Brain fog and insomnia ‘common in Covid long-haulers’

RAK Hospital study looks at fallout from pandemic and why some patients struggle to shift symptoms

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About a third of Covid-19 survivors continue to be plagued by health problems, said doctors treating "long-haulers" at a specialist UAE clinic.

Insomnia, depression and chronic fatigue were some of the long-term conditions reported by patients receiving care at RAK Hospital in Ras Al Khaimah.

Despite recovering from Covid, about 30 per cent of patients continued to suffer with symptoms, which were recorded as part of the hospital’s online Covid rehabilitation programme.

People have reported not feeling like themselves, experiencing confusion and short-term memory loss

Chronic fatigue was reported by 47.5 per cent to be the most persistent complaint, with more than a third experiencing sleep problems.

More than a quarter reported “brain fog” or confusion, and 32.5 per cent showed signs of depression.

A loss of taste and smell was another ailment, reported in one in five patients who recovered from the coronavirus.

“Since it’s a new disease and our understanding is still limited, we have learnt symptoms can continue for three to nine months and pose challenges for people,” said Dr Raza Siddiqui, executive director of RAK Hospital.

“Even though it is established that certain risk factors including high blood pressure, smoking, diabetes, obesity and heart conditions make people more likely to suffer a serious bout of the infection, there isn’t a clear link between these risk factors and long-term issues faced by people.

“Long Covid may also present in people who may have had mild symptoms during the infectious phase.”

Hospital researchers previously studied 3,200 people in Ras Al Khaimah to understand risk factors associated with severe reactions to Covid-19.

They found overweight people were 62 per cent more likely to develop complications.

Smokers were also found to be 45 per cent more at risk, with those over 50, and anyone with existing heart problems or with a diet high in junk food, also more likely to be admitted to hospital.

As primarily a respiratory ailment, Covid-19 impairs the body’s ability to oxygenate itself. This affects the entire body, causing cardiovascular and neurological problems.

Dr Sweta Adatia, specialist neurologist and medical director at RAK Hospital. Courtesy RAK Hospital
Dr Sweta Adatia, specialist neurologist and medical director at RAK Hospital. Courtesy RAK Hospital

More recent data was collated and shared by Arise, the Private Sector Alliance for Disaster Resilient Societies, a network of organisations led by the UN Office for Disaster Risk Reduction.

Doctors found chronic ailments such as diabetes, high blood pressure, arthritis, obesity and digestive ailments were often exacerbated by Covid-19 and uncontrolled for several months.

Research at RAK Hospital found more than one in five of their patients suffered cardiovascular problems and 35 per cent had neurological problems.

Doctors said affected people showed certain vulnerabilities that were consistent with existing chronic health problems, or a family history of complaints that may have been undiagnosed.

Social isolation on specialist Covid-19 wards or long periods of quarantine during recovery were likely to have contributed to insomnia or mental illness, the experts found.

“The disruption of the sleep cycle is one of the earliest warning signs of mental ill-health,” said Prateeksha Shetty, a clinical psychologist at RAK Hospital.

“In long Covid cases, they can manifest as an isolated symptom or as one of a cluster of symptoms such as mood fluctuations, dysphoria, crying bouts and a loss of interest.

“They may also be accompanied by worries about the future, health of themselves and loved ones.

“These outcomes can be partly attributed to the changes in our brain due to Covid-19 infection.”

RAK Hospital was one of the first in the country to offer bamlanivimab, a lab-made antibody shown to reduce the risk of infected patients falling seriously ill.

US regulators gave the drug emergency use authorisation in November to support those most vulnerable to more severe symptoms of the virus.

Mental illness is a common long-term symptom reported worldwide in recovering Covid-19 patients.

“People have reported not feeling like themselves, experiencing confusion, short-term memory loss or an inability to concentrate,” said Dr Sweta Adatia, a specialist neurologist who is medical director of RAK Hospital.

“The reasons are still unknown and are being investigated, though largely can be attributed to issues of blood supply and cytokines in the brain which cause inflammation.

“In reality, up to 70 per cent of patients with severe Covid-19 may have neurological sequelae [a condition resulting from a disease] of one kind or another.

“The best treatment to avoid brain fog when you contract the infection is to avoid anxiety, have good sleep, eat a balanced diet, avoid alcohol, and take multivitamins and other micronutrients.”

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