Months after overcoming COVID-19, many people continue to experience health problems that have been included under the generic name of persistent COVID and for which more than 200 symptoms have already been described. Scientists continue to study these sequelae of the disease and now new research that has been published in the scientific journal The Lancet Psychiatry reveals that people infected with the coronavirus would have a higher risk of developing certain psychiatric and neurological disorders, such as brain fog, psychosis or dementia, up to two years after diagnosis.
This study, which has been promoted by researchers from the University of Oxford, has also found, however, that the risk of suffering from anxiety and mood disorders is not greater after COVID than after having suffered from another respiratory infection. The Oxford scientists have explained that their objective was to verify if the increased risk of developing some psychiatric and neurological pathologies was reduced over time, if they affected differently depending on the age of the patient, and if the risk profiles varied with the evolution of the different variants of SARS-CoV-2.
The researchers collected clinical information from 1.28 million people registered in databases from various countries – most from the United States, but also from Australia, Bulgaria, Spain and Malaysia, among others – and crossed it with data from other countries. so many participants who had had other respiratory infections and who acted as a control group. In total, they analyzed 14 neurological and psychiatric diagnoses.
“The observation of comparable neurological and psychiatric risks just after (compared to just before) the appearance of the omicron variant suggests an ongoing neuropsychiatric burden of COVID”
In a meeting with the media Paul Harrison, professor at the University of Oxford and lead author of the study, explained that the risk of experiencing neurological and psychiatric problems after COVID is not excessive and differs significantly according to age groups, and specifies that it is not a 10 or 100 times higher risk. “I think the worst odds ratio is two or three: Some things are going to be two to three times more common after dealing with COVID than other infections. [respiratorias]. But those things that are relatively more common also tend to be rarer things,” he notes.
In fact, the results showed that the risk of common psychiatric disorders, such as anxiety or depression, disappeared within two months. This is “good news”, according to Max Taquet, a researcher in psychiatry at the National Institute for Health Research and co-author of the study, who declared at the same meeting: “The excess risk of some disorders, in particular anxiety disorders, it disappeared in three months with no general excess of cases in two years. What that means is that two years after infection, the number of people with Covid who had a diagnosis of depression or an anxiety disorder was the same as people who had another respiratory tract infection. And that is very reassuring,” he added.
Cognitive deficit or psychotic disorders increased after COVID
It was found, however, that up to two years after the diagnosis of COVID-19, the risks of psychotic disorders, cognitive deficits, dementia, and epilepsy or seizures continued to increase. “From risk horizons, if no anxiety disorder has been diagnosed within two months of COVID diagnosis, from that point on, the patient can be confident that their risk is no longer higher than after another Respiratory infection. If a patient had developed an ischemic stroke within two months of COVID diagnosis, it is plausible that the COVID diagnosis contributed (either directly or indirectly) to its onset, but beyond two months, actively consider other causes”, they detail in the study.
These scientists have highlighted that the findings do not mean that, for example, there will be a “tsunami” of cases of dementia, and that it is possible that the increase in psychotic disorders is not chronic, but specific and transient episodes. But they add that attention should be paid to this potential increase in diagnoses. They have also acknowledged that one of the limitations of their study is that they do not know “the severity or course of each disorder after diagnosis, or whether or not these are similar after COVID and after other respiratory infections.”
Lower risk of psychiatric sequelae in children
The study found that “children have a more benign overall psychiatric risk profile than adults and older adults, but their sustained increased risk for some diagnoses is cause for concern.” Specifically, it was observed that minors were more likely to suffer from a psychotic disorder or seizures in the two years following the diagnosis of COVID. “Children have three times the risk of developing psychotic disorders and they have twice the risk of epilepsy or seizures,” explained Taquet, who reported that despite this the absolute risk was very low because the incidence of these ailments in the pediatric population is minimal and that, for example, the incidence for psychotic disorders was 0.18% two years after COVID compared to 0.063% in the control group that had had other respiratory infections.
Risk patterns change with SARS-CoV-2 variants
The risk patterns for these diseases changed according to the evolution of the main variants of the coronavirus since, just after the delta variant appeared, the researchers observed a higher risk of ischemic stroke, epilepsy or seizures, cognitive deficits, insomnia and anxiety disorders than before their onset.
In the case of ómicron, the risks of neuropsychiatric disorders remained similar. “The observation of comparable neurological and psychiatric risks just after (compared to just before) the appearance of the omicron variant suggests an ongoing neuropsychiatric burden of COVID, even with variants leading to less severe disease,” the researchers write.
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