More than 33% of COVID-19 survivors receive a psychiatric or neurological diagnosis within 6 months of infection, according to a recent retrospective cohort study published online in The Lancet Psychiatry.
Using data from the TriNetX electronic health records network, researchers from the University of Oxford, United Kingdom, analyzed a primary cohort comprising 236,379 patients who had a COVID-19 diagnosis. They matched the primary cohort with 2 control cohorts consisting of patients diagnosed with influenza and patients diagnosed with any respiratory tract infection, including influenza, in the same period.
Researchers estimated the incidence of 14 neurological and psychiatric outcomes in the 6 months after a confirmed diagnosis of COVID-19, including psychotic, mood, and anxiety disorders, dementia, and insomnia. Using a Cox model, researchers compared those incidences with those in propensity score-matched cohorts of patients with influenza or other respiratory tract infections. They also investigated how these estimates were affected by COVID-19 severity.
Among the patients diagnosed with COVID-19, 12.84% received their first psychiatric or neurological diagnosis. More specifically, 17.39% were diagnosed with an anxiety disorder, the study found.
While the incidence of dementia within the entire COVID-19 cohort was modest, 2.66% of patients older than 65 years and 4.72% who had encephalopathy received a first diagnosis of dementia within 6 months of having COVID-19. Researchers called the associations between COVID-19 and cerebrovascular and neurodegenerative diagnoses “concerning” and said that further research on the disease course is needed.
Patients diagnosed with COVID-19 also had an increased risk of cerebrovascular events such as ischemic stroke and intracranial hemorrhage. Evidence on the association between COVID-19 and Guillain-Barre syndrome and parkinsonian syndromes need longer follow-up studies, researchers said.
"Our study provides evidence for substantial neurological and psychiatric morbidity in the 6 months after COVID-19 infection. Risks were greatest in, but not limited to, patients who had severe COVID-19. This information could help in service planning and identification of research priorities," researchers said in the study.
“The findings also highlight the need for enhanced neurological follow-up of patients who were admitted to [an Intensive Therapy Unit] or had encephalopathy during their COVID-19 illness.”
Taquet M, Geddes J, Husain M, et al. 6-month neurological and psychiatric outcomes in 236 379 survivors of COVID-19: a retrospective cohort study using electronic health records. The Lancet Psychiatry. 2021 April 06;[Epub ahead of print].