Long COVID risk extends two years after infection

Getting sick from COVID-19 is bad enough. What if you are one of the unlucky people experiencing a so-called long COVID? It’s a mix of symptoms that can appear months — and even years — after recovering from COVID, according to a new study of more than a million people from eight countries.

Adults’ risk of developing seizure disorders, brain fog, dementia and other mental illnesses remains high two years after recovering from COVID-19, the study finds.

“These are important findings, but they should not cause panic,” said co-author Paul Harrison, professor of psychiatry at Oxford University in the UK. “We’re not talking about things that are 10 or 100 times more common. I think the worst odds ratio is two or three.”

Children were at increased risk of developing epilepsy or seizures, encephalitis, and nerve root disorders, which can cause pain, weakness, or loss of sensation in an arm or leg. There was also a small but worrying risk of being diagnosed with a psychotic disorder, such as schizophrenia or delusional thinking.

“This is an extremely robust and well-conducted study using data from a large sample and across multiple nations,” said Rachel Sumner, senior research fellow at Cardiff Metropolitan University in the UK, who was not collaborator with the study.

“The findings are alarming and critical in our current context of unrestrained COVID spread,” she added via email.

The conclusions of the study are consistent with the clinical experience of Dr. Aaron Friedberg, a clinical assistant professor of internal medicine who works in the post-COVID recovery program at Ohio State University’s Wexner Medical Center in Columbus.

“I just spoke to someone who was originally diagnosed with COVID more than two years ago, but today they only see a post-COVID specialist,” said Friedberg, who was not involved with the study. “That doesn’t necessarily mean they’ll get those symptoms two years later. It means they are only diagnosed.”

Friedberg also said he sees people experiencing severe symptoms two years after diagnosis.

“They can’t think, they can’t breathe. I have a person whose illness is so severe that they basically can’t get out of bed,” he said. “I recently saw a person who, two years later, is still not working because of COVID symptoms.”

GOOD AND BAD NEWS

The study, published Wednesday in the journal Lancet Psychiatry, analyzed two years of hospital data for adults and children from the TriNetX electronic health data network. TriNetX is an international network of unidentified data from hospital, primary care and specialty providers. Around 89 million patients are in the data pool.

The study looked at 1.25 million patients two years after their COVID-19 diagnosis and compared them to a closely matched group of 1.25 million people who had another respiratory infection.

“We compared these two patient groups for 14 major neurological and psychiatric disorders over the two years following COVID-19 or respiratory infection,” said co-author Maxime Taquet, senior clinical associate in psychiatry at the National Institute for Health and Care Research’s Biomedical Research Center in the UK

The research team looked at the following conditions: anxiety disorders; mood swings; psychotic disorder; Insomnia; cognitive deficit (a combination of codes used to detect what is known as brain fog); Dementia; epilepsy or seizures; encephalitis; intracranial hemorrhage; stroke; parkinsonism; Guillain Barre Syndrome; nerve, nerve root and plexus disorders; and neuromuscular and muscle diseases. The researchers also looked at deaths from any cause.

Most of the patients were from the United States, but the study also included people from Australia, the United Kingdom, Spain, Bulgaria, India, Malaysia and Taiwan.

The study couldn’t tell whether people had ongoing symptoms for two years since a COVID-19 diagnosis: “It might be the case, it might not be the case,” Taquet said. “These data only look at the number of new diagnoses made, not the persistence or duration of symptoms.”

The news was both good and bad.

For adults, the risk of developing “brain fog, dementia, psychotic disorders, and epilepsy and seizures remains increased during the two years compared to people with other respiratory conditions,” Taquet said.

According to the study, adults over the age of 65 had a 1.2 percent increased risk of developing dementia. While “it’s very clear that this isn’t a tsunami of new cases of dementia, it’s (I think) just as hard to ignore given the severity of the consequences of being diagnosed with dementia,” he said.

There was some good news for adults, Taquet added: “The risk of some disorders — particularly anxiety and mood disorders — disappeared within two to three months without an overall too many cases over the two years.”

EFFECT ON CHILDREN

There was good news for children, too: “The risk of brain fog in children was transient — there was no overall risk,” Taquet said. Children are also not at greater risk of being diagnosed with anxiety and depression after COVID-19 “even in the first six months,” he said.

But there were troubling findings when it came to other conditions. For example, children had a “two-fold increased risk of epilepsy and seizures,” Taquet said, and a “three-fold increased risk of being diagnosed with a psychotic disorder within two years of COVID-19 compared to children diagnosed with another airway.” Infection.”

In the study of 10,000 children with a Covid-19 diagnosis, 260 had developed epilepsy and seizures within two years, compared with 130 of 10,000 children diagnosed with another respiratory infection, presenting a “two-fold increased risk,” Taquet said .

The risk of a psychotic disorder diagnosis in children is threefold increased two years after COVID-19 infection, Taquet said. Still, “the absolute risk remains fairly low,” he said, with 18 diagnosed cases of psychosis in 10,000 children.

“I think we have to be careful in interpreting the reported small increases in dementia and psychosis,” said Paul Garner, a professor emeritus of evidence synthesis in global health at the Liverpool School of Tropical Medicine in the UK, with whom Garner was not involved the study.

“These I think are more related to the societal upheaval and dystopia we’ve been through than to any direct impact of the virus.”

A LONG-TERM IMPACT

Overall, the evidence from the study is “particularly worrying,” Cardiff-based Sumner said, as even COVID-19 variants classified as milder appear to have the same long-term consequences.

Additionally, “Some of these conditions will continue to experience delays in diagnosis and treatment with healthcare systems struggling to cope with both COVID infections and patient waitlist backlogs,” Sumner added.

This reality aligns with the clinical experience of doctors like Friedberg, who has been treating long-term COVID-19 patients since shortly after the pandemic began.

“I have had severe post-COVID diseases (patients) from the ancestral tribe since March 2020 and I have the same in people who developed it a few months ago. So I think it can be equally difficult on each of those lines,” he said.

Still, Friedberg told CNN there have been “zero public policy decisions” about what is happening post-COVID-19.

“The idea that something terrible might happen that we won’t appreciate until months or years later isn’t adequately addressed,” Friedberg said.

“Let’s say kids just can’t walk as much as they used to or now have seizure disorders, or adults just can’t handle as many tasks at work or have trouble looking after their kids at home because they just have a brain fog, they have chronic shortness of breath.

“If that’s happening to, say, 5 percent of the population every time there’s a COVID wave, it adds up.”