However, COVID-19 varies in that a large subset of patients who did not require hospitalization appear to experience reoccurring, persisting, or new symptoms months after the initial infection (Almeria et al., 2020). These findings are similar to recovery from SARS in 2000, especially for patients who experienced severe symptoms and spent weeks in intensive care. It is now well known that almost a third of patients across the world will experience persisting symptoms weeks and months, sometimes 1-year after diagnosis (Taquet et al., 2021). The clinical presentation of COVID-19 resulting from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is primarily characterized by respiratory symptoms but can involve a diverse array of features including pulmonary (e.g., pneumonia, dyspnea on exertion), cardiac (e.g., ischemia, arrhythmias, myocarditis), gastrointestinal (e.g., anorexia, diarrhea), and neurological (e.g., headache, dizziness, ageusia, anosmia Taquet et al., 2021). Smith was then referred to specialists in psychology, integrated wellness, and sleep medicine to address other factors thought to be contributing to her chief complaint of brain fog. Smith was also provided with cognitive compensation strategies for inattention and difficulty problem-solving. Using her neuropsychological evaluation as a guide, Ms. Simple attention, reasoning, language, memory, other aspects of processing speed, and visuospatial function were generally within normal limits.ĭuring the neuropsychology feedback session, the neuropsychologist provided psychoeducation about the impact of poor sleep, mood disorder, and changes in eating patterns on cognitive health. Results were moderately impaired on tests assessing sustained attention and problem-solving and some aspects of processing speed. Smith’s neuropsychological test results reflected an individual with a high average baseline intelligence with variability in her test performance. She rarely drinks alcohol and does not use tobacco or other substances. Her primary medical history includes diabetes mellitus type II, hypertension, and hyperlipidemia.

Her current body mass index is 31.2, classified in the obese range. She attributes this to decreased physical activity due to the shortness of breath and increased eating, which she associates with depressive symptoms. Smith reports a 30-lb weight gain since she contracted COVID-19. She says that she is frequently awoken by coughing and then tends to stay awake due to ruminating thoughts about her recovery. She also describes insomnia and reports difficulty staying asleep. Her current mood includes reports of depressive and anxiety symptoms every day, nearly all day, such as feeling bad about herself, a loss of interest in her favorite hobbies, feelings of hopelessness, frequent worries about her recovery, and overeating to cope. Smith discloses prior psychiatric history of major depressive disorder that was relatively stable prior to developing COVID-19. She is concerned about her ability to continue her current workload. She sometimes feels drowsy during work hours and has made some inattentive mistakes. She is more reliant on notes that she was before she had COVID-19. Smith describes difficulty recalling details of conversations. During the neuropsychological evaluation, Ms. Based on her cognitive complaints, she is referred for a neuropsychological evaluation. She reports significant fatigue and concerns about her work performance. She also complains of significant “brain fog,” which she defines as difficulty maintaining her attention and recalling information.

Initial symptoms included shortness of breath, cough, fever, fatigue, and difficulty sleeping, which have persisted. She was hospitalized for 1 day but did not require mechanical ventilation. She tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or COVID-19) about 3 months ago.

Ella Smith is a 35-year-old Critical Care Nurse who identifies as female.

Brain fog anxiety