What Pharmacists Should Know About Long COVID and Brain Health

COVID-19 has impacts beyond the respiratory system, causing lasting changes in the brain even after recovery. Using advanced MRI techniques, researchers from Griffith University’s National Center for Neuroimmunology and Emerging Disease found significant neurological differences in individuals who had previously been infected compared to those who had never had COVID-19.^1,2

How Does Long Covid Impact the Brain?

Individuals with long COVID experience persistent symptoms, which often include fatigue, post-exertional malaise, sleep disturbances, and cognitive impairment. Specifically, cognitive impairment has emerged as a key neurological consequence of COVID-19. Previous research demonstrated that individuals with post-COVID-19 conditions experience significant cognitive slowing, and similar deficits are also observed in individuals who have fully recovered and no longer report symptoms compared to uninfected individuals. These cognitive impairments impact processing speed, executive function, and memory, and can continue for months after infection.¹

Despite these findings, the long-term effects of COVID-19 on the brain remain poorly understood. In this multimodal MRI study from Griffith University, researchers examined changes in brain tissue microstructure and neurochemical levels in individuals with long COVID and those who have recovered from COVID-19, and compared them with healthy individuals.^1,2

“We used multimodal MRI techniques to examine both grey and white matter brain regions critical for memory, cognition, and overall brain health and found clear differences across all participant groups,” Kiran Thapaliya, lead author from Griffith University, said in a news release.²

Overview of Study Methods and MRI Findings

Participants with long COVID were selected according to the World Health Organization definition, requiring symptoms to begin within 3 months of COVID-19 infection and persist for at least 2 months. Healthy individuals had no history of chronic or current medical conditions, and all participants were individuals aged 18 to 65 years with significant comorbidities were excluded based on detailed medical histories. A total of 47 individuals were included—19 with long COVID, 12 COVID-recovered and healthy, and 16 healthy without COVID-19 infection.¹

T1-weighted and T2-weighted MRI data were collected using a 3T Siemens Prisma scanner and a 64-channel head-neck coil. All participants across the long COVID, recovered COVID-19, and healthy control groups were scanned using identical protocols to ensure consistency.^1,2

The MRIs identified altered T1w/T2w signal intensity and tissue microstructure across comparisons among the long COVID, recovered COVID-19, and healthy control groups. Changes in T1w/T2w signal were significantly associated with physical and cognitive function, while differences in brain neurochemical levels were observed only between individuals with long COVID and those who had recovered from COVID-19.^1,2

“The unique MRI approach identified significant alterations in brain neurochemicals, brain signal intensity, and tissue structure not only in individuals with long COVID but also in those who considered themselves fully recovered,” Thapaliya said.²

The findings suggest how COVID-19 impacts the central nervous system and provide a greater understanding of cognitive issues that arise either shortly after or months after infection, including memory and concentration.^1,2

“The research also reported that altered brain tissue was associated with symptom severity in individuals with long COVID, suggesting the virus may leave a silent, lasting effect on brain health,” Thapaliya concluded.²

Understanding Long COVID

According to the CDC, long COVID is a serious illness that can lead to chronic conditions that require comprehensive care. The ongoing symptoms can last weeks, months, or even years after an individual is infected with COVID-19.3

Anyone who experiences COVID-19 can develop long COVID; however, studies have identified populations at higher risk. This includes women, individuals who identify as Hispanic or Latino, individuals who experience severe COVID-19 illness, individuals with underlying health conditions, and individuals who did not receive a COVID-19 vaccine. The CDC noted that while rates of new long COVID cases have decreased since the beginning of the COVID-19 pandemic, it remains a serious public health concern.³

How Pharmacists Can Help Patients with Long COVID

The findings emphasize that COVID-19 can cause lasting brain changes, even in patients who consider themselves fully recovered. Pharmacists should be aware of long-term neurological effects and recognize that symptoms such as brain fog, memory problems, slowed thinking, and fatigue could be signs of long COVID. Pharmacists can also help educate patients that COVID-19 is not only a respiratory illness, and that ongoing symptoms are recognized. This research supports the pharmacist’s role in recognizing long COVID by improving adherence and advocating for patients experiencing lingering neurological effects following COVID-19 infection.

REFERENCES

1. Kiran Thapaliya, Sonya Marshall-Gradisnik, Maira Inderyas, Leighton Barnden. Altered brain tissue microstructure and neurochemical profiles in long COVID and recovered COVID-19 individuals: A multimodal MRI study, Brain, Behavior, & Immunity - Health, Volume 50, 2025, 101142, ISSN 2666-3546. Doi: 10.1016.

2. COVID-19 leaves a lasting mark on the human brain. News release. EurekAlert! December 15, 2025. Accessed January 21, 2026. https://www.eurekalert.org/news-releases/1110061

3. Long COVID Basics. News release. CDC. July 24, 2025. Accessed January 22, 2026. https://www.cdc.gov/long-covid/about/index.html