Six months later, a third of COVID-19 patients have been diagnosed psychiatric or neurological illness

1 in 3 Covid-19 patients are diagnosed with a neuropsychiatric condition Six months after being diagnosed with Covid-19, 1 in 3 patients had also experienced a neuropsychiatric illness. Elizabeth Cooney STAT

Six months after being diagnosed with Covid-19, 1 in 3 patients also had experienced a psychiatric or neurological illness, mostly mood disorders but also strokes or dementia, a large new study shows.

About 1 in 8 of the patients (12.8%) were diagnosed for the first time with such an illness, most commonly anxiety or depression. Compared to control groups of people who had the flu or other non-Covid respiratory infections, first-ever neuropsychiatric diagnoses were almost twice as high.

The study, published Tuesday in The Lancet Psychiatry, used real-world health data on millions of people to gauge the incidence of 13 brain disorders. Anxiety, mood, and substance use disorders were most common, but the researchers also found worrying, if lower, rates of serious neurological complications, especially in patients who had been severely ill with Covid-19. In all Covid-19 patients, 0.6% developed a  brain hemorrhage, 2.1% an ischemic stroke, and 0.7% dementia. 

We need urgent research to better understand how and why does this occur in patients with Covid-19 and how they can be treated and [how to] prevent it,” Max Taquet, a clinical fellow in psychiatry at the University of Oxford and a study co-author, said on a call with reporters on Tuesday. “But we think that regardless of the explanation, health services need to be prepared for the increased demand that this data is showing.” 

The size of the study lends confidence to its findings, which confirm what has been hinted in smaller studies, including earlier work from the Oxford group. ...The researchers analyzed electronic health records of 81 million U.S. patients (both insured and uninsured), finding 236,379 people who had been diagnosed with Covid-19 and comparing them to three cohorts of similar people: one cohort had the flu, another had another respiratory illness such as sinusitis or pneumonia, and one cohort included people who were hospitalized for unrelated conditions such as bone fractures or gallstones. ...

Allison Navis, assistant professor in the division of neuro-infectious diseases at the Icahn School of Medicine at Mount Sinai, sounded a note of caution. The lead clinical neurologist at Mount Sinai’s post-Covid clinic, she was not involved in the Lancet study.  

“It does highlight that there is something unique going on with Covid,” she told STAT. “And the 12.8% who have a new diagnosis of something neuropsychiatric can sound very sensational. That 12.8% encompasses depression and anxiety, so it’s extremely important to not minimize that and not make that sound like a lesser diagnosis at all, but the more severe things like strokes are still fairly uncommon. I don’t want people thinking that 1 in 10 people get a stroke with Covid.” ...