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

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

Source: WUSTL

If you’ve had COVID-19, it can still get in the way of your brain. New research shows that people infected with the virus are more likely to develop a range of neurological conditions in the first year after infection.

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

In addition, the brain after COVID is associated with movement disorders, ranging from tremors and involuntary muscle contractions to seizures, hearing and vision impairment, and problems with balance and coordination, as well as other symptoms similar to those of Parkinson’s disease.

The results were published on September 22 in Medicine of nature.

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

“Earlier studies looked at a narrower set of neurological outcomes, mostly in hospitalized patients. We assessed 44 brain disorders and other neurological disorders in both outpatients and inpatients, including those admitted to the intensive care unit.

“The results show the devastating long-term effects of COVID-19. They are an inseparable part of the long COVID. The virus is not always as mild as some people think it is. “

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

Besides COVID infection, specific risk factors for long-term neurological problems are rare.

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

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

Previous research in Medicine of nature led by Al-Aly found that vaccines slightly reduced – by about 20% – the risk of long-term problems with the brain.

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

Researchers analyzed approximately 14 million unidentified medical records in a database maintained by the US Department of Veterans Affairs, the country’s largest integrated health care system. Patients were of all ages, races and genders.

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

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

Scientists studied brain health throughout the year. Neurological conditions occurred in 7% more people with COVID-19 compared to people who did not become infected with the virus. Extrapolating this percentage from the number of COVID-19 cases in the US, this translates to approximately 6.6 million people who have suffered from a virus-related brain impairment.

Memory problems – colloquially referred to as brain fog – are one of the most common symptoms related to the brain, long-term COVID. Compared to controls, those who contracted the virus had a 77% higher risk of developing memory problems.

“These problems work for some people, but persist for many others,” said Al-Aly. “Right now, the percentage of people who get better compared to people with long-term problems is unknown.”

Interestingly, scientists have noticed an increased risk of Alzheimer’s disease among people infected with the virus. Compared to the control groups, there were two more cases of Alzheimer’s disease in 1,000 people with COVID-19.

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

“Alzheimer’s will manifest itself for years. But we suspect that people who are predisposed to Alzheimer’s may be pushed to the limit by COVID, meaning they are on a faster path to developing the disease. It is rare but disturbing.

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

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

Comprehensive federal data analysis by researchers at Washington University School of Medicine in St. Louis shows that people who have had COVID-19 are at increased risk of developing neurological diseases in the first year after being infected. Complications include movement disorders, memory problems, strokes and seizures. Source: Sara Moser / Washington University 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 seizure,” said Al-Aly. “It helps to explain how a person without risk factors can suddenly have a stroke.”

Overall, compared to uninfected people, people with COVID-19 were 80% more likely to experience epilepsy or seizures, 43% more likely to experience mental health disorders such as anxiety or depression, and 35% more likely to experience mild or severe headaches, and 42% are more likely to encounter 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 develop eye problems such as blurred vision, dryness, and retinitis; and were 22% more likely to develop hearing disorders such as tinnitus or ringing in the ears.

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

Al-Aly said the long impact of COVID on the brain and other systems highlights the need for governments and health systems to develop public health and prevention policies and strategies to manage the ongoing pandemic and plan for the post-COVID world.

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

On news in the field of neuroscience and COVID-19

Author: Press office
Source: WUSTL
Contact: Press Office – WUSTL
Image: Image credit 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. Medicine of nature


Abstract

Long-term neurological outcomes of COVID-19

The neurological symptoms of acute COVID-19 are well characterized, but no comprehensive evaluation has been performed after the acute neurological sequelae after 1 year.

Here, we use the US Department of Veterans Affairs national health care databases to build a cohort of 154,068 people with COVID-19, 5,638,795 contemporary controls, and 5,859,621 historical controls; we use inverse probability weighting to balance cohorts and estimate the risk and burden of neurological disorders 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 number of neurological events, including ischemic and hemorrhagic stroke, cognitive and memory impairment, peripheral nervous system disorders, and episodic disorders (such as migraines and seizures). , extrapyramidal and movement disorders, mental health disorders, musculoskeletal disorders, sensory disturbances, Guillain-Barré syndrome, and encephalitis or encephalopathy.

We estimated the hazard ratio for any neurological sequelae to be 1.42 (95% confidence intervals 1.38, 1.47) and the burden of 70.69 (95% confidence intervals 63.54, 78.01) per 1,000 people after 12 months. . The risk and burden were increased even in those who did not require hospitalization during acute COVID-19. Restrictions include a cohort of predominantly white males.

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

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