Lyme Disease Brain Fog and COVID Brain Fog
Brain fog can follow Lyme disease and COVID-19.
Patients describe memory problems and slowed thinking.
Doctors continue studying the causes of these symptoms.
Lyme disease brain fog has long been described by patients struggling with memory problems, slowed thinking, and difficulty concentrating. Similar symptoms are now widely recognized in patients recovering from COVID-19.
Sara Harrison wrote in Wired about the growing number of patients reporting persistent cognitive symptoms after COVID-19 infection.
What Does COVID Brain Fog Feel Like?
Dr. Aluko Hope from Montefiore Hospital in New York City described what he learned from listening to COVID-19 patients.
“About a third of his patients say they can’t recall telephone numbers they used to know, or that they struggle to remember the right word, feeling like it’s on the tip of their tongue but just out of reach.”
Patients also reported:
- Difficulty remembering conversations
- Problems multitasking
- Slowed processing speed
- Feeling mentally overwhelmed
- Trouble returning to work or school
Dr. Adam Kaplan, a neuropsychiatrist at Johns Hopkins University, explained that many patients describe their brains as “working more slowly.”
What Causes Brain Fog?
The exact causes of brain fog remain uncertain.
Investigators studying COVID-19 have proposed several possible contributors, including:
- Immune activation
- Neuroinflammation
- Changes in blood flow
- Anxiety and depression
- Post-traumatic stress
- Nerve injury
Some experts believe prolonged immune activation may contribute to ongoing cognitive dysfunction.
“Something about that activation of the immune system is potentially causing worse cognitive function,” said Joanna Hellmuth, a neurologist at the UC San Francisco Memory and Aging Center.
Lyme Disease Brain Fog
Neurologists and Lyme disease specialists have long described similar cognitive complaints following infections including Lyme neuroborreliosis, Epstein-Barr virus, and other viral illnesses.
Marie Grill, a neurologist at the Mayo Clinic, noted that physicians have observed brain fog after infections for years.
“A lot of us are not surprised at all to be encountering this, because we have seen it so many times.”
Patients with Lyme disease brain fog may report:
- Word-finding difficulty
- Forgetfulness
- Difficulty concentrating
- Mental fatigue
- Slowed thinking
- Short-term memory problems
Up to 90% of patients with post-treatment Lyme disease syndrome (PTLDS) report cognitive symptoms such as brain fog, memory issues, and slowed processing. Advanced imaging (PET, fMRI, DTI) in these patients shows evidence of inflammation, glial activation, and changes in white matter structure.
How Can Doctors Tell the Difference?
Distinguishing Lyme disease brain fog from COVID brain fog can be challenging because symptoms often overlap.
Physicians may consider:
- History of tick exposure
- Prior erythema migrans rash
- Timing of symptoms
- Associated neurologic findings
- COVID-19 infection history
- Regional Lyme disease exposure risk
Some patients may also experience overlapping or sequential illnesses.
What Is the Future for Patients With Brain Fog?
Scientists continue to study how long post-infectious cognitive symptoms may persist and whether immune, inflammatory, or neurologic mechanisms are responsible.
Recognition of long COVID has also increased awareness of persistent cognitive symptoms following infections more broadly.
Clinical Perspective
Brain fog following infection is real and can significantly impair daily functioning, work performance, and quality of life.
Both Lyme disease and COVID-19 have highlighted the need for continued research into post-infectious cognitive dysfunction and individualized patient care.
FAQ: Lyme Disease Brain Fog
Can Lyme disease cause brain fog?
Yes. Patients with Lyme disease may report slowed thinking, memory problems, concentration difficulty, and mental fatigue.
Is COVID brain fog similar to Lyme brain fog?
Many patients describe overlapping symptoms including forgetfulness, word-finding problems, and slowed cognitive processing.
What causes brain fog after infections?
Researchers are studying possible contributors including immune activation, neuroinflammation, autonomic dysfunction, and changes in brain signaling.
Related Articles:
Changes in smell can be a sign of COVID-19 and Lyme disease
COVID-19 long-haulers and Lyme disease patients share similar frustrations
References:
- Sara Harrison. Confused About Covid Brain Fog? Doctors Have Questions, Too. Wired. November 6, 2020.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
