COVID can disrupt mental and brain health even two years after infection

As infections go, Jeffrey Siegelman’s first bout with COVID was unremarkable. The emergency physician and professor at Emory School of Medicine likely contracted the virus while on duty in August 2020. He experienced the usual symptoms: fever, headache, aches, chills, and loss of smell and taste. But in the weeks after he recovered, other symptoms set in, including palpitations, insomnia and significant fatigue after even minor physical exertion. The headache never went away, he said.

“Here we are two years later, and I’m still dealing with a lot of that stuff,” Siegelman told The Daily Beast.

Tens of millions of Americans, Siegelman included, are suffering the aftermath of COVID infection. Lung COVID, defined by the Centers for Disease Control and Prevention, represents “a wide variety of new, recurring, or ongoing health problems” that people experience weeks after being infected with the virus. A new study, published Wednesday in The Lancet Psychiatrymeasured the range of persistent neurological and psychiatric symptoms experienced by more than a million people after a diagnosed COVID infection, and compared them to people who had contracted another respiratory virus.

The biggest benefit is that these neurological and psychiatric symptoms can persist for at least two years after infection in some people. But the results relate to more than just COVID – the authors say they underscore the need for a new and deep commitment to mental health infrastructure to support increasingly strained health care systems.

“It is well known that in the few months after being diagnosed with COVID-19, adults are at increased risk for a range of neurological and psychiatric disorders,” lead study author Maxime Taquet, a psychiatric researcher from the University of Oxford, said in a news release. briefing. “There are quite a few questions that remain unanswered, and the first is what happens after six months.”

The researchers analyzed the health records of nearly 1.5 million patients diagnosed with COVID, and matched them with other patients with respiratory disease based on variables such as age, sociodemographics and risk factors. Then they determined whether members of each group were diagnosed with one of 14 psychiatric or neurological conditions, and when. These conditions ranged from anxiety and mood disorders to insomnia to dementia — according to Oxford psychiatric neuroscientist and study co-author Paul Harrison, these conditions “intersect the long COVID story” but do not include the full range of symptoms experienced by patients. reported.

It’s now two years later and I’m still doing a lot of that stuff.

Jeffrey Siegelman, Emory School of Medicine

For some of the conditions the researchers studied — including anxiety and mood disorders, stroke and insomnia — COVID patients’ risks started higher but decreased over the two years and became similar to the people who had other conditions. of the airways. This finding is “very reassuring,” Taquet said.

But then again, the risk of other conditions — including brain fog, dementia, psychotic disorders, and epilepsy and seizures — can remain high even after those two years. The researchers found that, compared to the other patients with a respiratory infection, two years after a COVID infection, more new cases of these conditions were still being diagnosed in humans.

The researchers also compared the rates of diagnosis of these conditions in patients infected with alpha, delta and ommicron variants of the virus. They found that the emergence of the delta variant corresponded to an increased risk of neurological and psychiatric diagnoses.

Still, the risks between delta and omicron were largely similar, leading the authors to conclude that “health services are likely to face a similar percentage of these post-COVID-19 diagnoses, even with SARS-CoV-2 variants leading to otherwise less severe disease.”

Siegelman said there is a misconception that long-term COVID is actually depression or anxiety and that the virus cannot possibly cause long-lasting physical symptoms. The new study “pretends quite strongly that this is not the case,” and that these symptoms can last for years or more, he said.

Although the study was large and followed people over a comparably long period of time, the researchers said there were several limitations to its generalizability. First, the use of electronic health records and confirmed COVID diagnoses limited their sample to people who may have had easier access to health care or had a more severe course of infection. In particular, the reliance on medical records may have excluded communities of color, which are underrepresented in both research and medical care, Siegelman said.

Even Taquet’s own experience underscores this point: “There are people who have had COVID-19, including myself, who have not sought medical attention and therefore it would not appear in their health records,” he said.

Relying on electronic health record data also allowed the researchers to compare rates of conditions based on disease severity or vaccination status, and the study does not explain how or why COVID leads to an increased risk of neurological and psychiatric diagnoses. Research is being done by labs around the world to answer these questions.

While an accompanying essay in The Lancet Psychiatry Calling for further investigation through forward-looking, prospective studies, Siegelman said it’s not too early to take action to help people with long-term COVID, as a clinician and patient themselves.

“I think there is enough evidence here that there is a large group of people who are infected, who are still suffering and who deserve attention,” he said.

Leave a Comment