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COVID-19 Fallout of Brain Health is Real

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Editor’s Note: Find the latest COVID-19 news and guidance from Medscape Coronavirus Resource Center.

Survivors of COVID-19 have a sharply increased risk of developing psychiatric or neuropathy within 6 months of being infected with the virus. This is a risk that increases with the severity of the symptoms.

According to what is said to be the largest study of its kind to date, one-third of 236,379 COVID-19 patients have at least one of 14 psychiatric or neuropathy within 6 months. It was shown to have been diagnosed.

Percentage of illnesses ranging from depression Stroke increased sharply among people with acute COVID-19 symptoms that required hospitalization.

“Looking at hospitalized patients, that percentage increased to 39%, to just under one in two patients who needed ICU admission at the time of COVID-19 diagnosis,” said Dr. Maximtake, Oxford, University of England. The Oxford Psychiatry Department in Tokyo told Media Briefing.

He added that the incidence of encephalopathy patients at the time of COVID-19 diagnosis jumped to almost two-thirds.

A study examining the brain health of 236,379 survivors of COVID-19 through a US database of 81 million electronic health records Published online April 6 Lancet psychiatry.

High rate of neurological and psychiatric disorders

The research team investigated the initial diagnosis or recurrence of 14 neurological and psychiatric outcomes in patients with confirmed SARS-CoV-2 infection. They also check the brain health of this cohort, influenza Or with non-COVID Respiratory tract infection In the same period.

All study participants are 10 years of age or older, have been diagnosed with COVID-19 since January 20, 2020, and are still alive as of December 13, 2020.

The 14 psychiatric and neurological conditions examined include: Intracranial hemorrhage; Ischemic strokePerkinsonism; Guillain-Barré syndrome; Nerve, nerve root and plexus disorders; Neuromuscular junctions and muscle disorders; Encephalitis; Dementia; Mental illness, mood, and Anxiety disorderSubstance use disorder; and insomnia..

Researchers used hospitalization, intensive care unit admission, and encephalopathy as indicators of the severity of COVID symptoms.

The study conducted a primary cohort benchmark of four patient populations diagnosed at the same time as non-respiratory disorders such as skin infections, urolithiasis, fractures, and pulmonary embolism.

The results showed that substantially more COVID-19 patients were diagnosed with neuropathy or psychiatric disorders than patients with other respiratory illnesses.

“On average, there is a 44% increased risk of having a neurological or psychiatric diagnosis after COVID-19 compared to after influenza, and a 16% risk compared to other respiratory tract infections, in terms of relative numbers. It has increased, “Take told reporters. ..

He said medical services should be prepared for an increase in psychiatric and neurological problems in the coming months, adding that further research is needed on why and how coronavirus affects brain health. It was.

The biggest research ever

Previous studies have suggested a link between the two, but this is the largest study of its kind, examining a wider range of neurological outcomes, and for the longest period of time, collaborative research. Paul Harrison, BM BCh, Department of Psychiatry, Oxford University.

Patients with severe COVID-19 symptoms had a lower incidence of mood and anxiety disorders and neuropathy. According to Harrison, the discovery that pandemic-related psychological stress may be causing these disorders and biological factors.

“This treatise is a follow-up to our previous work and found almost the same relevance. In our view, many of the effects of COVID on mental health have COVID. It has something to do with the stress of knowing that, for example, the effects of a brain virus or an immune response to a brain virus, not a direct effect, “he added.

In contrast, neurological diagnosis is likely to be “mediated by the direct consequences of COVID infection,” he added.

For example, psychosis and dementia were less common throughout the COVID-19 population, but much more often among people with severe symptoms. The researchers said these findings were “concerned,” along with findings related to the incidence of ischemic stroke.

“We found that one in fifty patients with COVID-19 continued to have ischemic stroke six months after the COVID-19 illness,” Take told reporters. “And when we looked at patients with encephalopathy at the time of COVID-19 diagnosis, the proportion increased to 1 in 11.”

The incidence of cerebral hemorrhage also increased sharply among people with acute symptoms. A total of more than 1 in 200 COVID patients were diagnosed with this neurological condition, but surged to 1 in 25 patients who experienced encephalopathy at the time of COVID-19 diagnosis.

Need for replication

The study’s co-author, Dr. Masud Husan of the University of Oxford’s School of Cognitive Neurology, told reporters that although there is evidence from other neurological studies that the virus can access the brain, there are few signs that the neurons themselves are affected. Told.

“There is little evidence that the virus itself attacks neurons in the brain, but it can cause inflammation and activate inflammatory cells in the brain,” he said.

“And these effects are probably very important in some of the biological effects on the brain. Moreover, of course, the virus can change the likelihood of coagulation and thrombosis in the blood, and their effects. We know that can also affect the brain, “he added.

Harrison will find it helpful to replicate the results obtained from the US database to other populations.

“It goes without saying that replicating these results in other electronic health records and in other countries is a priority,” he said, as to how and why the virus affects brain health. He added that the investigation is essential.

Harrison cited one funded by the British Institute for Research and Technology Innovation A study called COVIDCNS It tracks patients with neurological and / or psychiatric problems during acute COVID in the hope of exploring possible causes.

Beyond reasonable doubt

Sir Simon Wesserie, psychiatrist at King’s College London, UK, said of the findings: “This is a very important treatise. Without prima facie prima facie, we have confirmed that COVID-19 affects both the brain and the mind equally. Major.”

He added that while some of these effects, including stroke and anxiety disorders, were already known, other effects such as dementia and psychosis were less well known.

“Very new is the comparison with all respiratory viruses or influenza, which suggests that these increases are particularly associated with COVID-19 and are not a common effect of viral infections. “I will,” said Wessely. “In general, the worse the illness, the greater the neurological or psychiatric consequences, which is probably not surprising.

“The worst result was a patient with encephalopathy, an inflammation of the brain. This is also not surprising. However, the association with dementia is small and may reflect diagnostic problems, but so far. However, there seems to be no early evidence of an association with Parkinson’s syndrome, which was a major factor after the Spanish flu pandemic, but the author warns that it is too early to rule out. I will. “

Lancet Psychiatry.. Published online on April 6, 2021. Full text

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