Neurological and psychiatric risk trajectories after SARS-CoV-2 infection

The Lancet PsychiatryScott Cunningham MD PhD, et al. | September 12, 2022



Approximately one-third of patients diagnosed with COVID-19 have neurologic and psychiatric disorders.

Given the global impact of COVID-19, additional healthcare resources and social support systems will be needed to provide a proper level of care.

This was a 2-y retrospective cohort study. Data from 8 countries representing 89 million patients were extracted from TriNetX electronic health records.

The de-identified medical records of patients infected with SARS-CoV-2 between 20 January 2020 and 13 April 2022 were propensity-score matched 1:1 with patients with other respiratory infections.

Neurologic and psychiatric complications were compared for 3 age groups: < 18 years of age; 18-64 years of age; and > 65 years of age. Comparisons were also made between the alpha, delta, and omicron variants.

The records of 1,487,712 patients (185,748 children, 856,588 adults, and 242,101 elderly) diagnosed with COVID-19 were reviewed.

The increased risk of mood and anxiety disorders returned to baseline in 43 and 58 days, respectively. An equal incidence of mood and anxiety disorders to the matched patients with other respiratory infections was reached in 457 and 417 days, respectively.

The risks of cognitive deficits, dementia, psychotic disorders, and seizure disorders remained elevated 2 years after infection with SARS-CoV-2.

The risk trajectories differed between children and adults. Specifically, the risk of mood and anxiety disorders were not increased after 6 months in children; however, the risk of cognitive deficits, insomnia, intracranial hemorrhage, ischemic stroke, psychotic disorders, seizure disorders, and nerve, nerve root, and plexus disorders remained elevated. The risk of cognitive deficits in children returned to baseline in 75 days and the equal incidence to matched children was reached in 491 days.