COVID-19 infection increases risk of long-term brain problems – Washington University School of Medicine in St. Louis

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Strokes, seizures, memory and movement disorders are among the problems that occur in the first year after injury

Sarah Moser

If you have COVID-19, it may still be messing with your brain. New research shows that those who have contracted the virus are at increased risk of developing a range of neurological conditions in the first year after infection. These complications include strokes, cognitive and memory problems, depression, anxiety and migraines, according to a comprehensive analysis of federal health data by researchers at Washington University School of Medicine in St. Louis and the Veterans Affairs Health Care System in St. Louis.

In addition, the post-COVID brain is associated with movement disorders, from tremors and involuntary muscle contractions to seizures, hearing and vision disturbances, balance and coordination difficulties as well as other symptoms similar to those of Parkinson’s disease.

The results were published September 22 in the journal Nature Medicine.

“Our study provides a comprehensive assessment of the long-term neurological consequences of COVID-19,” said the study’s senior author. Ziyad Al-Ali, MD, a clinical epidemiologist at the University of Washington. “Previous studies have examined a narrower range of neurological outcomes, mostly in hospitalized patients. We evaluated 44 cerebrovascular and other neurological disorders among both out-of-hospital and in-hospital patients, including those admitted to the intensive care unit. The results show the devastating long-term effects of COVID-19. This is an inseparable part of the long COVID. The virus is not always as benign as some think.”

Overall, Al-Ali said, the COVID-19 virus has contributed to more than 40 million new cases of neurological disorders worldwide.

Other than having a COVID infection, specific risk factors for long-term neurological problems are rare. “We are seeing brain problems in previously healthy individuals who have had a mild infection,” Al-Aly said. “It doesn’t matter if you are young or old, female or male, or what your race is. It does not matter if you smoke or not, or if you have other unhealthy habits or conditions.”

Few of the people in the study were vaccinated against COVID-19 because vaccines were not yet widely available during the study’s time period, from March 2020 through early January 2021. The data also precedes delta, omicron, and other COVID variants.

for precedent study In Nature Medicine, led by Al-Ali, it was found that vaccines slightly – about 20% – reduce the risk of developing long-term problems in the brain. “It is certainly important that vaccination be done but it is also important to understand that it does not provide complete protection against these long-term neurological disorders,” Al-Aly said.

Researchers analyzed nearly 14 million anonymous medical records in a database maintained by the U.S. Department of Veterans Affairs, the nation’s largest integrated health care system. Patients included all ages, genders, and genders.

They created a controlled data set of 154,000 people who tested positive for COVID-19 sometime from March 1, 2020, through January 15, 2021, and who survived the first 30 days after infection. Statistical modeling was used to compare neurological outcomes in the COVID-19 data set with two other groups of people without the virus: a control group of more than 5.6 million patients who did not have COVID-19 during the same time frame; And a control group of more than 5.8 million people from March 2018 to December 31, 2019, long before the virus struck and killed millions worldwide.

Sarah Moser

A detailed analysis of federal data by researchers at Washington University School of Medicine in St. Louis shows that people who have contracted COVID-19 are at increased risk of developing neurological diseases within the first year after infection. Movement disorders, memory problems, strokes and seizures are among the complications.

The researchers examined brain health over an entire year. Neurological cases occurred in 7% more people with COVID-19 than in those who did not have the virus. Extrapolating this percentage based on the number of COVID-19 cases in the United States, which translates to approximately 6.6 million people with brain impairment linked to the virus.

Memory problems – colloquially called brain fog – are one of the most common and long-term brain-related symptoms of the coronavirus. Compared to the control groups, people who contracted the virus had a 77% higher risk of developing memory problems. “These problems are resolved in some people but persist in many others,” Al-Ali said. “At this point, the proportion of people who improve versus those who have long-term problems is unknown.”

Interestingly, researchers have observed an increased risk of Alzheimer’s disease among those infected with the virus. There were two more cases of Alzheimer’s disease for every 1,000 people with COVID-19 compared to the control groups. “It is unlikely that someone with COVID-19 will get rid of Alzheimer’s out of the blue,” Al-Aly said. It takes years for Alzheimer’s disease to appear. But what we suspect is happening is that people who are predisposed to developing Alzheimer’s may be pushed over the edge by COVID, which means they are on a faster path to developing the disease. It’s rare but worrisome.”

Also compared to control groups, people who contracted the virus were 50 percent more likely to have a stroke, which occurs when a blood clot or other blockage hampers the ability of the arteries to supply the brain with blood and oxygen. Ischemic strokes account for the majority of strokes, and can lead to difficulty speaking, cognitive confusion, vision problems, loss of sensation on one side of the body, permanent brain damage, paralysis, and death.

“There are several studies by other researchers that have shown, in mice and humans, that SARS-CoV-2 can attack the lining of blood vessels and then lead to a stroke or a seizure,” Al-Aly said. “It helps explain how someone who has no risk factors can suddenly have a stroke.”

Overall, compared to uninfected people, people with COVID-19 were 80% more likely to have epilepsy or seizures, and 43% more likely to develop it. mental health disorders Like anxiety or depression, 35% more likely to have mild to severe headaches, and 42% more likely to have movement disorders. The latter condition includes involuntary muscle spasms, tremors and other symptoms similar to Parkinson’s disease.

Those with COVID-19 were also 30% more likely to develop eye problems such as blurred vision, dehydration, and retinitis. And they were 22% more likely to have a hearing disorder such as tinnitus or ringing in the ears.

“Our study adds to this growing body of evidence by providing a comprehensive description of the neurological consequences of COVID-19 one year after infection,” Al-Aly said.

Al-Ali said the long-term effects of COVID on the brain and other systems underscore the need for governments and health systems to develop policies, public health and prevention strategies to manage the ongoing pandemic and make plans for a post-COVID world. “Given the sheer scale of the pandemic, addressing these challenges requires urgent and coordinated – yet absent – global, national and regional response strategies,” he said.

Matt Miller

Ziyad Al-Aly, MD, has led several long-running COVID studies as a clinical epidemiologist at Washington University School of Medicine in St. Louis and the Veterans Affairs Health Care System in St. Louis. His research has included the devastating effects of the virus on the heart, kidneys, and mental health.

Xu E, Xie Y, Al-Aly Z. Long-term neurological consequences of COVID-19. Nature medicine. September 22, 2022. DOI: https://doi.org/10.1038/s41591-022-02001-z

This research was funded by the US Department of Veterans Affairs. American Society of Nephrology. and KidneyCure. Data supporting the findings of this study are available from the US Department of Veterans Affairs. VA data is provided free of charge to the researchers behind the VA firewall with an approved VA study protocol.


About the University of Washington School of Medicine

Wash the medicine is a global leader in academic medicine, including biomedical research, patient care, and educational programs with 2,700 faculty members. The National Institutes of Health (NIH) research funding portfolio is the fourth largest among U.S. medical schools, and has grown by 54% in the past five years. Combined with institutional investment, WashU Medicine commits more than $1 billion annually to basic and clinical research innovation and training. Its faculty practice consistently ranks among the top five in the country, with more than 1,790 medical staff practicing in more than 60 locations who are also the medical staff in Barnes is a Jew And the St. Louis for children Hospitals BJC HealthCare. WashU Medicine has a rich history of MD/PhD training, recently committed $100 million in scholarships and curriculum renewals for medical students, and is home to top-tier training programs in every medical subspecialty as well as physical therapy, occupational therapy, audiology, and communication sciences.

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