Since the pandemic began, there has been growing concern that survivors might be at increased risk of neurological disorders.
One in three Covid-19 survivors received a neurological or psychiatric diagnosis within six months of infection with the SARS-CoV-2 virus, estimates an observational study of more than 2,30,000 patient health records published in The Lancet Psychiatry journal. The study looked at 14 neurological and mental health disorders.
Since the pandemic began, there has been growing concern that survivors might be at increased risk of neurological disorders. A previous observational study by the same research group reported that Covid-19 survivors are at increased risk of mood and anxiety disorders in the first three months after infection. However, until now, there has been no large-scale data examining the risks of neurological as well as psychiatric diagnoses in the six months after Covid-19 infection.
This latest study analysed data from the electronic health records of 2,36,379 Covid-19 patients from the US-based TriNetX network, which includes more than 81 million people. Patients who were older than 10 years and who became infected with the SARS-CoV-2 virus after January 20, 2020, and were still alive on December 13, 2020, were included in the analysis. This group was compared with 1,05,579 patients diagnosed with influenza and 2,36,038 patients diagnosed with any respiratory tract infection (including influenza).
Overall, the estimated incidence of being diagnosed with a neurological or mental health disorder following Covid-19 infection was 34 per cent. For 13 per cent of these people, it was their first recorded neurological or psychiatric diagnosis.
The most common diagnoses after Covid-19 were anxiety disorders (occurring in 17 per cent of patients), mood disorders (14 per cent ), substance misuse disorders (7 per cent), and insomnia (5 per cent). The incidence of neurological outcomes was lower, including 0.6 per cent for brain haemorrhage, 2.1 per cent for ischaemic stroke, and 0.7 per cent for dementia
Professor Paul Harrison, lead author of the study from Oxford University, said, “These are real-world data from a large number of patients. They confirm the high rates of psychiatric diagnoses after Covid-19, and show that serious disorders affecting the nervous system (such as stroke and dementia) occur too. While the latter are much rarer, they are significant, especially in those who had severe Covid-19.”
Authors say their findings should aid service planning and highlight the need for ongoing research. “Although the individual risks for most disorders are small, the effect across the whole population may be substantial for health and social care systems due to the scale of the pandemic and that many of these conditions are chronic. As a result, healthcare systems need to be resourced to deal with the anticipated need, both within primary and secondary care services.”
Risks of a neurological or psychiatric diagnosis were greatest in, but not limited to, patients who had severe Covid-19. Compared to the overall 34 per cent incidence, a neurological or psychiatric diagnosis occurred in 38 per cent of those who had been admitted to hospital, 46 per cent of those in intensive care, and 62 per cent in those who had delirium (encephalopathy) during their infection.
Dr Max Taquet, a co-author of the study from Oxford University, said: “Our results indicate that brain diseases and psychiatric disorders are more common after Covid-19 than after flu or other respiratory infections, even when patients are matched for other risk factors. We now need to see what happens beyond six months. The study cannot reveal the mechanisms involved, but does point to the need for urgent research to identify these, with a view to preventing or treating them.”
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