New study shows that Covid increases the risk of brain disorders

A study published this week in Lancet Psychiatry showed increased risks for certain brain disorders two years after infection with the coronavirus, shedding new light on the long-term neurological and psychiatric aspects of the virus.

The analysis, conducted by researchers at the University of Oxford and based on health record data from more than 1 million people worldwide, found that while the risks of many common psychiatric disorders returned to normal within a few months, people remained at increased risk for dementia, epilepsy, psychosis and cognitive deficit (or brain fog) two years after coronavirus infection. Adults appeared to be at particular risk of permanent brain fog, a common complaint among coronavirus survivors.

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The study was a mix of good news and bad news findings, said Paul Harrison, professor of psychiatry at the University of Oxford and lead author of the study. Among the reassuring aspects was the rapid resolution of symptoms such as depression and anxiety.

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“I was surprised and relieved at how quickly the psychiatric sequelae subsided,” Harrison said.

David Putrino, director of rehabilitation innovation at Mount Sinai Health System in New York, who has been studying the lasting effects of the coronavirus since the beginning of the pandemic, said the study revealed some very troubling results.

“It allows us to see without a doubt the occurrence of significant neuropsychiatric consequences in people who have had Covid and much more often than those who have not,” he said.

Because it focused only on the neurological and psychiatric effects of the coronavirus, the study authors and others stressed that it is not strictly long-term research on the coronavirus.

“It would be excessive and unscientific to make the immediate assumption that everyone in [study] The cohort had long had Covid,” Putrino said. Still, the study, he said, “informs research on Covid.”

Between 7 and 23 million people in the United States have long-standing coronavirus, according to recent government estimates — a catchall term for a wide range of symptoms, including fatigue, shortness of breath and anxiety that persist weeks and months after the acute infection subsides. These numbers are expected to increase as the coronavirus establishes itself as an endemic disease.

The study was led by Maxime Taquet, a senior researcher at Oxford University who specializes in using big data to shed light on psychiatric disorders.

The researchers matched nearly 1.3 million patients diagnosed with covid-19 between January 20, 2020, and April 13, 2022, with an equal number of patients who had other respiratory illnesses during the pandemic. The data, provided by the TriNetX electronic health record network, came largely from the United States, but also included data from Australia, Britain, Spain, Bulgaria, India, Malaysia and Taiwan.

The study group, which included 185,000 children and 242,000 older adults, revealed that the risks differed by age group, with those aged 65 and over at the highest risk of lasting neuropsychiatric effects.

For people aged between 18 and 64, a particularly significant increased risk was persistent brain fog, affecting 6.4 per cent of people who had Covid compared to 5.5 per cent in the control group.

Six months after infection, the children were not at increased risk of mood disorders, although they remained at increased risk of brain fog, insomnia, stroke and epilepsy. None of these effects were permanent for the children. With epilepsy, which is extremely rare, the increased risk was greater.

The study found that 4.5 percent of the elderly developed dementia in the two years after infection, compared with 3.3 percent of the control group. This 1.2-point increase in a diagnosis as damaging as dementia is particularly concerning, the researchers said.

The study’s reliance on a trove of de-identified electronic health data prompted some caution, particularly during the turbulent time of the pandemic. Tracking long-term outcomes can be difficult when patients may have sought care through many different health systems, including some outside the TriNetX network.

“I personally find it impossible to judge the validity of data or conclusions when the source of the data is shrouded in mystery and the sources of the data are kept secret by legal agreement,” said Harlan Krumholz, a Yale scientist who has developed an online platform where patients can enter their own health data.

Taquet said the researchers used several means to evaluate the data, including making sure it reflected what is already known about the pandemic, such as the drop in death rates during the Omicron wave.

Also, Taquet said, “the validity of the data is not going to be better than the validity of the diagnosis. If clinicians make mistakes, we will make the same mistakes.”

The study follows earlier research by the same team, which reported last year that a third of Covid patients developed mood disorders, strokes or dementia six months after contracting the coronavirus.

While cautioning that it is impossible to make full comparisons between the effects of recent variants, including omicron and its subvariants, that are currently causing infections, and those prevalent a year or more ago, the researchers described some initial findings: that omicron caused less severe immediate symptoms, long-term neurological and psychiatric effects appeared similar to delta waves, indicating that the burden on global health care systems may continue even with less severe variants.

Hannah Davis, co-founder of the Patient-Led Research Collaborative, which has been studying Covid for a long time, said the finding was important. “It goes against the narrative that micron is milder for long-term covid, which is not based on science,” Davis said.

“We see it all the time,” Putrino said. “The mainstream debate continues to leave out Covid for a long time. The severity of the initial infection is irrelevant when we’re talking about long-term consequences that destroy people’s lives.”

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Dan Keating of the Washington Post contributed to this report.

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