Cognitive Deficits in Long COVID-19: How to Recover from Them

“Long Covid” has gained significant attention over the past two years. While technically a respiratory disease, many people report that their symptoms last well beyond the infection period and impact other bodily functions.

Fatigue was the most common symptom reported in Long Covid, with a prevalence of 23%. This is followed by memory problems, reported by 14%. A large proportion of COVID-19 patients report neurological symptoms, with one study finding that 88% experienced cognitive dysfunction or memory issues.¹

There is now substantial evidence that some individuals may experience neural damage, with some studies suggesting loss of gray matter in several areas of the brain, particularly in the left hemisphere. Although conclusions about the nature of Long COVID-19 are still pending, it appears that the virus may cause mild cognitive deficits. This is more commonly known as ‘brain fog’, in which the affected individual experiences impaired thinking and poor memory.

Those unfamiliar with this phenomenon may be wondering, “what is cognitive deficits?” Cognitive impairment after Covid² has been described as a collection of symptoms affecting everyday brain function, similar to feeling sleep-deprived or highly stressed.

Cognitive deficits examples include may include:³

• Short attention span
• Impaired executive function
• Cognitive communication deficits
• Losing words when speaking
• Limited concentration
• Reduced memory
• Slower processing speed
• Sluggish, fuzzy thinking
• Difficulty making decisions or planning
• Mental fatigue
• Confusion
• Sluggish, fuzzy thinking
• Difficulty making decisions or planning
• Mental fatigue
• Confusion

Those affected say these symptoms have a significant effect on their quality of life. ‘Brain fog’ may affect their work, relationships, and activities such as driving and interacting with others.

Some researchers have compared these symptoms to those of patients with a history of traumatic brain injury (TBI) suffering from post-concussive syndrome (PCS).⁴

Some studies suggest that cognitive deficits in Long Covid-19⁵ appear around three months after the initial Covid infection period, with symptoms lasting for at least two months. However, it is also reported that symptoms can fluctuate or relapse over time. It is estimated that one out of 10 patients may have symptoms that persist for 12 weeks or more.⁶

A 2021 qualitative study involving patients affected by Covid-related brain fog found that symptoms usually appeared in the first few months after their initial COVID-19 infection. Around 65% reported that their symptoms improved after around 4-6 months.⁷

In some cases, patients had not yet recovered from their neurological symptoms for as long as seven months. These patients were unable to return to work and continued to suffer from the effects of their symptoms.⁸

Treatment for brain fog depends on the severity of the symptoms and the underlying causes. This may include nutrition, exercise, and various forms of cognitive rehabilitation.

Some medications have also been suggested for treating brain fog symptoms, such as guanfacine, which is prescribed for treating attention hyperactivity deficit disorder. Guanfacine is used to strengthen prefrontal cortical circuits.

However, brain fog can also be treated with natural solutions.

The first step in recovering from brain fog should involve an assessment of your diet and lifestyle habits. Implementing a nourishing diet and routine should be a priority, along with minimizing any factors that may hinder good health.

Eating a healthy diet rich in vitamins, minerals, and antioxidants will go a long way in improving your nutritional status. Dietary antioxidants are shown to support memory function by inhibiting reactions that accompany neurodegeneration, which can help prevent cognitive impairment.⁹

• Fatty fish rich in Omega-3, such as salmon, mackerel, tuna, sardines. Omega-3 fatty acids contain docosahexaenoic acid (DHA) which is important for brain and eye development. DHA plays a significant role in mental health, cellular membrane fluidity, brain function, neurotransmitter release, and overall neural health.¹⁰

• Brightly colored fruits and vegetables such as berries, broccoli, and leafy greens. Antioxidants protect brain cells against both oxidative stress and inflammation, helping to reduce the effects of neurodegeneration.¹¹

Brain training games can have important benefits in improving cognitive functions, including boosting attention and memory functions. Apps such as Lumosity have been found to improve various cognitive domains including attention and motor speed.¹²

Other cognitive exercises that may support executive function include doing jigsaw puzzles, Sudoku, creative writing, and learning a new language or hobby.

