Neurological and Mental Health Effects of COVID-19

Years after the emergence of COVID-19, it’s clear that it’s more than a respiratory virus. COVID can affect almost every organ in the body, including the brain and nervous system. 

Among people who get COVID, 1 in 3 have neurological or mental health issues within 6 months of their infection. These symptoms can happen with acute COVID infection. And they can last for months to years as part of “long COVID.”

How does COVID affect the brain and nervous system?

The virus that causes COVID enters the body through the nose, mouth, and eyes. The virus can enter the nervous system through the lining of the nose, which is close to the brain. Research shows that the virus can damage the blood vessels in the brain and cause inflammation and blood clotting.

Damaged blood vessels can harm brain cells and cause abnormal brain signals. This can lead to symptoms like loss of smell and trouble thinking. And it can cause complications like seizures and strokes. On top of that, memory problems, headaches, and post-COVID anxiety can be a problem for many people.

Can COVID cause neurological disorders?

Yes. Both children and adults with COVID infection can develop brain and nervous system issues. And these can occur even when other COVID symptoms are mild.

Leading research institutions continue to study the neurological effects of the virus. One example is the NeuroCOVID Project at NYU. 

COVID can lead to many neurological conditions, like:

• Stroke

• Seizures

• Encephalopathy (confusion, delirium)

• Sleep problems

• Dysautonomia (problems controlling heart rate, blood pressure, and body temperature)

• Neuropathies

• Guillain Barré syndrome (muscle weakness)

These conditions can happen with acute COVID infection. But they can also occur months later in long COVID. More research is needed to figure out exactly how — and for how long — the virus affects the brain and nervous system.

The most common neurological symptoms after COVID infection include:

• Cognitive issues (poor memory and difficulty finding words, also known as “brain fog”)

• Loss of taste and smell

• Headache

• Numbness or tingling

• Myalgias (muscle pain)

• Tremors

Mental health issues associated with long COVID

Many — if not most — people with long COVID experience mental health issues. This may be due to inflammatory and chemical changes in the brain — or stressors like coping with chronic illness and job loss. 

Mental health issues some people experience after COVID can include:

• Anxiety

• Depression

• Sleep disorders (insomnia)

• Psychosis

• Post-traumatic stress disorder (PTSD) 

If you’re experiencing mental health issues because of long COVID, you’re not alone. There are many support networks available to long COVID patients for support.

*Trigger warning due to sensitive content*

Some people can feel a sense of isolation and despair when dealing with post-COVID complications. In some cases of long COVID, people can experience suicidal thoughts. If you or someone you care for is having thoughts of self-harm, please reach out for help. There are resources available if you or someone you love is having a mental health crisis.  

Why do some people have neurological and psychiatric symptoms after COVID but not others?

Scientists are still trying to understand why some people have neurological and psychiatric symptoms with COVID. So far, it seems like women may have a higher risk of neurological or psychiatric issues after COVID. 

People with mental or neurological issues before COVID infection may also be at higher risk of worsening conditions. And genetics may play a role. More research is needed to determine the risk factors for developing neurological issues with COVID infection.

Quality of life and the neurological and mental health issues related to long COVID

Long COVID can be life changing. The CDC found that people with long COVID reported worse quality of life than people who were recovering from cancer. 

Some of the reasons why long COVID decreases quality of life include:

• Chronic illness: Long-term illness can include pain, discomfort, and mental health issues.

• Job loss: Some people lose their employment because they can’t perform previous duties at work.

• Financial hardship: This can happen due to loss of job and benefits, medical bills, and cost of medications, to name a few.

• Relationship difficulties: Issues related to intimacy and childcare can strain relationships. 

• Loss of physical abilities: This can limit almost every aspect of life.

• Inability to take part in leisure activities and hobbies: This can contribute to mental health issues.

• Inability to travel: Some people can’t travel due to mobility issues, oxygen requirements, or fear of virus exposure.

• Isolation: People may feel isolated due to quarantine or not being able to take part in certain activities.

• Mental health issues: These issues can include PTSD, depression, and anxiety.

This is only a partial list — every aspect of post-COVID life can be a challenge. If you know someone dealing with long COVID, reach out to see if they need support.

Treatment and resources for neurological and mental health disorders caused by COVID

If you have neurological symptoms or concerns about your mental health after COVID, your first stop should be your primary care provider (PCP). Your PCP may recommend testing or refer you to a specialist. Let’s take a closer look at some specific issues. 

Post-COVID neurological issues

For neurological symptoms, your PCP may refer you to a neurologist — a brain and nervous system specialist. The neurologist will ask about your symptoms and test things such as your memory, strength, and balance. They may order tests such as:

• A CT scan of your brain: This can detect problems like a stroke or tumor.

• A MRI of your brain and/or spinal cord: This can show more details about your brain, brainstem, and spinal cord.

• An electroencephalography (EEG): An EEG can detect abnormal electrical activity in the brain.

• Autonomic nervous system testing: This can look at how your body controls heart rate, blood pressure, and body temperature.

There’s no one specific treatment for the neurological issues caused by COVID. Medication can help manage many symptoms, such as nerve pain and headaches. Physical therapy can be helpful for people with mobility issues. And cognitive therapy can help people with memory loss issues.

Post-COVID mental health issues

If you’re experiencing mental health issues, such as anxiety or depression, your PCP may refer you to a mental health specialist:

• Psychiatrists can prescribe medication for psychiatric conditions.

• Psychologists can make a psychiatric diagnosis and treat it with specialized therapy.

• Therapists can provide coping strategies and ways to reduce symptoms of mental illness 

• Clinical social workers are trained in case management and advocacy.

There’s no specific treatment for the psychiatric issues caused by COVID. But to lessen or prevent your symptoms, your healthcare providers may prescribe medications like antidepressants or antianxiety medications. And they’ll likely recommend other strategies, like breathing exercises. 

Remember — if you’re having a mental health crisis, there are resources available for immediate help.

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Written by:

Alice Perlowski, MD, MA, FACC

Dr. Alice Perlowski is a board-certified cardiologist and fellow of the American College of Cardiology. She has seen patients and supervised trainees in the academic and private sector, with focuses in interventional cardiology, vascular medicine, preventative cardiology, and women’s heart health.

Edited by:

Alex Eastman, PhD, RN

Alex Eastman, PhD, RN, is a California-based registered nurse and staff medical editor at GoodRx, where he focuses on clinical updates and Latino health.

Reviewed by:

Kerry R. McGee, MD, FAAP

Kerry McGee, MD, FAAP, has over a decade of experience caring for babies, children, and teenagers as a primary care pediatrician. She has a special interest in adolescent health, particularly in adolescent mental health.

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