Episode Details

42%increased chance of developing a neuro problem after covid, equating to 7% of those infected.

Uploaded 26-09-22

Dr. Al-Aly

Overall, COVID-19 has contributed to more than 40 million new cases of neurological disorders worldwide

Long-term neurologic outcomes of COVID-19

https://www.nature.com/articles/s41591-022-02001-z

https://newatlas.com/health-wellbeing/mild-covid-risk-brain-neurological-problems/

https://medicine.wustl.edu/news/covid-19-infections-increase-risk-of-long-term-brain-problems/

Comprehensive evaluation of postacute neurologic sequelae at 1 year

National healthcare databases of the US Department of Veterans Affairs

Covid cohort = 154,068

(nonhospitalized, hospitalized and admitted to intensive care)

Contemporary controls = 5,638,795

Historical controls = 5,859,621 (2017 data)

Average age of 61

Estimate risks and burdens of incident neurologic disorders at 12 months following acute SARS-CoV-2 infection

Longitudinal observational study design

March 2020 through January 2021

(predates delta, omicron and other COVID variants)

Results

In the postacute phase of COVID-19, there was increased risk of an array of incident neurologic sequelae

Ischemic and hemorrhagic stroke

TIA

Cognition and memory disorders

Peripheral nervous system disorders

Episodic disorders (e.g. migraine, seizures)

Extrapyramidal and movement disorders

Mental health disorders, (anxiety depression psychosis)

Musculoskeletal disorders

Sensory disorders

Guillain–Barré syndrome

Encephalitis or encephalopathy

Headaches

Hazard ratio of any neurologic sequela

1.42 (1.38 to 1.47)

Burden

70.69 (63.54 to 78.01) per 1,000 persons at 12 months

Or, 7.069%

The risks and burdens were elevated even in people who did not require hospitalization during acute COVID-19

Risks and burdens increased according to the severity of the acute infection,

from nonhospitalized to hospitalized to intensive care

Dizzynes

Taken together, our results provide evidence of increased risk of long-term neurologic disorders in people who had COVID-19.

Incident neurologic outcomes in COVID-19 versus contemporary control

Cerebrovascular disorders (at 12 months)

Ischemic stroke HR 1.50, burden 3.40 per 1,000

Transient ischemic attacks HR 1.62, burden 2.03

Hemorrhagic stroke HR 2.19, burden 0.21

Cerebral venous thrombosis HR 2.69, burden 0.05

Composite of these cerebrovascular outcomes were HR 1.56, burden 4.92

Cognition and memory

Risks of memory problems HR 1.77, burden 10.07

Alzheimer’s disease HR 2.03, burden 1.65

Composite of these cognition and memory outcomes were HR 1.80, Burden 10.35

Disorders of peripheral nerves

Peripheral neuropathy HR 1.34, burden 5.64

Paresthesia HR 1.32, burden 2.89

Dysautonomia HR 1.30, burden 1.60

Bell’s palsy HR 1.48, burden 0.32

Composite of these disorders of peripheral nerves were HR 1.34, burden 8.64

Episodic disorders

Migraine, epilepsy and seizures, headache disorders

Composite of these episodic disorders were HR 1.32, burden 4.75

Extrapyramidal and movement disorders

Abnormal involuntary movements, tremor, Parkinson-like disease, dystonia, myoclonus

Composite of these extrapyramidal and movement disorders were HR 1.42, burden 3.98


Mental health disorders

Major depressive disorders, stress and adjustment disorders, a