COVID-19's hidden toll: how the pandemic has aged our brains
The research shows that COVID-19 doesn't just affect our lungs—it attacks our brain health, potentially adding months or even years to our biological brain age. This discovery has profound implications for millions of people worldwide, especially as we learn more about long COVID or Post-Acute Sequalae of COVID-19 (PASC) and its lasting effects.
What we are learning about brain ageing
Think of your brain like a car. Just as a car accumulates wear and tear over time, our brains naturally age as we get older. Scientists can now measure this process using advanced brain scans to determine someone's 'brain age'—how old the brain appears compared to the person's actual age.
In healthy people, brain age typically matches chronological age fairly closely. But recent studies have found something alarming: people exposed to COVID-19 or even just the pandemic environment show brains that appear significantly older than expected.
A major study using brain scan data from over 15,000 healthy adults found that people exposed to the pandemic environment showed an average brain age increase of 5.5 months compared to those studied before the pandemic. Even more concerning, this acceleration was more pronounced in men and those from disadvantaged socioeconomic backgrounds.
The double whammy: virus plus stress
COVID-19 appears to age brains through two main pathways. First, the virus itself is neurotropic—meaning it can invade and directly damage brain tissue. Studies show that SARS-CoV-2 has been found in neural tissues up to 230 days after infection, and immune system activation has persisted for as long as 2.5 years.
Second, the psychological stress and social isolation of the pandemic created a perfect storm for brain health. Researchers found that when people were shown faces labelled as 'infected,' their brains responded with elevated activity in fear and stress regions, including areas critical for memory and emotion. This suggests that fear of the virus alone can alter how our brains function.
Perhaps nowhere is this brain aging more apparent than in long COVID patients. Studies tracking COVID survivors for three years found that among those who weren't hospitalised, the brain still showed signs of ongoing damage, with cognitive issues persisting years after infection.
Long COVID affects at least 10% of people recovering from COVID-19 infections and possibly up to 50-70% of those who were hospitalised. Hallmark symptoms include brain fog, memory problems, difficulty concentrating, and persistent fatigue—all signs that the brain is struggling to function normally.
Brain scans of COVID survivors have shown measurable drops in cognitive abilities, with statistical significance, suggesting real physical changes in brain structure and function.
Particularly troubling is evidence that young people haven't escaped this brain ageing effect. Studies of adolescents before and after pandemic shutdowns found significantly higher levels of anxiety and depression, along with brain scans showing signs of accelerated brain maturation equivalent to 5-6 months beyond their actual age.
These effects varied by gender, with teenage girls showing widespread brain changes across 30 regions, including areas crucial for social and emotional processing, corresponding to about 4.2 years of accelerated aging. These findings suggest that the social and educational disruptions of the pandemic may have lasting effects on developing brains.
The science behind the damage
How exactly does COVID-19 age our brains? The process involves several mechanisms working together:
Inflammation: The virus triggers widespread inflammation throughout the body, including the brain. This chronic inflammation damages brain cells and disrupts normal brain function.
Blood-Brain barrier breakdown: COVID-19 can damage the protective barrier that normally keeps harmful substances out of the brain, allowing inflammation and toxins to enter.
Oxygen deprivation: Even mild COVID infections can reduce oxygen levels, starving brain cells of the fuel they need to function properly.
Immune system confusion: The virus can cause the immune system to attack healthy brain tissue, similar to autoimmune diseases.
What this means for recovery times
The latest three-year studies show both good and concerning news. Among people who had mild COVID and weren't hospitalised, the increased risk of death disappeared after the first year, and most brain-related symptoms improved significantly over time.
However, those who were hospitalised during their COVID infection, continued to show elevated death rates and persistent brain problems even three years later, with substantial ongoing health impacts. This suggests that the severity of the initial infection plays a crucial role in long-term brain health outcomes.
The news however, isn't all doom and gloom. Innovative treatment approaches are showing promise in reversing some of these effects. At specialised clinics, patients with persistent long COVID symptoms have seen significant improvements using comprehensive treatment programmes that combine advanced neurotechnology with holistic therapies.
Integrative neurorehabilitation, driven by neurotechnology and holistic therapies, can improve outcomes in individuals with Long COVID. Such interventions not only alleviate symptoms but may also slow or reverse the neurocognitive aging seen in this population.
The road ahead
As we continue to understand COVID-19's long-term effects, it is clear that brain health must be a priority in recovery efforts. With an estimated 65 million people worldwide living with long COVID symptoms, the scale of this challenge requires coordinated medical research and treatment approaches.
The pandemic has taught us that infectious diseases can have effects far beyond their initial symptoms. By taking brain ageing seriously and developing comprehensive treatment approaches, we can help millions of people recover not just their physical health, but their cognitive abilities as well.
Understanding these effects is the first step toward healing. With continued research and innovative treatments, there's reason for hope that we can help mitigate the neurological impacts of the pandemic and restore brain health through multidisciplinary and personalised care paradigms.
(Dr. Rema Raghu is chief clinical officer, Buddhi Clinic, Chennai. drrema@buddhiclinic.com; Vivek Misra is senior consultant , neuromodulation and clinical sciences, Buddhi Clinic; Thyagarajan S. is research assistant, Buddhi Clinic)
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