Six months after being diagnosed with Covid-19, 1 in 3 patients also experienced a psychiatric or neurological disease, mostly mood disorders, but also strokes or dementia, according to a large new study.
About 1 in 8 of the patients (12.8%) were first diagnosed with such a disease, mostly anxiety or depression. Compared to groups of people who had the flu or other respiratory infections that were not covoidal, neuropsychiatric diagnoses were almost twice as high.
The study, published in The Lancet Psychiatry on Tuesday, used actual health data on millions of people to determine the incidence of 13 brain disorders. Concerns, mood swings and drug use disorders were the most common, but the researchers also found serious, if lower, severe neurological complications, especially in patients who were seriously ill with Covid-19. In all Covid-19 patients, 0.6% had a cerebral haemorrhage, 2.1% had an ischemic stroke and 0.7% had dementia.
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‘We urgently need research to better understand how and why it occurs in patients with Covid-19 and how it can be treated and [how to] prevent it, ”said Max Taquet, a clinical fellow in psychiatry at Oxford University and co-author of the study, in a call with reporters on Tuesday. “But we think that regardless of the explanation, health services need to be prepared for the greater demand that these data show.”
The size of the study gives confidence in its findings, which confirm what has been indicated in smaller studies, including work earlier of the Oxford Group. The researchers analyzed electronic health records of 81 million U.S. patients (both insured and uninsured) and found 236,379 people diagnosed with Covid-19 and compared them to three groups of similar people: one group had the flu, another had ‘ had another respiratory illness. such as sinusitis or pneumonia, and one group includes people admitted to the hospital due to unrelated conditions such as bone fractures or gallstones. The researchers hoped that comparing the Covid group with the others would help isolate Covid-19 as a cause and bother its effects on the brain.
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After considering patients’ age, gender, ethnicity, and pre-existing health conditions, patients generally have a 44% higher risk of neurological and mental health diagnosis after Covid-19 than after influenza, and a 16% higher risk after Covid-19 than after other respiratory tract infections.
There were two exceptions: the researchers did not see an increased risk for Parkinson’s disease, a movement disorder or Guillain-Barré syndrome, which is a rare disease that appears after some viral infections as tingling and weakness when the immune system attacks nerves. .
Allison Navis, Assistant Professor in the Department of Neuroseptic Diseases at the Icahn School of Medicine on Mount Sinai, sounded a warning. She was the chief clinical neurologist at Mount Sinai’s post-Covid clinic and was not involved in the Lancet study.
“It does emphasize that there is something unique going on with Covid,” she told STAT. ‘And the 12.8% who have a new diagnosis of something neuropsychiatric may sound very sensational. It is 12.8% which includes depression and anxiety, so it is very important not to limit it and not make it sound like a lesser diagnosis at all, but the more serious things like strokes are still uncommon. I do not want people to think that 1 in 10 people have a stroke with Covid. ‘
The new study reinforces previous research showing that some brain disorders have increased with the severity of diseases; it increased in people who had to be admitted to hospital, and increased further in people in need of intensive care. While 33.6% of people generally had a neuropsychiatric illness, the risk increased to 46.4% among Covid patients treated in an ICU.
What is new is the distinction between neurological and psychiatric complications. People with very serious Covid-19 have a higher risk of complications such as stroke or dementia, but people who develop anxiety or depression span the spectrum of illness.
Although the mechanisms underlying the neuropsychiatric disorders associated with the virus have not been investigated, the authors in the call with reporters speculated that if patients know they have Covid-19, that and other stressors may contribute to a psychiatric illness. . “It could be psychological factors and biological factors and psychosocial factors, such as the need to isolate and the loss of income as a result,” Taquet said.
It is easier to link neurological disorders to the effects of the virus on the brain. Scientists believe that the virus can enter the brain through the olfactory bulb, where taste and smell are decoded. Inflammation in the body also damages blood vessels in the brain and can lead to stroke causing blood clots, delirium or dementia.
While the medical records could tell the researchers if anyone had previously had a stroke or been diagnosed with dementia, they could not suspect whether anyone would have a recurrence anyway or that Covid-19 caused it, Masud Husain said. , professor of neurology and cognitive neuroscience at Oxford and a co-author of the study, warned. Longer follow-up would be needed to answer the question, but the signal was too strong to ignore, he said.
Husain also warned that the numbers they reported could be an underestimation if they do not include people who have been infected with Covid but have not tested positive for it, or if people have no symptoms that lead them to seek medical attention. not to seek. On the other hand, it is possible that patients with Covid-19 are more likely to be diagnosed with neurological and psychiatric disorders because they receive more medical attention compared to patients with flu or other respiratory infections, Taquet said.
This was not a Long-Covid study, said Paul Harrison, professor of psychiatry at Oxford University and a co-author of the study, referring to the constellation of persistent symptoms that overlap with some of the causes. is caused by the neuropsychiatric diseases described in the present article. paper. But the need for more research and ongoing clinical care is the same.
“Unfortunately, many of the disorders identified in this study tend to be chronic or recurrent, so we can expect the impact of Covid-19 to be with us for many years to come,” said Jonathan Rogers and Anthony David of the University College London written in an article. comments appear along with the Lancet study.