Hayashi Teruaki, Iwata Masaaki
Department of Neuropsychiatry, Faculty of Medicine Tottori University Yonago Japan.
PCN Rep. 2024 Jan 24;3(1):e169. doi: 10.1002/pcn5.169. eCollection 2024 Mar.
One-third of individuals who contract novel coronavirus disease 2019 (COVID-19) reportedly experience persistent symptoms, including respiratory issues, headache, dizziness, taste disorders, fatigue, and various psychiatric and neurological symptoms, known as post-acute sequelae of SARS-CoV-2. In this case report, we present a patient who became aware of brain fog, which is cognitive impairment, approximately 2 months after their COVID-19 symptoms had resolved, accompanied by anxiety and depression.
The patient, a 35-year-old Japanese man, was infected with COVID-19 and resumed work approximately 2 weeks later after symptoms improved. Approximately 1 month after returning to work, the patient's concentration became impaired and he started making noticeable errors at work. These symptoms did not improve, leading him to the outpatient clinic specializing in COVID-19 sequelae at our hospital. Here, he underwent blood tests, electroencephalography, and head magnetic resonance imaging, which did not reveal any abnormalities. Cognitive decline due to COVID-19 sequelae was therefore suspected, prompting his evaluation in our department approximately 5 months after his initial COVID-19 infection. Detailed cognitive function tests were performed. He was monitored without the use of medications, and his cognitive function gradually improved. Approximately 11 months after his initial COVID-19 infection, the same cognitive function tests were conducted again, because his subjective cognitive function symptoms had disappeared, and improvement was observed in many items.
Since brain fog is a relatively common sequela, we emphasize the importance of keeping this in mind from the initial consultations and comparing results over time.
据报道，感染2019年新型冠状病毒病（COVID-19）的患者中有三分之一会出现持续症状，包括呼吸问题、头痛、头晕、味觉障碍、疲劳以及各种精神和神经症状，即SARS-CoV-2感染后的急性后遗症。在本病例报告中，我们介绍了一名患者，其在COVID-19症状缓解后约2个月出现脑雾（即认知障碍），并伴有焦虑和抑郁。
该患者为一名35岁的日本男性，感染了COVID-19，症状改善后约2周恢复工作。复工后约1个月，患者注意力下降，开始在工作中出现明显失误。这些症状没有改善，于是他前往我院专门诊治COVID-19后遗症的门诊就诊。在那里，他接受了血液检查、脑电图检查和头部磁共振成像检查，均未发现任何异常。因此怀疑是COVID-19后遗症导致的认知衰退，促使他在首次感染COVID-19约5个月后到我们科室接受评估。进行了详细的认知功能测试。在未使用药物的情况下对他进行监测，其认知功能逐渐改善。在首次感染COVID-19约11个月后，再次进行了相同的认知功能测试，因为他的主观认知功能症状已经消失，并且在许多项目中都观察到了改善。
由于脑雾是一种相对常见的后遗症，我们强调从初次会诊开始就牢记这一点并随时间比较结果的重要性。
