Podcast Summary
Long COVID's Lasting Effects: Millions of Americans continue to grapple with long-term symptoms of COVID-19, including physical, mental, and cognitive effects, despite most declaring the pandemic over. Long COVID's prevalence is uncertain due to underreporting, and neuropsychologists Tracy Van Orsdahl and Rowena Eng discuss its causes, treatments, and ongoing research.
While the majority of Americans have been infected with COVID-19 and many are ready to declare the pandemic over, millions are still dealing with the long-term effects of the virus. Long COVID can cause physical, mental, and cognitive symptoms that can last for months or even years. The exact prevalence of long COVID is uncertain, but researchers are working to identify risk factors, treatments, and similarities to other post-viral illnesses. Doctors Tracy Van Orsdahl and Rowena Eng, today's guests on Speaking of Psychology, are neuropsychologists who work with patients dealing with long COVID. They emphasized that while some individuals with long COVID are identified through medical records or long-term care, many others may not be reported, making it difficult to determine the true scope of the issue. They also discussed mental health and cognitive symptoms, causes, treatments, and ongoing research questions.
Understanding Long COVID in Children and Adolescents: Despite less research, long COVID symptoms in children and adolescents include fatigue, sleep disturbances, mood disorders, and headaches. Diagnosis is complex, and more research is needed to understand its prevalence, symptoms, and risk factors.
While COVID-19 affects children and adolescents, the prevalence and symptoms of long COVID in this age group are less understood and seem to be less frequent than in adults. The diagnosis of long COVID is still a complex issue, with no official agreement on its definition and duration of symptoms. Symptoms can include fatigue, sleep disturbances, cognitive changes, mood disorders, and headaches, but children may present with fewer cognitive changes compared to adults. The symptoms of long COVID can be difficult to distinguish from those commonly experienced by healthy adults, making it challenging to determine if they are causally related to the COVID-19 illness or the psychosocial stress of living through the pandemic. The risk factors for long COVID are not yet clear, but older adults and those with compromised immune systems may be more susceptible. The field of long COVID research is still evolving, and more work is needed to understand its prevalence, symptoms, and risk factors in children and adolescents.
Long COVID symptoms can affect individuals regardless of acute illness severity: Female sex, preexisting mental health conditions, certain racial or ethnic backgrounds, socioeconomic deprivation, and health comorbidities increase the risk of long COVID. Vaccination may help prevent long COVID, but more research is needed on reinfections and the role of vaccinations between infections.
Long COVID symptoms, such as neuropsychological and neuropsychiatric difficulties, can affect individuals who have had mild, moderate, or severe acute illnesses, with risk factors including female sex, preexisting anxiety or depression, certain racial or ethnic backgrounds, socioeconomic deprivation, and health comorbidities. Individuals who have been hospitalized in the intensive care unit are also at higher risk. The risk of long COVID may be reduced with vaccination, and the data suggests that vaccination may help prevent long COVID. However, there is limited research on the impact of reinfections and the role of vaccinations between infections. It is important to note that avoiding COVID in the first place, through vaccination and other preventative measures, remains the best defense against long COVID.
Cognitive symptoms in secondary or tertiary COVID-19 infections: Neuropsychologists assess patients to identify cognitive strengths and weaknesses, develop compensatory strategies, and address modifiable risk factors to improve cognitive functioning in those with COVID-19 related brain fog.
While there is limited research on the severity and presentation of cognitive symptoms in secondary or tertiary COVID-19 infections, many patients report feeling cognitively sluggish or inefficient, with symptoms such as difficulty finding words, decreased attention, and increased distractibility. Neuropsychologists assess these patients to identify strengths and weaknesses and develop compensatory strategies to minimize cognitive errors. Modifiable risk factors, including fatigue, poor sleep, certain medications, and mental health symptoms, should also be addressed to improve cognitive functioning. These strategies apply to patients of all ages, including younger patients, who may also experience brain fog. Treatment focuses on addressing these factors and helping patients adapt to their cognitive changes.
Long COVID effects on children's brains: Recognize the importance of pacing, day-to-day behavioral changes, cognitive rehabilitation, and a holistic approach to support children with long COVID's cognitive and physical symptoms.
