Numerous studies have confirmed that novel coronavirus infection in humans produced long-lasting side effects even after the symptoms of the initial infection disappeared completely, which we call long-term COVID. The effects of post COVID remnants mainly were the appearance of brain fog, fatigue, shortness of breath, chronic pain, loss of smell.
In 2021, in a study designed to describe long COVID symptoms in more than 3,000 people from 56 countries, researchers found that 88% of respondents represented brain fog symptoms such as cognitive or memory problems. During the first few months after the onset of COVID-19, these symptoms showed an increasing trend and then started to decrease gradually. At the beginning of the 7th month after the onset of COVID-19, 55.5% of respondents reported suffering from cognitive problems such as brain fog. Recent studies have found that brain fog symptoms may last more than a year after infection with COVID-19. Moreover, studies have shown that more than 20% of patients with long COVID brain fog still did not get an improvement for their symptoms after a year.
LongCOVIDCareCenter studied the long-term COVID-19 symptoms, finding that that there was a large proportion of patients with brain fog. They summarized the clinical manifestation of long COVID brain fog, analyzed the pathogenesis of brain fog caused by long COVID.
Then, combined with the pathogenesis, they gave the relieve ideas of western medicine for the disease after infection with COVID-19. Due to the limitation of western medicine treatment against long-term COVID-19 symptoms of brain fog, they also recommended some traditional Chinese medicine, including Chinese medicine formula and acupuncture treatment, to relieve the symptoms of brain fog.
What are The Clinical Manifestations of Long COVID Brain Fog?
According to the published medical papers on the symptoms of long COVID, Long COVID Care Center concluded clinical manifestations of brain fog as follows:
(1) Neurasthenia: feel that the brain is often in a state of confusion; without mentally lethargic; feel a slower thinking when pondering; respond slower when doing things; lose creativity when working; feel neurasthenic.
(2)Memory loss: feel that one has a cognitive impairment; often unable to remember something; memory loss, forgetfulness; appear similar symptoms to senile dementia-like and Parkinson’s disease.
(3)Attention disorder: feel that the brain is not in a state and mental trance; feel it is easy to distract and difficult to concentrate.
(4)Get lost: feel the brain often is in the state of vertigo; feel dull in discerning spatial directions.
(5)Language disorders: feel that it is not fluent and smooth when speaking; often forget to choose which words to express meaning.
(6)Dizziness: feel a false sense of movement or rotation, vertigo, feel lightheaded, unstable to stand or walk, and likely to lose balance and fall.
(7)Brain fatigue: feel drowsy, it’s easy for brain to feel tired, feel fatigued when thinking, it’s easy to feel sleepy when reading, feel sleepy in the daytime.
(8)Common accompanying symptoms,loss of smell: olfactory dysfunction, feel that one can not smell anything through the nose, or that the smell is abnormal.
(9)Common accompanying symptoms, blurry vision: blurred vision is presented in the morning, feel that the vision is in a trance and eyes are tired when staring at the computer plane and mobile phone screen for a longer time.
(10)Common accompanying symptoms,tinnitus: refers to the condition in which the external environment does not make a sound, but feels to hear a certain noise, feels that the ear is blocked by cotton, over-high internal pressure,buzzing, and it’s easy to be anxious or difficult to concentrate.
(11)Common accompanying symptoms,chronic headache: feel symmetrical chronic headache bilaterally on the head; often feel hot on the head and tightness on the head.
What are The Pathological Causes of Brain Fog Symptoms After Infection With COVID-19?
Patients infected with novel coronavirus would develop vascular inflammation and micro-coagulation, which allows some people to experience local hypoxemia, that is, virus-infected organs in the human body have experienced low blood oxygen concentrations. If this occurs in the brain, it would trigger a slight lack of oxygen in the brain, which in turn damages the nerves in the brain. The research paper confirmed that acute hypoxemia could cause post COVID-19 symptoms in cognitive impairment, namely, brain fog.
For patients with novel coronavirus, sometimes the novel coronavirus in the body may not be cleared completely, with a small amount of the virus remaining. The remaining virus would persistently infect endothelial cells of multiple organs of the human body, forming tiny thrombi between cells, which in turn produce a wide range of inflammatory responses. Inflammatory responses cause a rise in pro-inflammatory markers, including the increase of ferritin, coagulation protein VIII, and C-reactive protein (CRP), as well as the elevation of D-dimer. D-dimer levels are associated with acute ischemic stroke, especially cryptogenic stroke, and its increased level can easily cause nerve injury in the brain. This nerve injury causes post COVID-19 in terms of cognitive impairment, namely brain fog symptoms.
