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

Summary: Infection with COVID-19 has been linked to a range of lasting neurological and psychological disorders, including depression, memory problems and Parkinson-like disorders, within the first year after infection.

Source: WUSTL

If you’ve had COVID-19, it may still be wreaking havoc on your brain. Those who have been infected with the virus are at increased risk of developing a range of neurological conditions within the first year after infection, new research shows.

These complications include stroke, 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.

In addition, the post-COVID brain is associated with movement disorders, from tremors and involuntary muscle contractions to epileptic seizures, auditory and visual abnormalities, balance and coordination difficulties, as well as other symptoms similar to what is experienced with Parkinson’s disease.

The findings are published on September 22 a Natural Medicine.

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

“Previous studies have examined a smaller set of neurological outcomes, mainly in hospitalized patients. We evaluated 44 brain and other neurological disorders among non-hospitalized and hospitalized patients, including those admitted to the intensive care unit.

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

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

Other than having a COVID infection, specific risk factors for long-term neurological problems are few.

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

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

A study prior to Natural Medicine led by Al-Aly, found that vaccines slightly reduce the risk of long-term brain problems by about 20%.

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

The researchers analyzed about 14 million de-identified medical records in a database maintained by the US Department of Veterans Affairs, the nation’s largest integrated health care system. Patients included all ages, races, and sexes.

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

The statistical model was used to compare neurological outcomes from the COVID-19 data set with two other groups of people not infected with the virus: a control group of more than 5.6 million patients who did not have COVID- 19 during the same time 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 worldwide.

The researchers examined brain health over a one-year period. Neurological conditions occurred in 7% more people with COVID-19 compared to those who had not been infected with the virus. Extrapolating this percentage based on the number of cases of COVID-19 in the US, that translates to approximately 6.6 million people who have experienced brain impairments associated with the virus.

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

“These problems resolve in some people, but persist in many others,” Al-Aly said. “At this time, the proportion of people who improve compared to those with long-term problems is unknown.”

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

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

“Alzheimer’s takes years to manifest itself. But what we suspect is happening is that people who have a predisposition to Alzheimer’s may be pushed over the edge by COVID, meaning they are on a faster path to developing the disease. It’s rare but worrying.”

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

Ischemic strokes account for the majority of all strokes and can lead to difficulty speaking, cognitive confusion, vision problems, loss of feeling 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 are at high risk of developing neurological conditions in the first year after infection. Movement disorders, memory problems, strokes and seizures are among the complications. Credit: Sara Moser/University of Washington School of Medicine

“There have been several studies by other researchers that have shown, in mice and humans, that SARS-CoV-2 can attack the lining of blood vessels and then trigger a stroke or a seizure,” Al-Aly said. “It helps explain how someone with no risk factors could suddenly have a stroke.”

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

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COVID-19 sufferers were also 30% more likely to have eye problems such as blurred vision, dryness and inflammation of the retina; and were 22% more likely to develop hearing abnormalities such as tinnitus or ringing in the ears.

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

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

“Given the colossal scale of the pandemic, meeting these challenges requires urgent and coordinated global, national and regional response strategies, but, so far, absent,” he said.

About this neurology and research news COVID-19

Author: Press Office
Source: WUSTL
Contact: Press Office – WUSTL
Image: Image credited 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. Natural Medicine


Summary

Long-term neurological outcomes of COVID-19

The neurologic manifestations of acute COVID-19 are well characterized, but a comprehensive evaluation of neurologic sequelae beyond 1 year has not been performed.

Here we use US Department of Veterans Affairs national healthcare databases to create 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 cohorts and estimate risks and burdens of incident neurological disorders at 12 months after acute SARS-CoV-2 infection.

Our results show that in the late phase of COVID-19, there was an increased risk of a number of incident neurological sequelae, including ischemic and hemorrhagic stroke, cognitive and memory disorders, peripheral nervous system disorders, episodic disorders (eg, migraine and seizures). , extrapyramidal and movement disorders, mental health disorders, musculoskeletal disorders, sensory disorders, Guillain-Barré syndrome and encephalitis or encephalopathy.

The hazard ratio for any neurologic sequelae was estimated to be 1.42 (95% confidence intervals 1.38, 1.47) and the burden 70.69 (95% confidence intervals 63.54 , 78.01) per 1,000 people at 12 months. Risks and burdens were high even in people who did not require hospitalization during acute COVID-19. Limitations include a cohort that includes mostly white men.

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

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