fight off the infection.

This is called sickness behaviour and can often happen with Covid-19. In any case, where someone is seriously unwell, all sorts of changes can occur in their body and these changes can upset the function of the brain. The person can become confused, and this is called delirium. This also often happens with Covid-19, especially in older people.

In rarer cases the immune system can over-react to the infection and the brain ends up getting damaged. I have seen problems like this with Covid-19 but it does not seem to be happening in most people.

Does Covid-19 actually infect the brain?

Certain infections can actually infect the brain itself (encephalitis), the covering of the brain (meningitis), or the blood supply of the brain (vasculitis). This has been reported with Covid-19 but is likely to be in a small number of people. When millions of people are being infected, even if something only happens one in a million times there are likely to be a few cases.

What about mental health?

It is really important to recognise that Covid-19 can have a significant effect on mental health and this is just as important as all the other neurological problems. Mental and physical health are tied together. Many mental health problems may be triggered as part of an acute stress response. Stress is a bit of a loaded term but when I say stress I mean your body, brain and mind reacting to some kind of pressure.

Dealing with a nasty infection like Covid-19 is obviously a pressure, so it is no surprise that sometimes the mind might be affected.

Does Covid-19 cause a brain injury?

As mentioned above there are many ways that Covid-19 could potentially cause a brain injury. There is also a potential link between Covid-19 and stroke, where the blood supply to the brain is blocked or a weakened blood vessel in the brain bursts. A large international study found that the risk of being diagnosed with a neurological or psychiatric condition was higher in the six months after having Covid-19, including conditions such as stroke, dementia, and depression.

What is long Covid?

Long Covid is the name given to the symptoms of Covid-19 continuing at least four weeks after the infection. It includes a wide range of issues, most commonly tiredness and breathing problems. Some definitions use eight or twelve weeks as a cut-off.

What are the neurological symptoms of long Covid?

Many symptoms have been reported including fatigue, ‘brain fog’, insomnia, dizziness, problems with taste or smell, depression, and anxiety.

How many people are affected by long Covid?

It is difficult to be certain but in a recent survey by the Office for National Statistics 1.1 million people in the UK felt they had long Covid.

Are people with a neurological condition more at risk of developing long Covid?

The main risk factors for long Covid seem to be being older, female, and overweight. People who have a more severe initial infection, with more symptoms, seem to be at higher risk.

People with existing health conditions might be at a higher risk, but the evidence is not clear. There is some evidence that people with good general health and good mental health are less likely to get long Covid.

One study in people with multiple sclerosis (MS) found that people with worse neurological disability were more likely to get long Covid, but we do not yet know whether this applies to people with other neurological conditions.

What can I do if I have long Covid symptoms?

There is plenty of information on www.yourcovidrecovery.nhs.uk. Speak to your GP and consider asking for a referral to a specialist long Covid clinic. Your local Headway group or branch may be able to assist with issues such as coping with fatigue and memory problems.  

You may wish to get involved in research and a good place to start is to speak to your local hospital or visit bepartofresearch.nihr.ac.uk.

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