Long COVID: Higher Rates of Brain Fog and Depression in U.S. Patients

Jan 30, 2026, 2:54 AM

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A recent international study highlights a troubling disparity in the prevalence of neurological symptoms among long COVID patients. It finds that individuals in the United States report significantly higher rates of brain fog and depression compared to their counterparts in lower-income countries such as India and Nigeria.

The research, led by a team from Northwestern University and published in Frontiers in Human Neuroscience, is the first to conduct a cross-continental comparison of long COVID's neurological manifestations. The study tracked over 3,100 adults with long COVID from medical centers in Chicago, Medellin (Colombia), Lagos (Nigeria), and Jaipur (India). Notably, among non-hospitalized patients, 86% in the US reported experiencing brain fog, compared to just 15% in India, 63% in Nigeria, and 62% in Colombia.

Moreover, the mental health implications are stark. Around 70% of US participants reported symptoms of anxiety or depression, in contrast to approximately 40% in Colombia and fewer than 20% in both Nigeria and India.

Cultural Factors and Healthcare Access

The authors of the study suggest that these discrepancies are likely driven more by cultural attitudes towards mental health and access to healthcare rather than biological differences in how the virus affects individuals. Dr Igor Koralnik, the senior author of the study, emphasized that in the US and Colombia, discussing mental health issues is culturally accepted, whereas in Nigeria and India, such topics often face stigma and denial.

This cultural context may lead to underreporting of symptoms in lower-income nations, where mental health resources are often scarce. Dr Koralnik pointed out that the lack of mental health providers and treatment options further exacerbates the situation, making it difficult for individuals to seek help.

Common Symptoms and Impacts

Across all regions studied, the most frequently reported neurological symptoms included brain fog, fatigue, muscle pain, headaches, and sensory disturbances like numbness or tingling. Insomnia was particularly prevalent among US patients, with nearly 60% reporting sleep problems, compared to lower rates in Colombia (about 33%), Nigeria (26%), and India (12%).

Long COVID affects millions globally, with estimates suggesting that 10-30% of adults infected with COVID-19 will develop persistent symptoms. The impact of these symptoms can be profound, affecting not only quality of life but also workforce productivity and innovation. Dr Koralnik noted that long COVID has emerged as a significant public health challenge since the onset of the pandemic.

Future Directions

The findings of this study underscore the urgent need for culturally sensitive diagnostic tools and healthcare systems capable of supporting long-term care for long COVID patients worldwide. Researchers are now focusing on developing cognitive rehabilitation treatments for long COVID brain fog, specifically targeting populations in Colombia and Nigeria.

As the global health community grapples with the complexities of long COVID, understanding the interplay between cultural perceptions, healthcare accessibility, and symptom reporting will be crucial in addressing this ongoing public health crisis.

In conclusion, while long COVID continues to present challenges worldwide, this study highlights the necessity of tailored approaches to treatment and support, reflecting the diverse experiences of patients across different socioeconomic contexts.

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