We’ve heard from more and more COVID-19 survivors that the virus’ impact lasts beyond the first few weeks of immediate symptoms. For some patients, COVID-19 has a long-term, far-reaching impact on their daily lives, impacting them physically, emotionally, and cognitively. This is especially true for many people with previously diagnosed conditions, such as prior strokes, TBIs, or diagnoses of dementia. Read on to hear current research findings related to COVID-19’s lasting effects on cognitive function, and what we here at Constant Therapy Health are doing about it.
As we continue to learn more about COVID-19, a new term, “Long COVID”, emerged. So what IS Long COVID? What does the existing research tell us? When we analyze an illness like COVID-19 we look at mortality, or how deadly it is, as well as morbidity, or the overarching impact of the disease other than death. Research thus far mostly prioritized the mortality of COVID-19 (understandably so given the urgency to better understand this deadly virus). However, more and more research is emerging assessing the morbidity of COVID-19 and its long-term symptoms. Long COVID can cause a variety of symptoms. They range from more physical symptoms such as pulmonary, cardiovascular, and systematic issues like fatigue, to neuropsychological symptoms impacting cognition, speech and language, memory, emotion and mood, and the now hallmark symptoms of loss of smell and taste. As the scientific community continues to uncover the lasting symptoms associated with Long COVID, we also need to make a plan to figure out how to best help those currently struggling with these long-term effects.
There are four ways that COVID-19 is currently impacting speech, language, and cognitive skills:
As noted above, Long COVID is receiving more and more attention as scientists prioritize investigating the long term effects of the disease.
In a not-yet peer reviewed paper analyzing survey data from over 3,700 people who had symptoms consistent with COVID-19, researchers found trends not only in the types of symptoms that people had, but also in the timing at which they experienced them:
In another single-center study looking at persistent symptoms following COVID-19 hospitalization, scientists found that even after over 100 days, patients still reported fatigue (55%), shortness of breath (42%), loss of memory (34%), concentration difficulties (28%), and sleep disorders (30.8%).
Battling COVID-19 also brings mental health challenges, which can impact functional presentation and lower treatment engagement.
Do to the highly contagious nature of the virus, social isolation is a pervasive requirement for managing the spread of COVID-19. Patients with pre-existing conditions such as dementia, aphasia, traumatic brain injuries, and other neurological disorders are particularly vulnerable to the impacts of isolation. Without frequent social interaction, patients do not get to apply and practice their speech, language, and cognitive skills as readily, which can lead to a decline in each of these areas of need. While these patients are careful to isolate to stay safe from the virus itself, studies show that the isolation of COVID-19 results in a deterioration of emotional state and communication skills of these patients.
These long-term and comorbid effects of COVID-19 are all still very new issues, but due to their persistent, wise-reaching impact on people’s ability to participate in their daily lives and successfully return to work, continuing to educate ourselves is of the utmost importance. The social and economic impacts of Long COVID need to be addressed expediently.
Amy Ramage rightfully called upon speech-language pathologists to look at how we can help these patients given the applicability of speech-language pathology approaches to evaluation and intervention for similar populations of critical care patients. Whether the cause is a direct result of COVID-19 attacking patients’ neurological centers, or other neurological consequences of COVID-19 like stroke or intermittent hypoxia, we need to be prepared to help these patients. As Ramage aptly puts it, “although COVID-19 is novel, the cognitive and linguistic symptoms SLPs will observe in survivors are not novel.” We need to use objective and subjective evaluations to assess cognitive, linguistic, and social communication systems. We should treat all deficits with an interprofessional approach, and per Ramage’s article, treatment should not stop when patients are discharged but should continue when patients are at-home as well.
The research community hasn’t yet been able to study whether rehabilitation helps combat COVID-19 language and cognitive symptoms. However, that’s exactly what we’d like to find out. Constant Therapy has the therapy activities to address the language and cognitive symptoms associated with Long COVID and the neurological sequelae of COVID-19 – now it’s a matter of figuring out whether our therapy activities can help these specific patients.
We look forward to doing our part in the research community to help determine how we can best assist patients with long-term cognitive and language impairments resulting from the COVID-19 pandemic.
Jordyn is a practicing Speech-language Pathologist and Assistive Technology Specialist and is the Director of Pierce Speech, Language, and Learning Center. She also is the Vice President of Clinical Operations & Development for Constant Therapy Health, leading content development, advising on product features, and coordinating internal and external research projects.