Lung symptoms and health outcomes are increasingly reported in patients with coronavirus 2019 (COVID-19). Some individuals experience a number of persistent symptoms – from muscle weakness, to respiratory distress, to ‘brain fog’ – several months after recovering from the disease.
However, there is currently a lack of data on the brain and psychiatric outcomes of patients who have undergone COVID-19.
To address this, researchers at Oxford University and the Oxford University Hospitals NHS Foundation Trust in the UK have been aiming to determine the frequency of patients with brain and psychiatric illnesses six months after bypassing COVID-19.
The team estimated the frequency of international classification of 10 diseases (ICD-10) in the six months after they were confirmed with COVID-19. These conditions included intracranial hemorrhage, ischemic stroke, Guillain-Barre ‘syndrome, Parkinsonism, nerve root disorder, muscle disease, depression, encephalitis, anxiety, psychiatric disorders, substance abuse, and insomnia.
The researchers have published their results pre-printed medRxiv* server.
Symptoms and stable outcomes of COVID-19
The growing number of COVID-19 patients recovered exhibiting neurological and psychosocial sequelae months after infection highlights the need for further research and follow-up among convalescents.
COVID-19 long-haulers have been described as those patients who have recovered from the disease, but who have persistent symptoms months after the onset of their symptoms. Previous studies have also examined the frequency of relapsed patients who were at increased risk for brain disorders.
These studies were established using results from other coronaviruses and were followed by case series. There have been similar concerns about psychosocial sequelae of COVID-19. Evidence showed that survivors were at higher risk of mood disorders and anxiety, as well as depression, in the three months after being infected with SARS-CoV-2.
The study
The researchers used prospect cohort studies and time-to-event analysis to estimate the frequency of ICD-10 studies in the six months after COVID-19 detection.
The researchers obtained data from TriNetX’s electronic health record network, which includes more than 81 million patients. They compared the events with patients with influenza or other respiratory diseases using the Cox model.
The team also analyzed whether hospitalization and encephalopathy during COVID-19 starvation influence these risks.
The results of the study showed that 236,379 patients were recovering from COVID-19. These included an estimated frequency of six-month neurological or psychosocial sequelae at 33.6 percent. Approximately 12.8 percent of these patients received their first diagnosis of these conditions.
Further, the team found that most diagnoses were more common after COVID-19 than after flu or other respiratory diseases, including stroke, intracranial hemorrhage, psychiatric disorders, and depression.
The team also found that hospitalized COVID-19 and those with encephalopathy were more likely to develop brain and psychiatric conditions.
Possible mechanisms for this association include viral invasion of the central nervous system, hypercoagulable states, and neural effects of the immune response. On the other hand, it is also interesting that the frequency of these studies was increased even in the COVID-19 cases that did not require hospitalization, ”the researchers explained.
The study used a large sample size, although it acknowledges that electronic health records may contain unknown completeness, including scarce information on lifestyle and socioeconomic factors and a lack of confirmation of diagnoses.
Nonetheless, the study identified the potential scale of post-viral neurological and psychiatric sequelae. Further scrutiny is needed to strengthen the validity of the decisions.
* Important message
medRxiv publish preliminary scientific reports that are not peer-reviewed and, therefore, should not be seen as final, guiding health-related clinical practice / behavior, or be treated as information established.
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