There has been a growing interest in the impact of the pandemic on the brain, as well as our health, wellness and daily lives. This blog entry will focus on the current information available related to COVID-19 and the brain, in addition to what you can do now to optimize your brain wellness. I recently had the opportunity to attend a global neurology forum on the “Neurological Manifestations of COVID-19 and Care Challenges in Global Settings” through my fellowship training with the Global Brain Health Institute. This allowed me the unique opportunity to gain a field update from experts, as well as the global landscape in regards to the virus.
As you are reading this blog, it is about the one year marker since we entered our first global pandemic. By the end of March 2020, more than 100 countries across the globe entered a partial or full lockdown in solidarity to combat a novel virus that was spreading rapidly across the world. Now a year later, we are still living through the pandemic and the ripple effects of our collectively shared experience of a global pandemic along with its impact on our brain health (which we can address in future blogs, too).
What We Know
On April 10, 2020, a hallmark research study was released in JAMA Neurology that detailed the neurological manifestations of the novel coronavirus in 36% of COVID-19 patients. This was the first documentation of brain-related symptoms reported in a significant number of patients with the virus. Additional research studies have followed and confirmed the initial report, with neurological symptoms being reported among various age groups, especially adults aged 70 and above, and spanning to younger adults.
The brain-related symptoms of COVID-19 may include loss of smell, inability to taste, muscle weakness, tingling or numbness in the hands and feet, dizziness, confusion, delirium, and seizures and stroke (in severe cases). Brain-related symptoms have been reported across all age groups around the world.
What we know about COVID-19 and the brain is limited but is the focus of a rapidly growing area of research and interest. (New information is likely available by the time this blog is published.) General information that we know so far about the novel coronavirus is that detecting the virus in the brain is challenging and difficult. The virus may get to the brain across the blood brain barrier, an area that protects our brain from harmful substances that is difficult for toxins, viruses, etc. to pass through. It is unclear how the virus gets to the brain but there are multiple suggested pathways at this time.
Despite not detecting the virus in the brain, this does not mean that it was not there. One current limitation of our understanding of the virus has been limited to examining the brains of individuals who have made donations to science after losing their lives to the virus. Thus far, we have not been able to detect the virus’s direct impact on the brain beyond brain-related symptoms, brain imaging and tissue samples. We have detected the virus’s presence in the brain post-mortem and are seeking ways to identify the virus in the brain among current patients testing positive for COVID-19.
The current state of the field is that the virus appears to impact the brain due to systemic effects across other body systems such as the respiratory system and inflammation due to the infection. The impact on the brain is not the primary injury. As we are rapidly learning more about COVID-19 and the brain in the United States and across the world, the field seeks to understand how the virus gets to the brain, how the virus impacts the brain while it is active in the body, and what potential long-term impact the virus will have on the brain.
There is a growing need to understand the short-term and long-term impact of COVID-19 on the brain. At this time, it is unclear what implications the virus may or may not have for long-haulers (individuals who are not recovering from the virus within weeks or months of their initial symptoms). There are various reports and studies for neurological-related symptoms across age groups around the world for the dubbed “long haulers” and their brain-related symptoms of COVID-19. According to Harvard Health, tens of thousands of Americans are still reporting neurological symptoms of COVID-19 following their initial onset, representing upwards of 50-80% of COVID-19 patients. As the virus is newer, we are still uncovering the brain-related symptoms for long-haulers, which tend to include brain fog, headaches, sleep interruptions and fatigue.
At the end of January 2021, the National Institutes of Health’s National Institute of Neurological Disorders and Stroke launched the NeuroCOVID-19 project, its database to track neurological symptoms associated with COVID-19 via a COVID-19 database and COVID-19 biobank. This nationwide project aims to be a resource of pooled data for COVID-19 neurological-related event data. This is our start to better understanding the short-term and long-term impact of COVID-19 and the brain of individuals who have had the virus and survived.
What We Can Do
COVID-19 started out mainly as a respiratory virus, but its symptoms are more widespread throughout the body, including the brain and its function. There are things we can do now, today and moving forward, as part of our lifestyle, to have a direct impact on our brain wellness. Use the following 10 tips as tools for your brain health toolbox to combat the pandemic and its impact on our daily lives:
1. Prioritize your brain health. Each of us are faced with decisions to prioritize the health and wellness of ourselves, our families and our immediate social circles. Do what you can to make the best-informed decision for yourself. Work with your healthcare provider. Be safe and do what is best for your personal health circumstances.
2. Stay physically active. While our we may be more sedentary during the pandemic, finding ways to add movement to our day can give our brains and body a boost. Move daily. Event five minutes of movement offers health benefits.
3. Maintain a balanced diet. Initially, the pandemic may have disrupted our access to some foods and the way we accessed our food. Strive for balance with your diet to thrive throughout the day. Remember to keep properly hydrated with water for your brain and body.
4. Stay socially connected. We quickly adjusted on recommendations early on in the pandemic to emphasize the importance of staying socially connected while being physically distanced. Words matter and the recommendation for “social distancing” was not the proper message. Continue to stay engaged with others and look for ways to have fun while following guidelines for physical distancing recommendations. (Reference tip #1)
5. Maintain a regular sleep schedule. Sleep is vital to brain health and optimal function. Aim for 7-9 hours per night.
6. Engage your brain. Aim to engage your brain for 20 minutes per day or 2 x 10 minute sessions in something that new, novel and challenging. Select something that you enjoy to pique your interest.
7. Maintain your medical health. Do not delay or put off important medical appointments. Stay in touch with your medical providers. Maintain your health during this time. To preserve your health, make your brain health and overall health a priority.
8. Mind your mental health. Check-in how you are feeling, functioning and coping with the current circumstances and any challenges in your life. Take brain breaks or plan a no brainer day!
9. Pay attention to confusion. If you have tested positive for COVID-19, pay attention to signs of confusion or changes in mental health. Contact your healthcare provider for follow-up.
10. Monitor changes in brain health. Pay attention to changes in your brain health or performance. We have been living in an unusual time. Take time to check-in with yourself. If you are interested in a healthy brain check-up, there are ways to complete them virtually or computer-based, online.
I hope this list will provide a guide for some practical ways to achieve brain wellness during the pandemic and beyond. To read more on this topic, the Global Council on Brain Health recently published a report on “COVID-19 and Brain Health,” along with other reports that take a deeper dive into a brain-healthy lifestyle. This is the Council’s latest report on brain health and provided recommendations that can be helpful to all. May this be of use to your personal brain wellness path.
In brain health & wellness,
Disclosure: I hope this blog may provide you beneficial knowledge on COVID-19 and the brain. It does not intend to take the place of the important conversation that should occur with your healthcare provider if you or anyone you know is experiencing any neurological related symptoms from COVID-19. Contact your healthcare provider with any questions or concerns.