When Erica Taylor got COVID-19, her brain seemed to shut off completely.
“I couldn’t think. Suddenly I couldn’t hold onto any thoughts,” she said, adding “I didn’t know who I was, where I was. I don’t know how long I was like that.”
At the time, she was 31 years old and showing the usual first signs of infection, dry cough and nausea.
What ended up happening was far from typical. She started suffering from debilitating neurological symptoms that have now taken over her life. Her doctors don’t know why.
Taylor is a lawyer. Her ability to process information and remember details is critically important for her employment.
“It feels like your brain is broken,” Taylor said. “I forget things that I just did. I don’t remember doing things. I forget words. I don’t remember grammar all the time.”
It’s been dubbed “COVID brain fog” — a common term used to describe worrisome cognitive symptoms, signalling something might be going wrong inside the brain. These warning signs can include dizziness, memory loss, confusion and difficulty finding words.
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“The virus might impact the brain in certain people impairing their activities of daily living and potentially stopping them from being gainfully employed,” said Simon Graham, a senior scientist at the Sunnybrook Research Institute in Toronto. “So, this is a health issue and a societal issue.”
It’s a problem that is hitting patients of all ages, young and old — some with mild symptoms and others who didn’t test positive at all.
Now, doctors are struggling to treat these side effects and researchers are scrambling to figure out why it’s happening.
“Given the fact that there are so many people that are being infected by the virus, it winds up being a health issue that we need to deal with,” Graham said, who has already set up a study looking at the short-term and long-term effects of COVID-19 on the brain.
No one really knows how many people are suffering from coronavirus-induced brain injuries. But in November, researchers found nearly 10 to 35 per cent of COVID-19 survivors in the United States experienced similar disabling and persistent neurological symptoms.
“My short-term memory is nonexistent,” said Tracey Thompson, 52, who has had brain fog since the spring. “Like running a bath — it’s a treacherous thing to do now because I have to sit there and watch it because I don’t know, if I leave the room, if I am going to remember that that’s what I was doing.”
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Thompson is a chef in Toronto. Creating food is her passion. That’s why changes to her ability to taste and smell are concerning and she worries about her future.
“I’m eating food and from one bite to the next, it’s (like) the sense has just turned off, right? They turned off like a light switch and there was nothing — like a complete absence. No salt, no sweet, no nothing, just texture,” she said. “I was like, ‘Oh, you are profoundly unwell.’”
“More interestingly, though, I’ve been having olfactory hallucinations where I smell things that aren’t there. I’ve smelled smoke, like thinking something is on fire.”
The loss of smell and taste — known effects of COVID-19 — are considered to be neurological symptoms, but research into this area is in its infancy. Some evidence suggests the virus may be able to get into the brain through the nasal cavity and into the orbitofrontal cortex.
“Interestingly, the brain is covered with a membrane called the dura. And the orbitofrontal cortex actually doesn’t have any dura. It’s the only part of the brain that has this potential pathway. And so, the virus can get in there,” Graham said.
“The inability to smell is actually associated with other neurodegenerative diseases such as dementia, Parkinson’s Disease and multiple sclerosis,” said Teresa Liu-Ambrose, director of the Aging, Mobility, and Cognitive Neuroscience Laboratory at the University of British Columbia.
At UBC, Liu-Ambrose and her colleagues are trying to figure out if the damage caused by the virus is prematurely aging the human brain.
“I think the best I understand the potential impact of COVID-19 on the brain, I would describe it almost as an accelerated aging process,” said Liu-Ambrose, whose team is aiming to assess approximately 1,000 people, some with and without the virus.
Liu-Ambrose’s work is part of the Canadian Longitudinal Study on Aging COVID-19 Brain Health. The project is funded in part by the Canadian Institutes of Health Research and the Weston Brain Institute.
Using neuroimaging, one aspect of the study will be looking for signs of silent strokes in the brain. Silent strokes or mini-strokes can happen without any obvious behavioural warning signals. So, a person can have one without ever knowing.
“When we age, one of the common things that happens within our brain is that the blood vessels do become compromised in part because of chronic conditions,” Liu-Ambrose said. “And when that occurs in normal aging, what happens within the brain is … silent strokes.”
“We also know that they collectively do contribute to our risk of developing cognitive impairment and dementia.”
There is evidence to suggest COVID-19 impacts the same blood vessels that feed the brain. If the virus is damaging those vessels, which could speed up aging, this, in turn, means some survivors might be at risk of getting early-onset dementia.
“I worry that, you know, one day maybe I’ll have a big stroke,” said Taylor, who is on medical leave. “I’m still struggling a lot. And, you know, to be a lawyer means to use your brain. And I don’t know if I’ll ever get to the point where I’ll be the same. I fear that a lot.”
It’s a fear that consumes Thompson, too. She’s struggling with her short-term memory and she has to set up numerous alarms to help her through her daily activities.
“I was extremely healthy before this. You know, I worked in a kitchen, I was a chef. I worked the line. I can rock-and-roll with the best of them,” Thompson said. “If this is a permanent state for me, I’m going to have to figure out a new way to be in the world … My wall of Post-it notes can’t travel with me.”
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