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

In terms of infections, Jeffrey Siegelman’s first fight with COVID was unremarkable. The emergency room physician and professor at Emory School of Medicine likely contracted the virus at work in August 2020. He had the usual symptoms – fever, headache, aches, chills, and loss of smell and taste. But in the weeks following his recovery, other symptoms emerged, including palpitations, insomnia, and significant fatigue even after minimal physical exertion. The headache never went away either, he said.

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

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

The biggest finding is that these neurological and psychiatric symptoms can persist for at least two years after infection in some people. But the findings have more to do with more than just COVID — according to the authors, they underscore the need for a new and thorough commitment to mental health infrastructure to support increasingly strained healthcare systems.

“It is well known that adults are at increased risk for a range of neurological and psychiatric disorders in the few months following diagnosis of COVID-19,” said the study’s lead author Maxime Taquet, a psychiatric researcher at the University of Oxford, during a press briefing. “There are still some questions that remain unanswered and the first is what happens after six months.”

Researchers analyzed the medical records of nearly 1.5 million patients diagnosed with COVID and compared them to other respiratory disease patients based on variables such as age, sociodemographics and risk factors. They then determined if members of each group had been diagnosed with any of the 14 psychiatric or neurological disorders, and when. These disorders ranged from anxiety and mood disorders to insomnia and dementia — according to psychiatric neuroscientist and study co-author Paul Harrison, “these disorders overlap with the long history of COVID” but don’t capture the full breadth of those affected Patients reported symptoms.

“Here we are two years later, and I’m still dealing with a lot of this 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 out higher but decreased over the two years, becoming similar to those of people who had contracted other respiratory conditions. This finding is “very reassuring,” Taquet said.

But on the downside, the risk of other conditions — including brain fog, dementia, psychotic disorders, as well as epilepsy and seizures — can remain high even after those two years. Researchers found that more new cases of these diseases were still being diagnosed in people two years after contracting COVID, compared to the other patients with respiratory infections.

The researchers also compared the diagnosis rates of these diseases in patients infected with alpha, delta and omicron variants of the virus. They found that the occurrence of the delta variant was associated with an increased risk of neurological and psychiatric diagnoses.

Still, the risks between Delta and Omicron were broadly similar, leading the authors to conclude that “healthcare providers will likely continue to face a similar rate of these post-COVID-19 diagnoses, even for SARS-CoV-2 variants.” who are 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 “proves 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 comparatively long period of time, the researchers said there were several limitations to its generalizability. For one, the use of electronic health records and confirmed COVID diagnoses limited their sampling to individuals who might have had easier access to healthcare or a more severe course of infection. Dependence on health records, in particular, may have excluded communities of color that 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, myself included, who didn’t see a doctor and therefore wouldn’t show up on their medical records,” he said.

Relying on electronic health records also prevented researchers from comparing disease rates based on disease severity or immunization status, and the study does not explain how and why COVID leads to an increased risk of neurological and psychiatric diagnoses. These questions are being researched in laboratories all over the world.

While a related 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-COVID as clinicians and patients themselves.

“I think there is enough evidence here that there is a large group of people who have been infected who are still suffering and deserve attention,” he said. COVID can disrupt mental and brain health even two years after infection


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