Socializing is also important. Those who regularly interact with friends and enjoy other social situations are shown to perform better on cognitive tests than those who are less social.¹³

Nutritional supplements can greatly enhance a healthy diet and lifestyle. Nootropics are designed to boost memory, learning, concentration, and other aspects of cognitive function.

When researching supplements for cognitive decline, be sure to look for products that contain scientifically validated nutrients, particularly vitamins B6, B9 (folate) and B12. These vitamins play a major role in methylation, which in turn is required for proper neurological function - as well as other biochemical reactions affecting everyday functions. Studies show that adequate intake of folate and B12 is significantly associated with better cognitive performance in processing speed, working memory and memory recall, verbal fluency, and sustained attention.¹⁴

Vitamin A and vitamin C are also highly recommended for their important antioxidant actions, which can assist in enhancing cognition and preventing neural decline.¹⁵

The best way to ensure optimal uptake and utilization of these nutrients in the body is to take them in their methylated form. Methylated vitamins are already active, so they will be absorbed much more quickly and efficiently than unmethylated vitamins, which must first undergo several metabolic processes in the body before they can be used.

A comprehensive multivitamin such as Methyl-Life’s® Chewable Methylated Multivitamin is ideal for anyone looking to optimize their cognitive function. This scientifically formulated multi contains the active form of folate (L-methylfolate) and active B12 (hydroxocobalamin) to support neural pathways, learning, neurotransmitter production, and healthy homocysteine levels.

For those new to a supplement regime, a Methyl-Life® health bundle is a great place to start. The Cognitive Health Bundle is designed to target neural health and optimize overall mind and body function. It contains two of Methyl-Life's® key methylation products for neuro-protection: L-Methylfolate (5 mg) + Active B12 Complete (5 mg) and the Non-Methylated Multivitamin.

Alternatively, the Methyl-Life® General Health Bundle is perfect for those who want to build up their methylfolate intake slowly. This bundle contains L-Methylfolate 2.5 mg + Hydroxocobalamin and the Non-Methylated Multi.

Specific nootropics such as Citicoline (CDP-Choline) and Phosphatidylserine provide the nutrients required for structural phospholipids of cell membranes, helping to protect against deterioration in nerve cells. Methyl-Life's® widely regarded Focus & Recall product contains both Citicoline (as Cognizin® and Phosphatidylserine (as Sharp-PS® GREEN) to enhance cognitive function, and improve learning, mood, and memory function.

Another popular option is Magtein®, which contains L-Threonate Magnesium. This patented form of magnesium has been clinically proven to increase neural plasticity, helping to enhance executive function, working memory, attention, and memory.¹⁶

There is substantial evidence that physical exercise can benefit cognitive functioning and well-being by inducing structural and functional changes in the brain. This is shown to result in alterations in gene expression that can help protect against neurodegeneration.¹⁷

One study found that moderate intensity exercise can result in increased performance in working memory and cognitive flexibility, while high-intensity exercise can speed information processing.¹⁸

Regularly drinking alcohol can alter the brain structurally and contribute to neurotoxicity via nutrient deficiency and neuroinflammation. Alcohol is also known to cause functional dysregulation of key brain systems that control behavior, emotions, and memory processing.¹⁹ Reducing or avoiding alcohol should be key to maintaining neural health, especially when recovering from Covid-related cognitive impairment.

Like alcohol, smoking increases oxidative stress and inflammation in the brain and body. Exposure to cigarette smoke has been associated with an increased risk of neurological diseases such as stroke and Alzheimer’s disease.²⁰ Smoking provides no benefits to someone suffering from brain fog, and quitting is highly encouraged.

Recovery from the cognitive effects of Long Covid is possible, but it requires a holistic approach. All aspects of diet and lifestyle should be examined, and improvements made where needed.

Eating a healthy diet rich in antioxidants and ‘good fats’ is highly recommended, along with regular physical and mental exercise. Above all, a supplement such as Methyl-Life’s® Chewable Multivitamin and/or L-Threonate Magnesium can speed progress and help to restore normal cognitive function.