A study published this week in the Lancet Psychiatry showed increased risks of some brain disorders two years after infection with the coronavirus, shedding new light on the long-term neurological and psychiatric aspects of the virus.
The analysis, conducted by researchers at the University of Oxford and based on data from the health records of more than 1 million people worldwide, found that while risks for many common psychiatric disorders returned to normal within a few months, people remained at increased levels. risk of dementia, epilepsy, psychosis and cognitive impairment (or brain fog) two years after contracting covid. Adults appeared to be at particular risk of lasting brain fog, a common complaint among coronavirus survivors.
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The study was a mix of good and bad news findings, said Paul Harrison, a professor of psychiatry at the University of Oxford and senior author of the study. Among the reassuring aspects was the rapid resolution of symptoms such as depression and anxiety.
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“I was surprised and relieved at how quickly the psychiatric sequelae subsided,” Harrison said.
David Putrino, director of rehabilitation innovation at Mount Sinai Health System in New York, which has studied the lasting impacts of the coronavirus since the beginning of the pandemic, said the study revealed some very worrying results.
“This allows us to see beyond doubt the emergence of significant neuropsychiatric sequelae in individuals who have had covid and much more often than those who have not,” he said.
By focusing only on the neurological and psychiatric effects of the coronavirus, the study authors and others emphasized that it is not strictly long-term research.
“It would be exaggerated and unscientific to make the immediate assumption that everyone in [study] cohort had long covid,” Putrino said. But the study, he said, “informs long covid research.”
Between 7 million and 23 million people in the United States have long-term covid, according to recent government estimates — a catch-all term for a wide range of symptoms, including fatigue, shortness of breath, and anxiety that persist weeks and months after death. acute infection have subsided. These numbers are expected to increase as the coronavirus takes hold as an endemic disease.
The study was led by Maxime Taquet, a senior researcher at the University of Oxford specializing in the use of big data to clarify psychiatric disorders.
The researchers matched nearly 1.3 million patients diagnosed with Covid-19 between January 20, 2020 and April 13, 2022, with an equal number of patients who had other respiratory illnesses during the pandemic. The data, provided by the TriNetX electronic health records network, came largely from the United States, but also included data from Australia, Great Britain, Spain, Bulgaria, India, Malaysia and Taiwan.
The study group, which included 185,000 children and 242,000 elderly people, found that risks differ across age groups, with people aged 65 and older at greater risk of lasting neuropsychiatric effects.
For people aged 18 to 64, a particularly significant increased risk was for persistent brain fog, affecting 6.4% of people who had covid compared with 5.5% in the control group.
Six months after infection, the children were not at increased risk for mood disorders, although they remained at increased risk for brain fog, insomnia, stroke, and epilepsy. None of these affections was permanent for the children. With epilepsy, which is extremely rare, the increased risk was greater.
The study found that 4.5% of the elderly developed dementia in the two years after infection, compared with 3.3% of the control group. This 1.2-point increase in a diagnosis as harmful as dementia is particularly concerning, the researchers said.
The study’s reliance on a collection of unidentified electronic health data raised some precautions, particularly during the tumultuous period of the pandemic. Tracking long-term outcomes can be difficult when patients may have sought care through many different healthcare systems, including some outside the TriNetX network.
“Personally, I find it impossible to judge the validity of the data or the conclusions when the data source is shrouded in mystery and the data sources are kept secret by legal agreement,” said Harlan Krumholz, a Yale scientist who developed a platform where patients can enter their own health data.
Taquet said the researchers used several means of evaluating the data, including ensuring they reflected what is already known about the pandemic, such as the drop in death rates during the omicron wave.
Furthermore, Taquet said, “the validity of the data will not be better than the validity of the diagnosis. If doctors make mistakes, we will make the same mistakes.”
The study follows previous research by the same group, which reported last year that a third of Covid patients had mood disorders, strokes or dementia six months after being infected with the coronavirus.
While cautioning that it is impossible to make complete comparisons between the effects of recent variants, including omicron and its subvariants, that are currently causing infections, and those that were prevalent a year or more ago, the researchers outlined some initial findings: Although omicron did cause symptoms less severe immediate, long-term neurological and psychiatric outcomes appeared similar to delta waves, indicating that the burden on the world’s health systems may continue even with less severe variants.
Hannah Davis, co-founder of the Patient-Led Research Collaborative, which studies the long-running covid, said the finding was significant. “It goes against the narrative that micron is milder for long-term covid, which is not based on science,” Davis said.
“We see it all the time,” Putrino said. “The general conversation continues to leave out the long-term covid. The severity of the initial infection doesn’t matter when it comes to the long-term sequelae that ruin people’s lives.”
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Dan Keating of the Washington Post contributed to this report.
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