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| Topic - CoViD in the 1980's ???? Posted: 01 Jan 2025 at 8:37am By Dutch Josh 2 |
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https://x.com/drseanmullen/status/1873867049585549552 or
https://x.com/drseanmullen/status/1873867049585549552;  < aria-label="Grok s" role="" ="-175oi2r r-1777fci r-bt1l66 r-bztko3 r-lrvibr r-1loqt21 r-1ny4l3l" ="" style="text-align: inherit; font-size: inherit; font-family: inherit; align-items: stretch; border-width: 0px; border-style: solid; border-color: black; display: flex; flex-basis: auto; flex-direction: column; flex-shrink: 0; list-style: none; margin: 0px; min-height: 20px; min-width: 0px; padding: 0px; : relative; : 0; overflow: ; justify-: center; cursor: pointer; outline-style: none; user-: none;"> < aria-expanded="false" aria-haspopup="menu" aria-label="More" role="" ="-175oi2r r-1777fci r-bt1l66 r-bztko3 r-lrvibr r-1loqt21 r-1ny4l3l" -testid="caret" ="" style="text-align: inherit; font-size: inherit; font-family: inherit; align-items: stretch; border-width: 0px; border-style: solid; border-color: black; display: flex; flex-basis: auto; flex-direction: column; flex-shrink: 0; list-style: none; margin: 0px; min-height: 20px; min-width: 0px; padding: 0px; : relative; : 0; overflow: ; justify-: center; cursor: pointer; outline-style: none; user-: none;"> Cognitive Dysfunction in Long Covid: What You Need to Know
This paper dives deep into the complexities of cognitive dysfunction in people with Long COVID—what many call “brain fog” but what is actually a much more debilitating symptom. It’s not just about forgetting where you left your keys; it’s about struggling to work, parent, or even read without triggering post-exertional symptom exacerbation (PESE)—a worsening of symptoms after even minor physical, cognitive, or emotional effort.
Key Insights for Patients and Practitioners:
1. Cognitive Dysfunction is Overlooked and Episodic/Relapse-remitting - Standardized tests often miss the episodic nature of cognitive issues. Patients may appear fine in a controlled setting but struggle with real-world challenges like work or parenting. This is critical to understand for healthcare providers assessing these symptoms.
2. Cognitive Activity Can Trigger PESE - Unlike traditional rehabilitation, cognitive tasks like reading or attending a meeting can trigger a severe, delayed crash in symptoms. Cognitive PESE isn't caused by “deconditioning” but likely involves **neuroinflammation, vascular damage, or viral persistence.
3. Occupational Therapy (OT) Offers Hope - OTs are uniquely positioned to help through cognitive pacing, a strategy to balance mental workload with rest. This involves tailoring tasks to the individual, considering factors like time of day, task complexity, and even body positioning to improve blood flow to the brain. (That said, most OTs aren’t trained in brain training principles and applications to target specific weaknesses, something there is a certification for & I believe it’s necessary to complete claim one is remotely competent in this area)
4. Parallels with ME/CFS - The authors highlight the similarities between Long Covid and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). The hallmark symptom—PESE—demands energy management over “pushing through.” This flies in the face of typical rehabilitation models.
Clinical Takeaways:
- Cognitive pacing is a cornerstone of care. Strategies include journaling, biofeedback (e.g., heart rate monitoring), and modifying daily routines to prevent overexertion.
- Patient-led adaptations are essential. Many people with Long Covid have already developed coping strategies like breaking tasks into chunks or limiting multitasking. OT can refine and support these.
Why This Matters
Cognitive dysfunction doesn’t just steal moments of clarity—it robs people of their roles and identities. Parenting, working, or even driving becomes impossible without worsening symptoms. This isn’t laziness or lack of willpower; it’s a physiological reality backed by research showing changes in brain structure, blood flow, and inflammatory markers.
A Note from Me
As a health behavior scientist and advocate for safe rehabilitation, this hits home. While exercise and cognitive training are my bread and butter, they must be approached with extreme caution in conditions like Long Covid and ME/CFS. This paper reinforces what patients have been saying for years (decades): rehabilitation without understanding PESE does more harm than good. The focus needs to shift from “fixing” to listening and supporting.
If we’re going to move the needle on recovery, research and clinical practice need to keep pace with what patients already know—rest, pacing, and careful scaffolding are key. - < aria-expanded="false" aria-haspopup="menu" aria-label="More" role="" ="-175oi2r r-1777fci r-bt1l66 r-bztko3 r-lrvibr r-1loqt21 r-1ny4l3l" -testid="caret" ="" style="text-align: inherit; font-size: inherit; font-family: inherit; align-items: stretch; border-width: 0px; border-style: solid; border-color: black; display: flex; flex-basis: auto; flex-direction: column; flex-shrink: 0; list-style: none; margin: 0px; min-height: 20px; min-width: 0px; padding: 0px; : relative; : 0; overflow: ; justify-: center; cursor: pointer; outline-style: none; user-: none;"> Thanks for the summary. Very helpful. Have you seen any papers about ADHD and #LongCovid? My colleagues tell me that ADHD can worsen, even in previously stabilized clients (with meds/therapy). DJ, What may work well for one person with L.C/M.E may not help another. In part related to the damage virus infection(s) did. |
