COVID-19 infections increase the risk of long-term brain problems

Overview: COVID-19 infection has been linked to a range of persistent neurological and psychological conditions in the first year after infection, including depression, memory problems and Parkinson’s-like disorders.

Source: WUSTL

If you’ve had COVID-19, it can still mess with your brain. Those infected with the virus are at an increased risk of developing a range of neurological disorders in the first year after infection, new research shows.

Such complications include strokes, cognitive and memory problems, depression, anxiety and migraines, according to a comprehensive analysis of federal health data by researchers at Washington University School of Medicine in St. Louis and the Veterans Affairs St. Louis Health Care System.

In addition, the post-COVID brain is associated with movement disorders, from tremors and involuntary muscle contractions to seizures, hearing and vision abnormalities, and balance and coordination problems, as well as other symptoms similar to those experienced in Parkinson’s disease.

The findings were published Sept. 22 in naturopathy.

“Our study provides a comprehensive assessment of the long-term neurological consequences of COVID-19,” said senior author Ziyad Al-Aly, MD, a clinical epidemiologist at Washington University.

“Previous studies have examined a narrower range of neurological outcomes, mostly in hospitalized patients. We evaluated 44 brain and other neurological disorders in both non-hospitalized and hospitalized patients, including those admitted to intensive care.

“The results show the devastating long-term effects of COVID-19. These are an essential part of the protracted COVID. The virus is not always as benign as some people think.”

Overall, COVID-19 has contributed to more than 40 million new cases of neurological disorders worldwide, Al-Aly said.

Aside from having a COVID infection, specific risk factors for long-term neurological problems are scarce.

“We see brain problems in previously healthy individuals and in people who have had mild infections,” Al-Aly said. “It doesn’t matter if you’re young or old, female or male, or what your race is. It doesn’t matter if you smoked or not, or if you had other unhealthy habits or conditions.”

Few people in the study were vaccinated against COVID-19 because the vaccines were not yet widely available during the study period, from March 2020 to early January 2021. The data also predates delta, omicron and other COVID variants.

A previous study in naturopathy led by Al-Aly found that vaccines slightly reduce the risk of brain problems in the long term – by about 20%.

“It’s absolutely important to get vaccinated, but it’s also important to understand that they don’t provide complete protection against these long-term neurological disorders,” Al-Aly said.

The researchers analyzed about 14 million anonymized medical records in a database maintained by the U.S. Department of Veterans Affairs, the nation’s largest integrated health care system. Patients include all ages, races, and genders.

They created a controlled dataset of 154,000 people who tested positive for COVID-19 sometime from March 1, 2020 to January 15, 2021 and survived the first 30 days after infection.

Statistical modeling was used to compare neurological outcomes in the COVID-19 dataset with two other groups of people who were not infected with the virus: a control group of more than 5.6 million patients who did not have COVID-19 during the same period; and a control group of more than 5.8 million people from March 2018 to December 31, 2019, long before the virus infected and killed millions of people around the world.

The researchers examined brain health over a one-year period. Neurological disorders occurred in 7% more people with COVID-19 compared to those not infected with the virus. Extrapolating this percentage based on the number of COVID-19 cases in the US, amounts to approximately 6.6 million people who have suffered brain damage related to the virus.

Memory problems — popularly called brain fog — are one of the most common brain-related, long-term COVID symptoms. Compared to those in the control groups, people who contracted the virus had a 77% increased risk of developing memory problems.

“These problems resolve in some people, but persist in many others,” Al-Aly said. “Right now, the percentage of people who get better versus those with long-term problems is unknown.”

Interestingly, the researchers noted an increased risk of Alzheimer’s disease in those infected with the virus. There were two more cases of Alzheimer’s per 1,000 people with COVID-19 compared to the control groups.

“It is unlikely that someone who has had COVID-19 will get Alzheimer’s disease out of the blue,” Al-Aly said.

