Neurologic complications from COVID-19 have been well established, such as cognitive and memory disorders (brain fog). To date, most of the research on post-COVID neurologic problems has been limited to people previously hospitalized with acute infection and monitored for under six months, while the study focus has been narrow in terms of neurologic outcomes.

To broaden the study scope and knowledge, several researchers with the Veterans Affairs (VA) St. Louis Healthcare System in Missouri set out to do a comprehensive one-year analysis of post-COVID neurologic outcomes in not just formerly hospitalized but also nonhospitalized people.*

What the researchers did

The VA records of over 150,000 people previously diagnosed with COVID-19 were compared to two large control groups totaling over 11 million people with no history of infection.

The COVID group consisted mostly of men with an average age of 61 years and included both previously hospitalized and nonhospitalized people.

New instances of 44 neurologic issues were examined in the COVID group roughly one year after infection, and compared to new neurologic episodes in the control group.

What they found

Published in the journal Nature Medicine, the analysis revealed a 42% greater risk of neurologic issues in former COVID patients a year after testing positive for infection.

Specifically, compared to controls, individuals in the COVID group had:

• An 80% greater chance of seizures
• A 43% greater chance of mental health issues
• A 42% greater chance of movement disorders
• A 35% greater chance of mild-to-severe headaches
• A 50% greater chance of an ischemic stroke
• A 77% greater chance of memory issues (some regained their memory over time)

COVID patients were also at greater risk of Alzheimer’s disease. “It’s unlikely that someone who has had COVID-19 will just get Alzheimer’s out of the blue,” said lead study author Ziyad Al-Aly, M.D., of Washington University in St. Louis and Veterans Affairs St. Louis Health Care System. His concern, he said, is that COVID may somehow be putting people already vulnerable to Alzheimer’s “on a faster track” to the disease. “It’s rare,” he added, “but concerning.”

Overall, about 71 of every 1,000 COVID group individuals experienced long-term neurologic problems. This increased neurologic burden happened regardless of whether or not patients were hospitalized.

These issues were seen across all ages, though the effect of COVID on neurologic functions such as memory, cognition, and physical senses was stronger in younger adults.

What it means

The researchers note their results are limited in that mostly White males were included in the study, and most weren’t yet vaccinated in 2020. (COVID vaccination has been shown to reduce the risk of neurologic complications.) Also, the effects of the Delta and Omicron variants are unknown, since the COVID group was selected between March 2020 and January 2021.

That said, “COVID can lead to long-term neurologic consequences,” Al-Aly emphasized. “It is not only brain fog. There is clearly an increased risk of strokes, headaches, seizures, peripheral neuropathy, and more.”

This is of special concern to younger adults. “The effects of these disorders on younger lives are profound and cannot be overstated,” the authors wrote. “Urgent attention is needed to better understand these long-term effects and the means to mitigate them.”

*George, J. (2022, September 25). Long-Term Neurologic Problems Rise by 7% After SARS-CoV-2 Infection. MedPage Today. https://www.medpagetoday.com/neurology/generalneurology/100907