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High Incidence of Neurological and Psychiatric Illness After COVID-19

Dariusz J. Nasiek, MD - Pain Management
April 22, 2021

High Incidence of Neurological and Psychiatric Illness After COVID-19
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In a study of electronic health records from multiple institutions in the U.K., researchers estimated the incidence of neurological or psychiatric sequelae in 236,000 people with COVID-19.

Mood disorders and anxiety disorders were especially common.

During 6 months of follow-up, 13% of patients with no history of neurological or psychiatric conditions received a first diagnosis of such a condition, and another 21% of patients with past neurological or psychiatric conditions developed new conditions.

These rates were compared with rates in 342,000 people (matched for pertinent variables) with influenza or other respiratory tract infections. Incidence of neurological or psychiatric diagnoses were significantly higher in COVID-19 patients: The most common diagnoses were anxiety disorder (17.4%), psychotic disorder (2.8%), ischemic stroke (2.1%), dementia (0.7%), and intracranial hemorrhage (0.6%). Neurological or psychiatric conditions were significantly more likely after severe COVID-19, particularly for patients whose acute COVID-19 caused encephalopathy (defined as delirium or other altered mental states). In those with encephalopathy, the chances of developing mood disorder, anxiety disorder, ischemic stroke, psychosis, or dementia were 22%, 22% 9%, 7%, and 5%, respectively.

COMMENT

This large study demonstrates that various neurological or psychiatric disorders develop with a relatively high incidence in the 6 months following acute COVID-19 — in people with and without previous disorders. Interventions to lower risk for these sequelae are needed urgently. An interesting question: Are post-COVID mood and anxiety disorders due to the psychosocial stresses of the illness, or are they triggered by neuroinflammation caused by the infection?

Anthony L. Komaroff, MD, reviewing Taquet M et al. Lancet Psychiatry Apr 1, 2021 

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Dariusz Nasiek, MD
Board Certified
Anesthesiologist
Pain Specialist

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