People with long COVID have similar rates of psychiatric diagnoses and neuropsychiatric symptoms as people who recovered from a heart attack, research shows. Key TakeawaysPeople with long COVID have similar rates of psychiatric diagnoses and neuropsychiatric symptoms as people who recovered from a heart attack.While most people recovering from COVID-19 infection had poor cognitive performance after
More hospitalized patients are reporting cognitive symptoms from COVID-19 infection. But their risk for developing long-term neuropsychiatric and neurological complications is not so different from people who go to the hospital for heart problems, according to a new study published in JAMA Psychiatry.
People who recovered from COVID-19 infection had similar neuropsychiatric symptoms as people who recovered from a heart attack six months after leaving the hospital. Although, people infected with COVID-19 experienced more severe cognitive impairment.
To the study authors’ knowledge, this is the first study comparing neurological symptoms and diagnoses from COVID-19 illness with other health conditions.
“In order to say there’s a neurological difference between COVID-19 versus other diseases, you need to have a control group,” Michael E. Benros, MD, PhD, a professor of immuno-psychiatry at the University of Copenhagen and senior author of the study, told Verywell. “This is the basics in research [design] but COVID-19 research has gone very fast and most studies have forgotten that.”
One study reviewing the methodology of COVID-19 studies found most to be of poor quality, and likely because of the rush to publish in a timely manner.
Researchers are learning more about long COVID—a range of new or existing symptoms that persist more than a month after the virus has left the body. An October 2021 study estimates that more than half of people who recover from COVID-19 illness develop long COVID. The findings also suggest that most long COVID symptoms affect the lungs and the brain.
A study from 2021 found that the most common neurological symptoms after COVID-19 infection include:
A 2021 survey of people with long COVID found that more than 91% took over 35 weeks to recover and almost 86% experienced relapses when trying to exercise or under stress. Additionally, 88% of respondents experienced cognitive or memory problems, and about 45% needed to reduce their work hours because of long COVID. At the time of the survey, about 22% were not working because of illness.
A March 2022 study suggests the severity of long COVID symptoms contributed to worse cognition and more memory deficits.
Scientists have not determined why some people experience cognitive and neurological symptoms after infection. However, research suggests that people who experience fatigue or neuropsychiatric symptoms during infection are more likely to have cognitive symptoms after infection.
Getting vaccinated is the best way to protect yourself against COVID-19 infection. Benros advises people remain vigilant about their cognitive state even if their medical condition is not a COVID-19 infection.
The research team compared the cognitive and neuropsychological side effects six months after people were hospitalized for either a COVID-19 infection or a heart attack between July 2020 and July 2021.
They recruited people who had heart attacks because, like COVID-19 illness, the condition is life-threatening and carries a risk for psychological complications.
There were 85 people who recovered from COVID-19 illness and 61 people who recovered from a heart attack. People were of similar ages, with the average age for both groups in the 50s range. Groups were also matched by gender and their ICU admission status in the hospital.
The research team used a series of cognitive and neuropsychiatric tests to measure a person’s cognitive state. Results showed that people who recovered from COVID-19 infection performed worse on cognitive tests than people with a non-COVID illness. However, while the COVID-19 group had low cognitive scores, their scores improved by almost seven points when they took the test at discharge.
The six-month follow-up also revealed that 19% of people in the COVID-19 group and 20% of people in the non-COVID-19 group were diagnosed with a psychiatric condition, indicating similar rates of diagnoses after leaving the hospital.
The team conducted a semi-structured interview to assess subjective symptoms. About 81% of people in the COVID-19 group and 93% of people in the non-COVID-19 group complained of at least one symptom. Both groups had similar complaints about cognitive and neurologic symptoms, including trouble with memory or concentrating. The only exception between the groups was the loss of smell, which was more common among the COVID-19 group.
Benros explains that the most likely explanation behind similar neuropsychiatric symptoms with COVID-19 and non-COVID-19 conditions is a worsening inflammatory response that he said is very equal between the two patient groups.
“They have similar CRP levels, which is a marker of inflammation, which were [around] 200 in both groups,” Benros said. “Both groups actually have similar severe inflammatory responses, whereas if you’ve seen healthy individuals, the CRP is below one.”
A 2021 review said there is firm evidence to suggest a potential way COVID-19 enters the brain is by promoting inflammation, which in turn disrupts the blood-brain barrier.
“There are multiple potential underlying causes I see are similar across the two groups,” Benros said. “With the literature right now, it seems the effect on the brain is mainly because of the inflammatory response, but you might also have a period where the brain has not had enough oxygen which can also cause cognitive deficits and psychiatric symptoms.”
Fortunately, because the neuropsychiatric complications are similar, the cognitive exercises and treatments that work for non-COVID conditions could apply to people with long COVID. Benros also said that because most cognitive scores improved six months after hospital discharge, it’s likely the symptoms will resolve by themselves.
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