Long-term neurological problems increase by 7% after SARS-CoV-2 infection

Risk of movement disorders, memory problems, stroke and seizures increased 1 year after acute SARS-CoV-2 infection, analysis of millions of US veterans’ records showed.

Former COVID patients had a 42% increased risk of neurological problems 12 months after testing positive (HR 1.42, 95% CI 1.38-1.47), reported Washington University’s Ziyad Al-Aly, MD in St. Louis and Veterans Affairs St. Louis Health System and colleagues.

The burden was an approximately 7% increase in long-term neurological problems (70.69 per 1,000 people, 95% CI 63.54-78.01), the researchers wrote naturopathy. Risks and burdens were also increased among those who did not require hospitalization during acute COVID-19.

“COVID can lead to long-term neurological consequences,” Al-Aly said MedPage today. “The virus is not always as benign as some people think.”

“It’s not just brain fog,” he pointed out. “There is clearly an increased risk of stroke, headaches, seizures, peripheral neuropathy and more.”

Using the Veterans Affairs national health databases, Al-Aly and co-authors created cohorts that included 154,068 people diagnosed with COVID-19 from March 2020 to January 2021, 5,638,795 contemporary controls who were uninfected, and 5,859 .621 historical controls from 2017.

The median age of the COVID cohort was 61 years and 89% were males. Researchers used inverse probability weighting to balance the cohorts. In the COVID group, they evaluated the occurrence of 44 brain and other neurological disorders about 1 year after acute SARS-CoV-2 infection. Both hospitalized and non-hospitalized COVID patients were included.

Compared to controls, COVID patients were 80% more likely to have epilepsy or seizures again, 43% more likely to have mental disorders such as anxiety or depression, 42% more likely to have movement disorders, and 35% more likely to have mild to severe headaches have after 1 year. They were also 50% more likely to have an ischemic stroke.

People with COVID had a 77% higher risk of memory problems than those in the control groups. For some patients, post-COVID memory problems have resolved over time, Al-Aly noted.

COVID patients also had an increased risk of being diagnosed with Alzheimer’s compared to their peers who were not infected (HR 2.03, 95% CI 1.79-2.31).

“It is unlikely that someone who has had COVID-19 will get Alzheimer’s out of the blue,” Al-Aly said in a statement. “Alzheimer’s takes years to manifest.”

“But what we suspect is that people predisposed to Alzheimer’s could be sidelined by COVID, meaning they’re on a faster path to developing the disease,” he added. “It’s rare but worrying.”

Analysis of age as a continuous variable yielded two important findings, the researchers noted. “Regardless of age and across the age range, people with COVID-19 were at higher risk for all neurological outcomes examined in this analysis,” they found.

In addition, “our interaction analyzes suggest that the effect of COVID-19 on the risk of memory and cognitive disorders, sensory disorders and other neurological disorders (including Guillain-Barré syndrome and encephalitis or encephalopathy) is stronger in younger adults” , they stressed . “The impact of these diseases on younger people is profound and cannot be overstated; urgent attention is needed to better understand these long-term effects and the means to mitigate them.”

The limitations of the study included a cohort of mostly white males. Few people were vaccinated against COVID because vaccines were not widely available during the study period. Other research led by Al-Aly has shown that vaccines reduce, but do not eliminate, the risk of neurological complications from COVID-19.

The study also predated Delta and Omicron variants.