Brain Fog and Fatigue following COVID-19 Infection: An Exploratory Study of Patient Experiences of Long COVID 2022 Chasco et al

Abstract

Post-acute sequelae of SARS-CoV-2 (PASC) is a poorly understood condition with significant impact on quality of life. We aimed to better understand the lived experiences of patients with PASC, focusing on the impact of cognitive complaints (“brain fog”) and fatigue on (1) daily activities, (2) work/employment, and (3) interpersonal relationships.

We conducted semi-structured qualitative interviews with 15 patients of a Midwestern academic hospital’s post-COVID-19 clinic. We audio-recorded, transcribed, and analyzed interviews thematically using a combined deductive-inductive approach and collected participants’ characteristics from chart review.

Participants frequently used descriptive and metaphorical language to describe symptoms that were relapsing-remitting and unpredictable. Fatigue and brain fog affected all domains and identified subthemes included symptoms’ synergistic effects, difficulty with multitasking, lack of support, poor self-perception, and fear of loss of income and employment. Personal relationships were affected with change of responsibilities, difficulty parenting, social isolation, and guilt due to the burdens placed on family. Furthermore, underlying social stigma contributed to negative emotions, which significantly affected emotional and mental health.

Our findings highlight PASC’s negative impact on patients’ daily lives. Providers can better support COVID-19 survivors during their recovery by identifying their needs in a sensitive and timely manner.

Open access, https://www.mdpi.com/1660-4601/19/23/15499

 

I agree with your point about assuming people will recover and just need "kind words along the way".

That's what I encountered regarding ME from health care practitioners with a caring bedside manner.

In our household we call this technique positive non-interventioinism (PNI).

PNI appears prevalent in regards to post viral conditions.

In fact, PNI is universally subscribed to, by many. At least in some situations.

 

After years of seeing papers like this published, I don't understand why anyone bothers. No one reads this. Likely fewer people will read this than the number of people who have participated in its production. It adds nothing. No one learns anything. It doesn't produce useful information, doesn't even get anywhere after that.

All modern EBM and guidelines production ignores this stuff, they don't even bother with the actual substance of trials as it all gets mixed together, so it never actually does anything. It doesn't help us. Doesn't help clinicians do any better. It's far less substantial that what the patients write themselves.

It's like a parody of useless academia.

Is that it? Identify needs? And then what? How does that help anyone? Do the needful? This is mindless self-indulgence with far more serious communication problems than language barriers.

 

I mean specifically the process of creating clinical guidelines to be used in healthcare, like the NICE process or IQWIG in Germany. All they evaluate are trials, they don't look at any of this. There is far too much to begin with, and it doesn't really inform anything about how to treat the patients.

In the end this is the only process that matters. Nothing else reaches the clinicians who make decisions based on what they're told to do. And all the details about the treatments get lost, the recommendations are just generic this or that, CBT or exercise, do whatever.

Maybe this get a glance, I don't know. The IOM report was very exhaustive, but I still don't see how they could go through reading all of those meaningless papers and make some sense of it when they can't even do that reliably with actual trials. This is academic publishing for the sake of publishing stuff.

 

I can at least imagine a near future where AI allows this kind of studies to be used when summing up the whole body of knowledge and trying to understand what the hell happened. So far it doesn't seem to have informed anything, though. I place it pretty much in the same category as the record the patient community leaves, it may have a future use. Just seems so pointless when there's so much real work to do right now and for the last several decades.