[28F] Experiencing post-COVID cognitive and speech issues

Patient Description

A 28-year-old female has been experiencing cognitive decline, speech errors, and unusual skin sensations since contracting COVID-19 in 2020. The patient reports mispronouncing words, misplacing words, or using the wrong words entirely, especially towards the end of the day. Cognitive issues include difficulties with attention, problem-solving, and short-term memory, although these symptoms are not consistent. The patient also describes sensations of static or crawling on her legs and a sore spot on her head that feels better when massaged, accompanied by a slight headache. No medications are currently being taken, and there is no history of pre-existing conditions or chronic illnesses. The patient expressed concern about the possibility of multiple sclerosis or a brain tumor, noting a family history of multiple sclerosis.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, it's possible you could be experiencing:

  • Post-Acute Sequelae of SARS-CoV-2 infection (PASC), also known as Long COVID: This condition is characterized by a range of symptoms that continue for weeks or even months after the acute phase of the COVID-19 infection has resolved. These symptoms can include cognitive impairment (often referred to as "brain fog"), speech difficulties, and unusual skin sensations. The exact cause of PASC is not yet fully understood, but it is thought to be related to the body's immune response to the virus.

  • Fatigue or stress: Your symptoms seem to worsen towards the end of the day, particularly after work. This could suggest that fatigue or stress might be playing a role in your symptoms. Both can affect cognitive function and speech, and stress can sometimes cause unusual physical sensations.

  • Multiple Sclerosis (MS): MS is a chronic disease that affects the central nervous system, which includes the brain and spinal cord. MS can cause a wide range of symptoms, which can vary greatly from person to person. Some of these symptoms can include difficulties with speech and cognitive function, as well as unusual skin sensations. However, it's important to note that MS is typically diagnosed through a combination of neurologic exams, medical history, and an MRI of the brain and/or spinal cord.

  • Brain tumor: Although less likely, a brain tumor can cause a variety of symptoms depending on its size, location, and rate of growth. Some brain tumors can cause cognitive changes and speech difficulties. However, brain tumors often cause other symptoms as well, such as persistent headaches, seizures, personality changes, or weakness or numbness in part of the body.

What you can do

Given your symptoms, it would be best to consult a healthcare provider for a thorough evaluation. They may recommend the following:

  1. Neurological examination: This can help assess your cognitive function, speech, and other aspects of your neurological health.
  2. Imaging studies: Depending on the results of your neurological examination, your healthcare provider may recommend imaging studies, such as an MRI, to further investigate your symptoms.
  3. Referral to a specialist: Depending on your symptoms and the results of any tests, you may be referred to a neurologist or other specialist for further evaluation and treatment.

In the meantime, you might find it helpful to:

  1. Rest and manage stress: Given that your symptoms seem to worsen towards the end of the day, ensuring you get enough rest and managing stress might help alleviate your symptoms.
  2. Keep a symptom diary: Tracking your symptoms, including when they occur, their severity, and any potential triggers, can provide useful information for your healthcare provider.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Sudden, severe headache
  • Seizures
  • Sudden weakness or numbness in part of your body
  • Sudden changes in your vision
  • Difficulty walking or maintaining balance
  • Any other new or worsening symptoms

Please remember that while I strive to provide accurate and helpful information, I am an AI and not a substitute for professional medical advice. Always consult with a healthcare provider for a formal diagnosis and treatment.

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9 mo ago

People Also Ask


What is Long COVID and how does it affect cognitive function?

Long COVID, or Post-Acute Sequelae of SARS-CoV-2 infection (PASC), refers to a range of symptoms that persist for weeks or months after the initial COVID-19 infection. It can affect cognitive function, leading to issues like 'brain fog,' memory problems, and difficulties with concentration and speech.


Can stress and fatigue cause speech and cognitive issues?

Yes, stress and fatigue can significantly impact cognitive function and speech. They can lead to difficulties in concentration, memory, and language, often worsening towards the end of the day when a person is more tired.


What are the common symptoms of Multiple Sclerosis?

Multiple Sclerosis (MS) is a chronic condition affecting the central nervous system. Common symptoms include fatigue, difficulty walking, numbness or tingling, muscle weakness, vision problems, and cognitive changes such as memory and speech difficulties.


How are brain tumors diagnosed and what symptoms should prompt immediate medical attention?

Brain tumors are typically diagnosed through imaging studies like MRI or CT scans. Symptoms that should prompt immediate medical attention include sudden, severe headaches, seizures, sudden weakness or numbness, vision changes, and difficulty with balance or walking.


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