Alzheimer’s takes years to manifest. But what we suspect is happening is that people with a predisposition to Alzheimer’s could be pushed over the edge by COVID, meaning they’ll be on their way to developing the disease more quickly. It’s rare, but worrying.”

Also compared with the control groups, people who had the virus were 50% more likely to have an ischemic stroke, which strikes when a blood clot or other obstruction blocks an artery’s ability to supply blood and oxygen to the brain.

Ischemic strokes are responsible for the majority of all strokes and can lead to problems with speech, cognitive confusion, vision problems, loss of sensation on one side of the body, permanent brain damage, paralysis and death.

A comprehensive analysis of federal data by researchers at Washington University School of Medicine in St. Louis shows that people who have had COVID-19 have an increased risk of developing neurological disorders within the first year of infection. Movement disorders, memory problems, strokes and seizures are among the complications. Credit: Sara Moser/Washington University School of Medicine

“There have been several studies done by other researchers that have shown in mice and humans that SARS-CoV-2 can attack the lining of the blood vessels and then cause a stroke or seizure,” Al-Aly said. “It helps explain how someone without risk factors can suddenly have a stroke.”

Overall, people with COVID-19 were 80% more likely to have epilepsy or seizures compared to uninfected people, 43% more likely to develop mental health disorders such as anxiety or depression, 35% more likely to have mild to severe headaches, and 42% more likely to have movement disorders. The latter includes involuntary muscle contractions, tremors and other Parkinson-like symptoms.

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COVID-19 patients were also 30% more likely to have eye problems such as blurred vision, dryness and retinal inflammation; and they were 22% more likely to develop hearing abnormalities such as tinnitus or tinnitus.

“Our study adds to this growing body of evidence by providing a comprehensive overview of the neurological consequences of COVID-19 one year after infection,” Al-Aly said.

The long-lasting effects of COVID on the brain and other systems emphasize the need for governments and health systems to develop policies and public health and prevention strategies to manage the ongoing pandemic and devise plans for a post-COVID world, Al-Aly said.

“Given the colossal scale of the pandemic, addressing these challenges requires urgent and coordinated – but as yet absent – ​​global, national and regional response strategies,” he said.

About this neurology and COVID-19 research news

Author: press office
Source: WUSTL
Contact: Press agency – WUSTL
Image: The image is attributed to Sara Moser/Washington University School of Medicine

Original research: Open access.
“Long-term neurological outcomes of COVID-19” by Ziyad Al-Aly et al. naturopathy


Abstract

Long-term neurological outcomes of COVID-19

The neurological manifestations of acute COVID-19 are well characterized, but a comprehensive evaluation of post-acute neurological consequences after 1 year has not been performed.

Here we use the US Department of Veterans Affairs national health databases to build a cohort of 154,068 individuals with COVID-19, 5,638,795 contemporary controls, and 5,859,621 historical controls; we use inverse probability weighting to balance the cohorts and estimate the risks and burdens of incident neurological disorders at 12 months after acute SARS-CoV-2 infection.

Our results show that in the post-acute phase of COVID-19, there was an increased risk of a range of incident neurological consequences, including ischemic and hemorrhagic stroke, cognition and memory impairment, peripheral nervous system disorders, episodic disorders (e.g., migraine and seizures). , extrapyramidal and movement disorders, mental disorders, musculoskeletal disorders, sensory disorders, Guillain-Barré syndrome, and encephalitis or encephalopathy.

We estimate that the hazard ratio of neurological sequela was 1.42 (95% confidence intervals 1.38, 1.47) and burden 70.69 (95% confidence intervals 63.54, 78.01) per 1,000 subjects at 12 months. The risks and burdens were increased, even in people who did not require hospitalization during acute COVID-19. Limitations included a cohort composed of mostly white males.

Overall, our results provide evidence of an increased risk of long-term neurological disorders in people who had COVID-19.

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