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1 in 3 COVID Survivors Struggle With Mental Health Issues Months Later
  • Posted April 7, 2021

1 in 3 COVID Survivors Struggle With Mental Health Issues Months Later

Doctors are seeing such cases around the world: About a third of COVID-19 patients go on to develop "long-haul" neurological or psychiatric conditions months after being infected, new research shows.

The findings suggest a link between COVID-19 and a higher risk for later mental health and neurological disorders, researchers report.

The new analysis of data from more than 236,000 COVID-19 survivors focused on 14 neurological and mental health disorders. It found that 34% of patients were diagnosed with such disorders in the six months after infection with the new coronavirus.

Most commonly, these disorders ranged from anxiety disorders to substance misuse disorders, insomnia, brain hemorrhage, stroke, and (much more rarely) dementia.

For 13% of those patients, it was their first such diagnosis.

"Sadly, many of the disorders identified in this study tend to be chronic or recurrent, so we can anticipate that the impact of COVID-19 could be with us for many years," Jonathan Rogers, of University College London, wrote in an editorial accompanying the new study. Both were published April 6 in The Lancet Psychiatry.

One U.S. expert who was not part of the study agreed.

"Services and resources will need to be allocated for this care," said Dr. Andrew Rogove, medical director of stroke services at South Shore University Hospital in Bay Shore, N.Y.

The new study was led by Paul Harrison of the University of Oxford in England. His team looked at electronic health records to track outcomes for 236,379 COVID-19 patients, mostly from the United States.

About a third did go on to experience some kind of neurological or mental health issue within six months of their coronavirus infection. Anxiety (17%), mood disorders (14%), substance abuse disorders (7%) and insomnia (5%) were the most commonly diagnosed disorders, the team said.

Overall rates of neurological problems were much lower, including 0.6% for brain hemorrhage, 2.1% for ischemic stroke, and 0.7% for dementia.

Neurological conditions were more common in patients who had been seriously ill with COVID-19. For example, among patients admitted to intensive care, 7% had a stroke and almost 2% were diagnosed with dementia, Harrison's group reported.

Neurological and mental health diagnoses were more common in COVID-19 patients than in flu or respiratory tract infection patients over the same time period. That suggests COVID-19 has an impact that's unique among viral infections, the study authors said.

"These are real-world data from a large number of patients. They confirm the high rates of psychiatric diagnoses after COVID-19, and show that serious disorders affecting the nervous system [such as stroke and dementia] occur, too," Harrison said in a journal news release. "While the latter are much rarer, they are significant, especially in those who had severe COVID-19."

Just how COVID-19 affects the brain remains unclear. "We now need to see what happens beyond six months. The study cannot reveal the mechanisms involved, but does point to the need for urgent research to identify these, with a view to preventing or treating them," study co-author Max Taquet, from the University of Oxford, said in the release.

According to Rogove, the study highlights an "increased risk for neurological disease and diagnosis in COVID-19 infected persons with further increased risk in hospitalized and critically ill COVID-19 infected patients."

All of this means "there will be a great need for more neurological care following COVID infection," Rogove added.

Brittany LeMonda is senior neuropsychologist at Lenox Hill Hospital in New York City. Reading over the findings, she theorized that "the virus may 'unmask' or accelerate the presentation of certain underlying psychiatric and neurologic conditions."

In other words, "it's possible ... that an individual has underlying risk factors predisposing them to development of these conditions and the virus stresses the system enough so that these symptoms become clinically significant," LeMonda said.

More information

The U.S. Centers for Disease Control and Prevention has more on the long-term effects of COVID-19.

SOURCES: Brittany LeMonda, PhD, senior neuropsychologist, Lenox Hill Hospital, New York City; Andrew Rogove, MD, PhD, medical director, stroke services, South Shore University Hospital, Bay Shore, N.Y.; The Lancet Psychiatry, news release, April 6, 2021

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