For the retrospective study, a research team from Oxford University examined the medical records of 236,379 COVID-19 survivors over the age of 10 for new or repeat diagnoses of specific neurological and psychiatric disorders within six months of their COVID diagnosis:

• Intracranial Hemorrhage
• Ischemic Stroke
• Dementia
• Parkinsonism
• Psychotic, Mood, and Anxiety Disorders
• Encephalitis
• Guillain-Barré Syndrome
• Substance Abuse Disorder
• Nerve, Nerve Root, and Plexus Disorders
• Insomnia

The team explored the relationship(s) between these developments and COVID-19 severity.

Matched comparison groups for the same time period (Jan 20, 2020-Dec 13, 2020) included:

• Patients Diagnosed with Influenza 
• Patients Diagnosed with Any Respiratory Tract Infection, Including Influenza 
• Patients Who Sought Medical Care for:
  • Skin Infections 
  • Kidney Stones 
  • Fractures of Large Bones 
  • Blood Clots in the Lung 

What They Found

The researchers found that the odds of having one of the 14 disorders was 44 percent higher for COVID-19 survivors than for those who had the flu. Nearly all the ailments were more common among patients who were sick enough to be hospitalized with COVID-19, with an even greater risk in those admitted to an intensive care unit.

Even patients who were not hospitalized were more likely to receive a diagnosis for one or more neuropsychiatric disorders than those who had suffered a bout of flu or some other respiratory condition.

Regarding the COVID survivors, within six months of falling ill:

• Stroke, nerve disorders, and dementia were higher than in those treated for other issues.
• Nearly 3% were diagnosed with disorders of the nerves or nerve roots
• 24% had a confirmed mood, anxiety or psychotic disorder. For 36% of those patients, this was their first psychiatric diagnosis.
• 2.1% suffered ischemic strokes (blockage of oxygen to the brain) 
• 2.7% aged 66 or older were diagnosed with dementia
• 0.67% of all ages were diagnosed with dementia. This number rose to almost 1.5% among those hospitalized, and to nearly 5% among those with encephalitis.

What It Means

The sheer variety and frequency of these after-effects is likely to send researchers down diverse paths to find their causes with the hope of discovering effective treatment approaches as well as ways to prevent these effects altogether. So far, the study findings strongly support the premise that the SARS-CoV-2 virus somehow invades the brain.

According to Dr. Avindra Nath, who conducts research on the brain and immune system at the National Institute of Neurological Disorders and Stroke, scientists suspect a combination of several mechanisms:

• The virus, or even fragments of it, might bypass the blood-brain barrier (which typically protects the brain from infection), and affect a variety of brain functions from body temperature to judgement.
• The extreme immune reaction (often called ‘cytokine storm’) facilitated by the virus may forcefully launch immune cells and proteins into the brain, damaging tissue and interfering with the organ’s delicate systems.
• SARS-CoV-2’s tendency to attack blood vessel lining and encourage blood clots, can heavily impact the miles of tiny blood vessels that feed the brain.
• Since all coronaviruses affect the nose, the viruses may travel up the olfactory nerve into the brain. Once in the brain, the virus may attack various systems such as the limbic system, where emotions–including fear and anxiety–are processed.

Time and research will determine the severity, duration, and long-term consequences of COVID-related neuropsychiatric health conditions. That research needs to be a top priority, warned Dr. Anna Cervantes-Arslanian, a neurologist at Boston University School of Medicine. “I think the public health implications of these findings are going to be massive,” she said. “This paper raises alarms.”

Much about the novel coronavirus, i.e., COVID-19, is still not fully understood. As research progresses and our knowledge of the virus increases, information can change rapidly. We strive to update all of our articles as quickly as possible, but there may occasionally be some lag between scientific developments and our revisions.

*Healy, M. (2021, Apr. 8). Psychiatric and Neurological Problems Are Common in COVID-19’s Wake, Study Finds. Los Angeles Times.