Neuropsychiatric sequelae of COVID-19 similar to other respiratory infections
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Patients hospitalized for COVID-19 infection and those who survived other severe acute respiratory infections were at similarly higher risk for subsequent neuropsychiatric diagnoses and treatment, researchers reported in JAMA Psychiatry.
Ashley Kieran Clift, MA, MBBS, of the Nuffield Department of Primary Care Health Sciences at the University of Oxford, and colleagues identified adults from QResearch electronic health record databases, which included national SARS-CoV-2 testing, hospital statistics, ICU admissions and mortality registers from Jan. 24, 2020, to July 7, 2021.
Researchers assessed new-onset diagnoses of neuropsychiatric conditions — anxiety, dementia, psychosis, depression and bipolar disorder — or first prescription for relevant medications, including antidepressants and antipsychotics, during 12 months of follow-up after hospital discharge.
A total of 8.38 million adults were included (4.2 million men; mean age, 49 years), of whom 16,679 (0.02%) survived a hospital admission for a severe acute respiratory infection (SARI), and 32,525 (0.03%) survived a hospital admission with COVID-19.
According to the authors, compared with the remaining adults (99.05%), survivors of SARI and COVID-19 hospitalizations were at higher risk for subsequent neuropsychiatric diagnoses.
The HR for anxiety was 1.86 (95% CI, 1.56-2.21) for those with SARI and 2.36 (95% CI, 2.03-2.74) for those with COVID-19. For dementia, those with SARI had an HR of 2.55 (95% CI, 2.17-3), and those with COVID-19 had an HR of 2.63 (95% CI, 2.21-3.14).
The authors reported similar findings for medications analyzed: For prescriptions of antidepressants, HR for SARI patients was 2.55 (95% CI, 2.24-2.9) and 3.24 (95% CI, 2.91-3.61) for those with COVID-19.
No significant differences were reported between the COVID-19 group and the SARI group, other than a lower risk for antipsychotic prescriptions in the COVID-19 group (HR = 0.80; 95% CI, 0.69-0.92).
“These results may help refine our understanding of the post-severe COVID-19 phenotype and may inform post-discharge support for patients requiring hospital-based and intensive care for SARI regardless of causative pathogen,” Clift and colleagues wrote.