【《We Chinese in America》Media Editor Tang Zhao, September 22, 2022】National Institute for Health and Care Research Oxford Health Biomedical Research Centre, The Wolfson Foundation, and MQ Mental Health Research provided funding to conduct a two-year study to understand if COVID-19 is associated with increased risks of neurological and psychiatric sequelae in the weeks and months thereafter. (Photo Credit: medicine.wustl.edu)

The research focused on how long these risks remain, whether they affect children and adults similarly, and whether SARS-CoV-2 variants differ in their risk profiles.

In this analysis of 2-year retrospective cohort studies, the data were extracted from the TriNetX electronic health records network, an international network of de-identified data from health-care records of approximately 89 million patients collected from hospital, primary care, and specialist providers (mostly from the USA, but also from Australia, the UK, Spain, Bulgaria, India, Malaysia, and Taiwan).

A cohort of patients of any age with COVID-19 diagnosed between Jan 20, 2020, and April 13, 2022, was identified and propensity-score matched to a contemporaneous cohort of patients with any other respiratory infection. Matching was done on the basis of demographic factors, risk factors for COVID-19 and severe COVID-19 illness, and vaccination status. Analyses were stratified by age group (age <18 years [children], 18–64 years [adults], and ≥65 years [older adults]) and date of diagnosis. The risks of 14 neurological and psychiatric diagnoses were assessed after SARS-CoV-2 infection and compared these risks with the matched comparator cohort.

The 2-year risk trajectories were represented by time-varying hazard ratios (HR’s) and summarized using the 6-month constant HRs (representing the risks in the earlier phase of follow-up, which have not yet been well characterized in children), the risk horizon for each outcome (ie, the time at which the HR returns to 1), and the time to equal incidence in the two cohorts. Researchers also estimated how many people died after a neurological or psychiatric diagnosis during follow-up in each age group. Finally, researchers compared matched cohorts of patients diagnosed with COVID-19 directly before and after the emergence of the alpha (B.1.1.7), delta (B.1.617.2), and omicron (B.1.1.529) variants.

The analysis of 2-year retrospective cohort studies of individuals diagnosed with COVID-19 showed that the increased incidence of mood and anxiety disorders was transient, with no overall excess of these diagnoses compared with other respiratory infections. In contrast, the increased risk of psychotic disorder, cognitive deficit, dementia, and epilepsy or seizures persisted throughout. The differing trajectories suggest a different pathogenesis for these outcomes. Children have a more benign overall profile of psychiatric risk than do adults and older adults, but their sustained higher risk of some diagnoses is of concern. The fact that neurological and psychiatric outcomes were similar during the delta and omicron waves indicates that the burden on the health-care system might continue even with variants that are less severe in other respects. Our findings are relevant to understanding individual-level and population-level risks of neurological and psychiatric disorders after SARS-CoV-2 infection and can help inform our responses to them.

(Source: National Institute for Health)

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