Fighting brain fog and fatigue, grad student turns to long COVID Clinic

Elana Cooper is a regular at Finao Fit in Smyrna.

The Georgia Tech graduate student says the workouts keep her grounded.

"I ran track in college," Cooper said. "I grew up running track. I'm used to working out four, five days a week."

But, these days, the 34-year-old works out only once a week, and she is constantly checking her watch to monitor her heart rate, which was never a problem when she was a sprinter.


"But, now, I can just jog for 10 minutes, my heart rate spikes, my heart is pounding," Cooper said. "Sometimes, I'll bend down, and I'll black out."

Cooper has Long COVID.


She has caught the coronavirus twice, the first in March 2020 at her grandfather's funeral in New York, then again in January.

Each time, Cooper says, she experienced flu-like symptoms followed a few weeks later by new symptoms, like severe headaches or memory problems.

"The first time I had COVID, it was primarily migraines, fatigue and brain fog," Cooper said.  "Now, it's trouble breathing, memory and cognitive."

The morning after her gym workout at home in her Atlanta apartment, Cooper is tired, but trying to push through her work as a Ph.D. student in biomedical engineering at Georgia Tech.

"What I'm growing to realize is that my memory has been affected," she said.  "When brain fog kicks in, you're trying to find words, you're trying to think through problems, but you're moving slower, you're processing slower. And, that's hard to do in a Ph.D. environment."

Over the years, Cooper has seen a neurologist, a lung specialist and her primary care doctor.  

In March, she came to AbsoluteCare in Buckhead, one of five long COVID clinics in Georgia.

"I've been dealing with symptoms for almost 2 years now, and this is the first time I've had a comprehensive analysis," she said.  "Before, I'd go to the doctor, and they'd say, 'Ah, wait it out for three to six months, you should improve.'"

Dr. Joel Rosenstock, a veteran infectious disease physician in Atlanta, runs the clinic.

"It's a one-stop-shop here," Dr. Rosenstock says.  "So, that they're not going to the pulmonologist and the cardiologist and the family doctor and the neurologist."

After an initial telemedicine appointment, Cooper came in for two hours of tests and a physical exam.

She got blood drawn, took a cognitive test to evaluate her brain function, and even took a scratch and sniff test designed to detect the loss of smell common with COVID-19.

Cooper also took a test to measure changes in her heart rate and blood pressure as she walked around outside the clinic.

"When we do our simple walk test, somebody will start with a pulse of 64, and they've walked 80 yards, and their pulse is 165," Dr. Rosenstock said. "They have heart rate abnormalities. They have blood pressure abnormalities."

Dr. Rosenstock says the workup will help his team objectively measure and track what he says can be subjective complaints, like fatigue, pain and brain fog.

He began his career nearly 40 years ago in the early HIV epidemic, at a time, Rosenstock says, many patients felt stigmatized and isolated.

"It's very similar in the Long COVID world," Rosenstock said. "People are not validated in their complaints.  They're not believed."

While some hospital-based long COVID clinics focus on patients who were hospitalized with severe complications of the virus, Dr. Rosenstock said most of the patients at AbsoluteCare are dealing with "softer" symptoms, like brain fog, fatigue and joint pain.

"So, what we do is reassure them, validate their complaints, let them understand that they are real, and that myself and the rest of my Long COVID staff believe them, and then come up with an action plan," Dr. Rosenstock said.

Elana Cooper's biggest concern is brain fog.

"It kicks in at any point," she said. "So, when you're in the middle of a conversation, and you have to, like, think for a word and pause, and it's a little embarrassing."

Rosenstock said patients sometimes also have memory issues or difficulty working with automated systems that used to be simple to master.

"One of the classical findings is misnaming," he said. "So, they'll be talking, and a word will come out that is not the correct word."

He says they do not fully understand why or how COVID-19 affects the brain, but brain fog is a common complaint among the 50 or so active long COVID patients in his clinic.

"Their main question is, "When am I going to get better, Doc, and if I'm going to get better," Rosenstock says.  "And, that's a harder question."

Still, Rosenstock says, most of about 150 patients AbsoluteCare's Atlanta clinic has treated in the past year have improved.

"Now, I'm not saying they're 100% better; they're not all back at work doing the job they used to do, but they are markedly improved," he says.

Cooper says she used to work long hours, especially when there was a deadline involved.

"Now, I have to work for about 4 hours at a time, otherwise the fatigue will kick in," she says.

Rosenstock has helped her qualify for work accommodations at Georgia Tech. 

"But, expectations are still high," she said. "So, that's what I'm dealing with now: how to remain in the program, but also maintain my health."

She says she is fighting to stay in her Ph.D. program.

"They pretty much told me to return to the program once my symptoms have improved," Cooper said. "As a Ph.D. student, you're a student employee, but you're not eligible for certain benefits.   So, it's navigating this tricky path of trying to stay in school and be productive.   Because, if not, you don't have income or insurance. It's a tricky balance."

This week, Dr. Rosenstock and Cooper will meet to go over her test results and come up with a personalized treatment plan for her long COVID symptoms.

For the first time in two years, Cooper is hopeful.

"I feel like I am at a good point, because I feel like I have a team of people who are supportive and friendly, and I can relate to, and they're experts in their field." she said.