Long COVID: The Top 2 Neuropsychiatric Symptoms

A quarter of people with long COVID met the criteria for depression.

A quarter of people with long COVID met the criteria for depression.

Headaches and fatigue are the top neuropsychiatric symptoms of so-called ‘long COVID’, research finds.

These were the two most common symptoms reported over four months after people had had COVID, with 69 percent reporting fatigue and 67 reporting headaches.

Next most common were:

  • changes to taste (54 percent) and smell (55 percent),
  • mild cognitive impairment (47 percent),
  • 30 percent had problems with memory,
  • and 20 percent report confusion.

Other physical symptoms of long COVID include:

  • cough,
  • muscle aches,
  • nasal congestion,
  • and chills.

Perhaps unsurprisingly, 25 percent also met the criteria for depression.

Dr Elizabeth Rutkowski, study co-author, said:

“There are a lot of symptoms that we did not know early on in the pandemic what to make of them, but now it’s clear there is a long COVID syndrome and that a lot of people are affected.”

Long COVID study

The results come from 200 patients who were recruited around four months after becoming infected with COVID.

The numbers suffering some effects of long COVID may be higher, as some people did not notice the changes in themselves.

Dr Rutkowski explained that taste strips were used to check people’s sense of taste, but it may be that the sense of taste has changed, rather than having totally gone:

“They eat a chicken sandwich and it tastes like smoke or candles or some weird other thing but our taste strips are trying to depict specific tastes like salty and sweet.”

Long COVID and fatigue

Fatigue is likely such a common symptom of long COVID because the infection raises levels of inflammation in the body — and these levels remain raised.

Dr Rutkowski said:

“They have body fatigue where they feel short of breath, they go to get the dishes done and they are feeling palpitations, they immediately have to sit down and they feel muscle soreness like they just ran a mile or more.

There is probably some degree of neurologic fatigue as well because patients also have brain fog, they say it hurts to think, to read even a single email and that their brain is just wiped out.”

Cognitive problems, including lack of vocabulary, may also reflect the long spells people have spent in isolation.

Dr Rutkowski said:

“You are not doing what you would normally do, like hanging out with your friends, the things that bring most people joy.

On top of that, you may be dealing with physical ailments, lost friends and family members and loss of your job.”

ACE2 receptors

COVID is thought to have such widespread effects on the human body because the virus attaches itself to angiotensin-converting enzyme-2, or ACE2.

ACE2 regulates many different bodily functions including inflammation and blood pressure.

ACE2 is found throughout the body: in the brain, heart, lungs kidneys and gastrointestinal tract.

The ACE2 receptor is on the surface of cells and acts like a doorway to allow the virus inside.


The study was published in the journal  Brain, Behavior, & Immunity (Chen et al., 2022).

Author: Jeremy Dean

Psychologist, Jeremy Dean, PhD is the founder and author of PsyBlog. He holds a doctorate in psychology from University College London and two other advanced degrees in psychology. He has been writing about scientific research on PsyBlog since 2004. He is also the author of the book "Making Habits, Breaking Habits" (Da Capo, 2013) and several ebooks.

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