One in three COVID-19 patients had a neurological or psychological diagnosis within six months of infection

Since the start of the pandemic, there are fears that survivors may have an increased risk of neurological disorders. This concern, at the start based on the findings of other coronaviruses, was quickly followed by case series, emerging data involvement of COVID-19 in the central nervous system (CNS) and identification of mechanisms why this could happen.

Similar concerns have been raised regarding the psychiatric sequelae of COVID-19, with evidence showing that survivors are at increased risk for mood and anxiety disorders within 3 months of infection.

In a new study, a group of medical professionals Department of Psychiatry Oxford University used a network of electronic health records to investigate the incidence of neurological and psychiatric diagnoses in survivors within 6 months of documented clinical infection with COVID-19, and compared the risks associated with those of other health problems. In addition, researchers explored whether the severity of the COVID-19 infection, represented by hospitalization, admission to an intensive care unit (ICU) and encephalopathy, impacted on these risks. Too assessed the trajectory of risk rates (HR) throughout the 6 month period.

The data presented in this study, drawn from a large network of electronic health records, support the predictions that Adverse neurological and psychiatric findings have been reported after COVID-19, and provide estimates of the incidence and risk of these findings in patients who had COVID-19 compared to matched cohorts of patients with other health conditions that occur concurrently with the disease.

“The severity of COVID-19 has had a clear effect on subsequent neurological diagnoses,” the specialists said in their document. In general, depending on your data, COVID-19 was associated with an increased risk of neurological and psychiatric findings, but their incidence and heart rate were higher in patients who required hospitalization, and especially in those who had to be admitted to the ITU or who had developed encephalopathy, even after a strong propensity for other factors (age or history of cerebrovascular disease). Possible mechanisms of this association include CNS viral invasion, hypercoagulable states and neuronal effects of the immune response. However, the incidence and relative risk of neurological and psychiatric diagnoses have also increased, even in COVID-19 patients who did not require hospitalization.

According to various other reports, the risk of cerebrovascular events (ischemic attack and intracranial hemorrhage) increased after COVID-19 and the incidence of ischemic strokes increased to almost one in ten (or three out of 100 for a first accident) in patients with encephalopathy. A similar increased risk of stroke has been reported in patients with COVID-19 compared to those with the flu.

A previous study reported preliminary evidence of an association between COVID-19 and dementia. Data from the new study supports this association. Although the estimated incidence was modest across the COVID-19 cohort, 66% of patients over 65 and 72% who had encephalopathy were first diagnosed with dementia within 6 months of COVID-19. The associations between COVID-19 and cerebrovascular and neurodegenerative diagnoses have been described by the specialists in charge of the report as “worrying”.

They stated that it is not known if COVID-19 is associated with Guillain-Barré syndrome; Their data was also equivocal, as CF increased with COVID-19 compared to other respiratory tract infections, but not influenza, and increased compared to three of the other four health events indexed. Concerns were also raised regarding Parkinsonian syndromes after COVID-19, fueled by the lethargic encephalitis epidemic that followed the 1918 influenza pandemic.

The data supports this possibility, although the incidence was low and not all were significant. Parkinsonism may be a late outcome, in which case a clearer signal may emerge with longer follow-up.

Sick of mind

Findings concerning anxiety and the mood disorders were broadly consistent with previous data. They also observed a significantly increased risk of psychotic disorders. The substance use disorders and the insomnia too They were most common in COVID-19 survivors than in those who have had the flu or other respiratory tract infections (except for the incidence of a first diagnosis of substance use disorder after COVID-19 compared to other respiratory tract infections).

Therefore, as with neurological findings, The psychiatric sequelae of COVID-19 appear to be widespread and persist for up to and possibly beyond 6 months. In relation to neurological disorders, common psychiatric (mood and anxiety disorders) a weaker relationship with COVID-19 severity markers. This could indicate that its occurrence reflects, at least in part, the psychological and other implications of a diagnosis of COVID-19 rather than being a direct manifestation of the disease.

The results presented are robust given the sample size, the propensity score matching, and the results of the sensitivity and secondary analyzes.

In summary, Current data shows COVID-19 is followed by significant rates of neurological and psychiatric diagnoses over the next 6 months. Services need to be configured and resourced to meet this anticipated need, which has also been delayed in their care due to the pandemic.

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