The neuropsychiatric effects of severe COVID-19 infection appear to be similar to those of other severe acute infections. Respiratory tract infection (Sally).
The results of a large study show that the risk of new neuropsychiatric disorders was significantly and similarly increased in adults who survived either severe COVID-19 infection or other SARIs compared to the general population. I did.
Researchers point out that this suggests that the severity of the disease, not the pathogen, is the most relevant factor in the newly developed neuropsychiatric illness.
The risk of new neuropsychiatric disorders after a severe COVID-19 infection is “substantial, but similar to the risk after other severe respiratory infections,” said researcher Peter Watkinson, MD. , Nuffield Department of Clinical Neurosciences, University of Oxford, and John Radcliffe Hospital, Oxford, UK, said Medscape Medical News..
“For both service providers and test runners, neuropsychological sequelae should be considered after all severe respiratory infections, not just severe COVID-19 disease,” Watkinson said. Said.
The research is Published online May 11 JAMA Psychiatry..
Significant mental health burden
Studies have shown a significant burden of neuropsychological illness after severe COVID-19 infection. However, it is unclear how this risk will be compared to SARI.
To investigate, Watkinson et al. Reported Electronic Health Records (EHR) for more than 8.3 million adults, including 16,679 (0.02%) who survived SARI hospitalization and 32,525 (0.03%) who survived COVID-19 hospitalization. Evaluated the data.
New risks compared to the rest of the population Anxiety disorderDementia, psychotic disorder, depressionAnd the diagnosis of bipolar disorder was significantly and similarly increased in adults who survived hospitalization with either COVID-19 or SARI.
|
diagnose |
SARI HR (95% CI) |
COVID-19 HR (95% CI) |
|---|---|---|
|
anxiety |
1.86 (1.56 to 2.21) |
2.36 (2.03 to 2.74) |
|
dementia |
2.55 (2.17 to 3.00) |
2.63 (2.21-3.14) |
|
Psychotic disorder |
3.63 (1.88-7.00) |
3.05 (1.58-5.90) |
|
depression |
3.46 (221-5.40) |
1.95 (1.05 to 3.65) |
|
Bipolar disorder |
2.26 (1.25-4.08) |
2.26 (1.25 ~ 4.07) |
Survivors of severe SARI or COVID-19 were also at increased risk of starting treatment with antidepressants, hypnotics / anxiolytics, or antipsychotics, compared to the larger population.
When comparing survivors admitted to SARI with survivors admitted to COVID-19, newly developed anxiety disorders, dementia, depression, or Bipolar affective disorder..
The SARI and COVID groups also had no difference in post-discharge risk from antidepressant or hypnotic / anxiolytic use, but COVID survivors had a 20% lower risk of starting antipsychotics. rice field.
“In this cohort study, SARI was found to be associated with the prevalence of serious acute post-neuropsychosis, with no distinct difference in COVID-19,” Watkinson et al. Wrote.
“These results may help to better understand the COVID-19 phenotype after severe illness, and post-discharge of patients requiring hospital-based intensive care in SARI, regardless of the causative agent. It may be useful for support, “they write.
Warnings and precautions
Dr. Kevin McConway, an emeritus professor of applied statistics at the Open University in Milton Keynes, England, described the study as “impressive.” However, he pointed out that the observational design of the study is limited.
“We cannot be completely convinced of the interpretation of the results of observational studies. What the studies do not know is due to the increased psychiatric risk of people hospitalized for COVID-19 or other serious respiratory illness.” Said McConway.
“Many people are hospitalized with COVID-19 than in the first two waves, reducing the current backlog of some medical service offerings,” he said.
“Therefore, in general, serious COVID-19 does not have almost the same neuropsychiatric consequences as other very serious respiratory illnesses. Maybe not,” McConway said. Warned.
Dr. Max Taquet of Oxford University said the study was limited to inpatient adult patients, leaving the problem of risk in non-hospitalized individuals and children, the overwhelming majority of COVID-19 patients. ..
In a statement, Take said whether the neuropsychiatric risk has remained the same since the advent of the Omicron variant: “Unresolved questions because all patients in this study were diagnosed before July 2021. “.
This study was funded by Cancer Research UK through the Welcome Trust, the Oxford University Press Research Fund, the Oxford Welcome Institutional Strategy Support Fund, and the Oxford Center for Cancer Research. Watkinson disclosed grants from the National Institute of Health and Senshin Health outside of the submitted study. Prior to this job, he was Chief Medical Officer of Sensyne Health and held a stake in the company. McConway is a councilor and member of its advisory board at the UK Science Media Center. His comments were provided in his position as an independent professional statistician. Taquet has undertaken similar studies attempting to identify, quantify, and identify the neurological and psychiatric effects of COVID-19.
JAMA Psychiatry. Published online on May 11, 2022. Full text
Join us for news on Medscape Psychiatry twitter When Facebook..