How to Relieve Long COVID Brain Fog
Western Medicine
Patient need to take a thorough physical examination of their bodies, and besides taking routine examinations, they need to do another four examinations.
The first item: do several more PCR tests to check whether the result shows positive.
The second item: perform a neurological examination, including functional magnetic resonance imaging MR angiography of the brain.
The third item: in addition to basic blood tests, we assessed thyroid hormones, zinc, ferritin, antinuclear antibodies, rheumatoid factor, and blood sedimentation rate.
The fourth item: Comprehensive heart function test.
For the main direction of western medicine
If novel coronavirus remains in the body, antiviral drugs such as Paxlovid should be used as a priority. If there is no virus in the body, the drug is used from the perspective of reducing or eliminating the chronic inflammation of the patient, improving the metabolic circulation and immune mystery of patients. For example, rintatolimod (immunomodulator) and coenzyme Q10 + NADH (mitochondrial modulator) can be used to improve the immune system of patients.
Traditional Chinese Medicine (TCM)
From the theory of syndrome differentiation and treatment of TCM, the treatment of long COVID brain fog can obtain more accurate TCM syndrome differentiation and more suitable TCM formulas from the following three steps.
(1)Perform the observation, smelling, hearing, and inquiring of traditional Chinese medicine diagnosis, and consult the comprehensive physical examination report and four special examination reports of western medicine. Only in this way can TCM doctors obtain the most detailed disease information of patients to support them to make the most accurate syndrome differentiation and treatment of patients’ conditions.
(2)TCM doctors will classify and summarize the main symptoms, accompanying secondary symptoms, physical condition, and sick parts of the internal organs of the patients according to the most comprehensive disease information of the patients. First, the main symptoms are the most unbearable symptoms of patients at present, such as dizziness. Second, accompanying secondary symptoms, which means the patient is experiencing other uncomfortable symptoms, such as occasional chronic headache. Third, to find out the physical condition of the patient, which means the patient’s current physical health status, belongs to which category in the TCM constitution. For example, yang-deficiency constitution, phlegm-dampness constitution, qi-deficiency constitution, blood stasis constitution, etc.
(3)TCM doctors, according to the above summary, combined with the internal organs and meridians related to symptoms, comprehensively use the theory and practical experience of TCM to make TCM prescriptions for patients. If acupuncture and moxibustion are required, these programs will also be prescribed.
Traditional Chinese medicine (TCM) theory is mainly based on: Zhang Zhongjing’s “Treatise on Febrile Diseases”, “Synopsis of Golden Chamber”, Huang Yuanyu’s “Four Sacred Hearts Source”, “Typhoid Fever Suspension”, “Jinkui Suspension”, “Changsha Yao Jie”, Li Dongyuan ‘s “Treatise on the Spleen & Stomach”, and Zhang Jingyue’ s “Jingyue Quanshu”.
For the main direction of TCM
(1) Banxia Tianma Pills are used to invigorate the spleen and removing dampness, reducing phlegm and wind, and lessen dizziness symptoms.
(2) Mailuotong capsule is used to dredge meridian vascular congestion.
(3) Xifeng Tongluo Headache Tablets are used to clear away heat and toxic substances and reduce the symptoms of chronic headache.
Acupuncture program given by the TCM: electricity is exerted to heat the moxibustion apparatus, and apply moxibustion at the following acupoints.
- Baihui, Ashi, Shenshu and Guanyuan points to improve brain metabolism.
- Stick Clear Brain Fog Vapour Patches to the neckline of clothes to get rid of symptoms of brain fog, dizziness, and tiredness.
TCM Practical experience, which can be found in Google Scholar (https://scholar.google.com/), and search for keywords for TCM treatment of long-term novel coronavirus symptoms. For example, COVID-19 Traditional Chinese Medicine, Long COVID Traditional Chinese Medicine. A large number of academic papers on medical research on the treatment of Long Covid by traditional Chinese medicine can be found in this way.