About one-third of COVID-19 survivors have a neurological or psychiatric condition six months later, a large-sample study conducted by British researchers has found.
Researchers examined health records of more than 236,000 patients. They found that about 34% of COVID-19 survivors were diagnosed with a neurological or psychiatric condition and were more likely to develop brain conditions than those suffering from other respiratory tract infections, according to the study published Tuesday in The Lancet Psychiatry journal.
The incidence of brain conditions was even higher for those with severe COVID-19, say the researchers, who hail from the University of Oxford: Nearly 39% of patients who were hospitalized, 46% of those admitted to intensive care and 62% of those with encephalopathy (any brain disease that alters brain function or structure) were diagnosed with a neurological or psychiatric condition.
Anxiety was the most common condition, diagnosed in 17% of patients. Fourteen percent of patients experienced mood disorders, 7% had substance misuse disorders and 5% experienced insomnia. About 13% had their first diagnosis of a mental health issue.
“COVID-19 is a virus with still many ‘unknowns.’ Additional research is required to learn if psychiatric concerns may be due to intrinsic factors caused by the virus compared to external factors. Intrinsic factors can be defined as the way the brain was directly affected by the virus,” said Geri Lynn Utter, a clinical psychologist in Philadelphia. “External factors can be defined as outside components that impact your mental health, ie, job loss, financial distress, interpersonal relationship conflict, chronic pain, etc.”
Neurological disorders such as dementia (0.7%), stroke (2.1%) and brain hemorrhage (0.6%) were not as common as psychiatric disorders among patients. The risk for developing brain disorders was usually higher in patients who had severe COVID illness. For example, 7% of those admitted to intensive care had a stroke, while nearly 2% were diagnosed with dementia.
“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,” said Dr. Paul Harrison, the study’s lead author and a psychiatry professor at the University of Oxford.
The researchers also studied data from more than 105,000 patients with influenza and 236,000 patients diagnosed with any respiratory tract infection. They used the TriNetX Analytics Network, which contains electronic health records for 81 million patients from 62 health care organizations, mostly in the U.S.
The researchers found a 44% overall greater risk of neurological and mental health diagnoses after COVID-19 than after the flu. Compared to any respiratory tract infections, there was a 16% higher risk for COVID-19 patients.
Dr. Ayush Batra, an assistant professor of neurology and pathology at Northwestern Medicine, who has studied the neurological effects of COVID such as encephalopathy, said the results of this study are similar to other findings already out there.
He said the study affirms that more research on long COVID-19 is needed as well as evaluation of patients post-infection.
“Many institutions should probably pay closer attention to how to follow these patients and how to assess and screen for these neurologic and psychiatric disorders,” Dr. Batra said. “Whether that was being done or not previously, I think this will encourage more health care systems across the country and the world to 1) keep better track of these manifestations and 2) start to build an infrastructure to support patients.”
“I think what was interesting was that individually although the rates of neurological diseases are small, cumulatively they’ve reached one-third of patients,” he said.
Dr. Batra added that the statistically significant differences in the incidence rate of brain disorders with COVID-19 could help set it apart from other viruses like influenza.