Wave of cognitive disorders in young people from COVID-19

Among the many frightening and potentially life-altering consequences for survivors of COVID-19 is an increased risk of stroke, particularly in young, otherwise healthy people who show no other risk factors.

Possibly even more common for those who suffer the disease is hypoxia, or lack of oxygen to the brain, which can be associated with disease of the lungs and heart from COVID-19, which can have many of the same long-term effects.

As we continue to learn about how this coronavirus attacks the body, we are also beginning to see what likely effects it may have years and even decades down the road.

Of course, doctors and researchers are focused right now on the immediate crisis: Treating patients in acute distress and developing effective treatments that may lessen the impact and reduce hospitalizations and death.

Emergency room doctors, pulmonologists, nurses, and others are on the frontlines today battling the disease. In the years to come, it may well be medical professionals who focus on the brain and cognitive function who are seeing and helping many post-COVID patients.

The reason is that hypoxia, cardiac dysfunction, blood clots, strokes and similar conditions — all of which have been observed, to one degree or another, in those suffering COVID-19 — can all have long-term effects on brain function and cognition.

When the brain is deprived of oxygen, even for a short period of time, it can cause loss of mental function.

As patients recover from the illness, they may find that their memory is not as good as it once was. They may find themselves having trouble grasping the right words or be more accident-prone. Some could see personality changes, such as becoming quicker to anger, more impulsive, depressed, slower at processing information, even a tendency towards drug or alcohol addiction.

These are all common symptoms of cognitive damage which also can be seen in patients who become ill with Lyme disease, MS, and other conditions that cause long-term cognitive damage, for instance. They are also seen in older people who show early signs of dementia.

The difference with COVID-19, it appears, is that younger people are suffering these effects and will need treatment for a much longer period of time. If someone in their teens and 20s suffers a stroke or embolism, it could impact their long-term life choices in profound ways.

If brain functioning is diminished, or someone experiences personality changes or memory loss, that is going to be a factor in determining what careers they can choose, relationships they have, and all the other major life-defining decisions people typically make in their 20s or 30s. 

That is why it is crucial that we prepare for this coming wave of cognitive problems and alert the mental health professionals who are usually the first line of defense.

There are basic diagnostic assessments that can be done to determine these conditions. Neuropsychologists perform them every day in their offices, and currently, more often by telehealth. 

Once a condition is diagnosed, treatment regimens can be developed, or patients referred to specialists to help them. Loss of cognitive capacity can be treated, but it is important that intervention happens early.

Depression, mood disorders and other psychological conditions caused by brain dysfunction are harder to treat than when those conditions are purely emotional in nature. There are cognitive rehabilitation methods,

medication, and other therapies that are effective, but the conditions must be properly diagnosed first.

Hundreds of times a year, I see patients with these very same medical concerns for testing to address a range of conditions, and as the long-term impact of COVID-19 begins to take shape, it is likely many more will be needed.

Dr. Wilfred Van Gorp is a neuropsychologist with over 30 years in private practice and academic research. He is a former president of the American Academy of Clinical Neuropsychology.