Researchers explore neurological manifestations among long-term COVID patients

In a recent study published in nature medicineIn this study, researchers evaluated the long-term post-acute neurological consequences of coronavirus disease 2019 (COVID-19), or prolonged COVD.

COVID Long refers to the spectrum of severe COVID-19 sequelae involving many extrapulmonary manifestations, including neurological abnormalities. Most studies investigating prolonged neurological disorders associated with COVID were limited to patients hospitalized during acute SARS-CoV-2 infection (Severe Acute Respiratory Syndrome coronavirus 2), and were followed for less than 6 months for a small set of neurological outcomes. .

Comprehensive assessment of neurological outcomes long after a year of severe COVID-19 is required, and assessment of neurological outcomes across different care settings in the acute phase of COVID-19, including those who have not been hospitalized, hospitalized residents, and the intensive care unit (ICU) -He confessed).

about studying

In this study, researchers evaluated the neurological consequences among long-term COVID patients.

Data were obtained from the United States Department of Veterans Affairs (US) national health care databases for 154,068 individuals who lived after the first month of SARS-CoV-2 infections and two control groups: the contemporary control group comprising 5,638 US VHA (Veterans’ Health System Division) users lacking exposure to SARS-CoV-2, and historical control group of 5,859,621 US VHA users that preceded the SARS-CoV-2 pandemic (2017).

Inverse probability weighting was used to balance COVID-19 and contemporary control groups, hazard ratios (HRs) were calculated, and the burdens and risks of pre-specified neurological disorders one year after severe COVID-19 were estimated. Furthermore, the team evaluated neurological disturbances occurring among the SARS-CoV-2 infection cohort based on acute COVID-19 care settings (hospital, hospital admission, and intensive care unit comprising 131,915, 16,764, and 5,389 patients). , Straight).

Furthermore, two sensitivity analyzes were performed; One involved only predefined covariates, and the other involved applying covariate and weight adjustments. To verify the reproducibility of the study approach, fatigue was assessed as a positive outcome control and receiving influenza vaccinations between March 1, 2020 and January 15, 2021, on even and odd calendar days between 571,291 and 605,453 individuals, respectively, as negative exposure controls.

consequences

Individuals who lived after the first month of SARS-CoV-2 infection showed an increased risk of cerebral venous thrombosis (CVT, HR 2.7; burden 0.1), hemorrhagic stroke (HR 2.2; burden 0.2), and stroke. [HR 1.5; burden 3.4 for every 1,000 individuals at one-year, transient ischemic attacks (HR 1.6; burden 2.0)]. The burden and risk of the composite cerebral neovascularization outcome were 4.9 and 1.6, respectively.

An elevated risk of Alzheimer’s disease (AD, HR 2.0, burden 1.7) and memory problems (HR 1.8; burden 10) were observed with a combined memory burden, cognition outcome, and risk 10 and 1.8, respectively. Risk and burden of peripheral neuropathy (HR 1.3, burden 5.6), paraesthesia (HR 1.3, burden 2.9), Bell’s palsy (HR 1.5, burden 0.3), and dyskinesia (HR 1.3, burden 1.6) with peripheral nerve disorder outcome complex burden and risk 8.6 and 1.3, respectively.

Symptomatic disorder outcomes included seizures and epilepsy (HR 1.8; burden 2.0), headache-related illness (HR 1.4, burden 1.5), and migraine (HR 1.2, burden 2.0), with the combined burden and risk of symptomatic disorder outcome being 4.8 and 1.3, respectively. Motor and extrapyramidal disorders included abnormalities of involuntary movement (HR 1.4, burden 2.9), tremor (HR 1.4, burden 1.1), Parkinson’s-like disease (HR 1.5, burden 0.9), myoclonus (HR 1.4, burden 0.1), and dystonia (HR ) 1.6, burden 0.4) with compound burden and risk for movement outcome and extrapyramidal perturbation 4.0 and 1.4, respectively.

Mental health conditions included primary depressive illnesses (HR 1.4, burden 17), stress-adaptive diseases (HR 1.4, burden 14.3), anxiety (HR 1.4, burden 12.4) and psychotic diseases (HR 1.5, burden 1.0). The compound burden and risk for mental health issues were 25 and 1.4, respectively. Musculoskeletal disease includes joint pain (heart rate 1.3, burden 28), muscular disease (heart rate 2.8, burden 0.7), and myalgia (heart rate 1.8, burden 16), with the combined burden and risk of musculoskeletal disorder 40 and 1.5, respectively.

Outcomes of sensory disturbances included tinnitus or hearing abnormalities (HR 1.2, burden 11.9), visual impairment (HR 1.3, burden 5.6), loss of smell (HR 4.1, burden 1.1) and loss of taste (HR 2.3, burden 0.1), with a compound burden and risk The incidence of sensory disturbance 17 and 1.3, respectively. Outcomes of other neurological or associated disorders included somnolence (HR 1.7, burden 0.6), dizziness (HR 1.4, burden 6.7), Guillain-Barré syndrome (HR 2.2, burden 0.1), transverse myelitis (HR 1.5, burden 0.03), and encephalitis or encephalitis (HR 1.8, burden 0.1) and the compound burden and risk for outcome of other neurological or associated disorders were 7.4 and 1.5, respectively.

The overall burden and risk for any pre-specified neurological sequelae were estimated to be 71 and 1.4 per 1000 person-years at 1 year after acute COVID-19 infection, respectively, compared to contemporary controls. Risks and burdens among COVID-19 patients (versus contemporary controls) increased even among patients who did not require hospitalization in acute COVID-19, based on the severity of COVID-19.

The risk of developing symptomatic disorders, mental health disorders, musculoskeletal disorders, and any neurological disorder increases with age. In contrast, perceptual and memory disturbances, sensory disturbances, and other neurological or related disorders decreased with age. Similar results were obtained in sensitivity analyses, and COVID-19 was associated with a higher risk of fatigue compared to contemporary controls but had no significant association with influenza vaccines.

Overall, the study findings shed light on the neurological consequences of prolonged Covid-19, which should help guide policy-making and health care planning for the care of long-term Covid patients.

from San Jose News Bulletin https://sjnewsbulletin.com/researchers-explore-neurological-manifestations-among-long-term-covid-patients/