Neurological and psychiatric complaints are common in the 6 months after a diagnosis of COVID-19, with the highest risk in those with severe COVID-19, according to study results published in The Lancet Psychiatry.
Previous studies have raised concerns about neurological and psychiatric complications from COVID-19. The aim of the current study was to provide extensive, robust and long-term data on the potential neurological and psychiatric consequences of COVID-19.
Using data from the TriNetX electronic health record network, study researchers identified patients over 10 years of age diagnosed with COVID-19, and each patient was assigned to two control group participants. A matching control cohort included patients diagnosed with influenza and another cohort included patients diagnosed with respiratory infection during the same time period.
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The study included 236,379 patients diagnosed with COVID-19, including 190,077 patients who were not hospitalized, 46,302 patients who were hospitalized, 8945 patients who were admitted to an intensive care unit, and 6229 patients who diagnosed with encephalopathy.
About a third (33.62%) of all patients diagnosed with COVID-19 had a neurological or psychiatric diagnosis in the 6 months following the viral infection, with 12.84% receiving their first such diagnosis. The incidence was higher in patients admitted to an intensive care unit (46.42%).
The most common neurological and psychiatric diagnoses across the COVID-19 cohort were mood, anxiety, or psychotic disorders (23.98%). Substance use disorder (6.58%); and insomnia (5.42%); followed by nerve, nerve root, or plexus disorders (2.85%); ischemic stroke (2.10%); Dementia (0.67%); intracranial hemorrhage (0.56%); Parkinsonism (0.11%); Encephalitis (0.10%); and Guillain-Barre Syndrome (0.08%).
Compared to the participants in the control group who were diagnosed with influenza, the risk of neurological or psychiatric complications was 44% higher in those with COVID-19 (hazard ratio [HR], 1.44; 95% CI 1.40-1.47 and the risk was 78% higher with each initial diagnosis (HR 1.78; 95% CI 1.68-1.89). Patients with COVID-19 were also at an increased risk for these complications compared to control subjects who had other respiratory infections (HR 1.16; 95% CI 1.14-1.17 for each diagnosis; HR 1.32 ; 95% CI 1.27.). -1.36, for each initial diagnosis).
The severity of COVID-19 had a significant impact on the risk for these neurological and psychiatric complications, as the incidence and hazard ratio of hospital admissions were higher and significantly increased in those who were admitted to an intensive care unit or who had developed encephalopathy.
The study had several limitations, including those related to an electronic health record study, incomplete data on socioeconomic and lifestyle factors, inadequate coverage of encephalopathy, and the inability to rule out undiagnosed COVID-19 in the comparator cohorts.
“[T]The available data show that COVID-19 was followed by significant rates of neurological and psychiatric diagnoses in the following 6 months. Services need to be configured and provisioned to meet these anticipated needs, ”the study’s researchers concluded.
Disclosure: An author is an employee of TriNetX. For a full list of the author’s disclosures, see the original reference.
reference
Taquet M, Geddes JR, Husain M, Luciano S, Harrison PJ. 6-month neurological and psychiatric outcomes in 236,379 survivors of COVID-19: a retrospective cohort study of electronic health records. Lancet psychiatry. 2021; 8 (5): 416-427. doi: 10.1016 / S2215-0366 (21) 00084-5
