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Review
. 2025 Jan:123:928-945.
doi: 10.1016/j.bbi.2024.11.007. Epub 2024 Nov 3.

Acute and long-term effects of COVID-19 on brain and mental health: A narrative review

J Douglas Bremner  1 , Scott J Russo  2 , Richard Gallagher  3 , Naomi M Simon  4
Affiliations
Review

Acute and long-term effects of COVID-19 on brain and mental health: A narrative review

J Douglas Bremner et al. Brain Behav Immun. 2025 Jan.

Abstract

Background: COVID infection has been associated with long term sequalae (Long COVID) which include neurological and behavioral effects in thousands of patients, but the etiology and scope of symptoms is not well understood. This paper reviews long term sequelae of COVID on brain and mental health in patients with the Long COVID syndrome.

Methods: This was a literature review which queried databases for Pubmed, Psychinfo, and Medline for the following topics for January 1, 2020-July 15, 2023: Long COVID, PASC, brain, brain imaging, neurological, neurobiology, mental health, anxiety, depression.

Results: Tens of thousands of patients have developed Long COVID, with the most common neurobehavioral symptoms anosmia (loss of smell) and fatigue. Anxiety and mood disorders are elevated and seen in about 25% of Long COVID patients. Neuropsychological testing studies show a correlation between symptom severity and cognitive dysfunction, while brain imaging studies show global decreases in gray matter and alterations in olfactory and other brain areas.

Conclusions: Studies to date show an increase in neurobehavioral disturbances in patients with Long COVID. Future research is needed to determine mechanisms.

Keywords: COVID; Depression; Immunity; Infection; Long COVID; Olfactory bulb.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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