The ongoing health effects of COVID-19, particularly in children and adolescents, are causing concerns beyond just the respiratory symptoms. Many individuals are reporting issues with brain fog, which can manifest as slower thinking, memory challenges, and difficulty processing information. From a clinical and educational perspective, it's crucial to provide a supportive environment for these students as they adjust to the school setting. This includes recognizing the importance of pacing school activities and workloads, as well as implementing day-to-day behavioral changes to promote overall health and wellness. Cognitive rehabilitative exercises are also being utilized to support both cognitive coping skills and physical symptom management, including headaches, fatigue, and anxiety. Early in the pandemic, there was significant attention given to the loss of smell and taste in COVID-19 patients, and this continues to be a concern for some individuals with long COVID. Overall, it's essential to prioritize a holistic approach to supporting the health and well-being of those affected by long COVID.
Long COVID Symptoms in Children: Fatigue and Sleep Issues: Long COVID symptoms in children differ from adults, with fatigue and sleep issues being more common. Access to specialized care is a challenge due to limited clinics and socioeconomic barriers. Telehealth has been helpful, but more trained medical specialists are needed to meet the demand.
Long COVID symptoms, particularly in children, often include fatigue and sleep issues rather than frequent changes in sense of smell and taste. Access to specialized care for long COVID is a challenge due to the limited number of multidisciplinary clinics and socioeconomic barriers. Telehealth has been a valuable solution to increase access to care, especially for patients with fatigue who face mobility issues. However, there is a significant need for more trained medical specialists to address the increasing number of patients seeking care for long COVID symptoms. While specialized clinics are becoming more common, they cannot currently meet the demand. The pediatric side sees a growing number of specialized clinics, but access remains a concern, and telehealth has been a valuable addition to healthcare services.
Telehealth appointments surge during COVID-19 pandemic: Patients opt for telehealth due to pandemic challenges and long COVID symptoms, while healthcare providers offer empirically based guidance for treatment.
The COVID-19 pandemic has led to a significant increase in telehealth appointments for patients, especially those who are out of state or dealing with long COVID symptoms. This shift is due in part to the challenges of traveling for in-person appointments and the fatigue experienced by patients. Telehealth evaluations and feedback sessions have become the norm for many healthcare providers, including neuropsychological evaluations. However, some patients still prefer in-person appointments and are willing to travel for them. Regarding treatments for physical symptoms of long COVID, there is a growing trend of patients seeking out unproven therapies due to desperation. Healthcare providers are encouraging patients to consult with their primary care doctors before pursuing such treatments, as many may not have efficacy data or logical mechanisms for improving patient functioning. For patients already receiving care in a multidisciplinary clinic, they are receiving empirically based guidance for the treatment of their symptoms.
Identifying common mechanisms and effective interventions for managing long COVID and related conditions: Urgent research is needed to better understand long COVID and related conditions, including more treatment outcomes research and a better understanding of the general COVID presentation and potential subgroups.
Long-term COVID symptoms overlap significantly with those of other postviral conditions, such as chronic fatigue syndrome and postural orthostatic hypotension syndrome. These conditions, which can include symptoms like fatigue, headaches, cognitive difficulties, and autonomic dysfunction, have historically been challenging to understand and treat. From a clinical perspective, researchers and healthcare professionals are focused on identifying common mechanisms and effective interventions for managing these complex conditions. Urgent research questions include the need for more treatment outcomes research, particularly for behavioral health interventions, and a better understanding of the general COVID presentation and potential subgroups within long COVID.
Considering controlled case studies with comparison groups for long COVID research: Differentiating between those with COVID and psychosocial stressors, hospitalization severity, and acknowledging mental health treatments for long COVID can lead to better understanding and minimizing stigma.
When studying long COVID, it's crucial to consider controlled case studies with comparison groups, such as those who have experienced psychosocial stressors during the pandemic but haven't had COVID. Additionally, it's important to differentiate between those who have tested positive for COVID and those with a clinical presentation of the disease based on symptoms. Furthermore, hospitalization severity should also be taken into account. Regarding the stigma surrounding long COVID symptoms, especially for women and those with preexisting mental health vulnerabilities, it's essential to understand that mental health and cognitive treatments can improve functioning and quality of life without negating the reality of symptoms. The dichotomy of long COVID being "all in your head" versus real is not helpful. Psychologists are contributing to long COVID research, and their findings suggest that mental health treatments can be beneficial. By acknowledging this, we can minimize stigma and instill hope for those affected.
