Neuropsychiatric problems are among Covid-19’s many concerning side effects as reported by STAT.
Dementia after Covid
A year ago researchers from Oxford University reported that 1 in 3 patients experienced mood disorders, strokes, or dementia six months after Covid infection.
Now the same group is back with a longer-term analysis of 1.25 million Covid patient records, including what they believe is the first large-scale look at children and at new variants.
Up to two years after Covid-19 infection, the risk of developing conditions such as psychosis, dementia, “brain fog,” and seizures is still higher than after other respiratory infections, the researchers report in their study published Wednesday in the Lancet Psychiatry.
But they were still more likely than children recovering from other respiratory infections to have seizures and psychotic disorders.
Overall, the likelihood of all these diagnoses was lower in children than in adults.
Similar risks continued with Omicron, even though that variant has milder effects during the acute phase of infection.
“What these data show in this very large cohort retrospectively analyzed is that the mood disorders and anxiety problems that are really, really prevalent in long Covid tended to resolve in a matter of months, which is great news for patients with long Covid who are not used to suffering in those ways,” Wes Ely, a critical care physician at Vanderbilt University Medical Center and associate director for research for the VA Tennessee Valley Geriatric Research and Education Clinical Center, told STAT. He was not involved in the Oxford studies.
He was not involved in the Oxford studies.
“The other finding of this fascinating investigation is that the cognitive problems, the neurocognitive deficits that make people have brain fog, do not resolve so quickly,” he said.
“Clinically, in my own practice and in our long Covid clinic, this is exactly what we’re seeing: that the acquired dementia that these patients get tends to be lasting and very problematic.”
To reach their conclusions, the Oxford team combed through data on 14 neurological and psychiatric diagnoses entered into electronic health records in the TriNetX network, mostly from the U.S., over a two-year period.
For a control group, the 1.25 million Covid patients were matched with an equal number of patients with any other respiratory infection and no history of Covid.
Compared with the people in the control group:
- Adults under 65 with a history of Covid infection up to two years previously had a higher risk of cognitive deficit, better known as brain fog (640 vs. 550 cases per 10,000 people), and muscle disease (44 vs. 32 cases per 10,000 people).
- Adults 65 and over who had Covid over the same time span had more diagnoses of brain fog (1,540 vs. 1,230 per 10,000 people), dementia (450 vs. 330 per 10,000 people), and psychotic disorder (85 vs. 60 per 10,000 people).
- Children who had Covid were more likely to have seizures (260 vs. 130 cases per 10,000 children) and psychotic disorders (18 vs. 6 per 10,000 children).
Note of caution
Max Taquet, National Institute for Health and Care Research academic clinical fellow in psychiatry at Oxford and a study co-author, stressed that the elevated risk for seizures and psychotic disorders in children was still low.
Taquet made the same point about adults.
“Certainly, for some conditions, there appears to be a nontrivial and persisting greater risk of these diagnoses being made,” he said on the call with reporters.
While waiting for the mechanisms of long Covid — and any potential treatments — to be understood, “What’s important for me as a physician is that we know that we can have long-term outcomes in very severe persistent and disabling, neuropsychiatric disorders,” some of which can be treated, Teodor Postolache, professor of psychiatry at the University of Maryland School of Medicine, said.
An editorial published with the paper sounds like a note of caution on psychiatric diagnoses.
“Although concerning, the findings regarding psychosis and dementia need replication in a cohort in which there is more thorough ascertainment of case status.”
This is only picking up very blunt stuff.
“The finding of complex and potentially severe psychiatric and neurological fallout of Covid infection adds yet more weight and concern to the impact of repeated infections that will occur should the virus continue to be allowed to spread to re-infect with little to no control,” she said in a statement.
“This paper … fits the narrative both of clinically what I see in practice, but also the actual brain science that we’re coming up against,” he said.
As for cognitive impairment, he said, “This is something that is very hard for people to cope with because they can’t go back to work.
They have to retire early, and they desperately need answers.”
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