Neurological and psychiatric risk trajectories after SARS-CoV-2 infection: an analysis of 2-year retrospective cohort studies including 1 284 437 patients

The Lancet Psychiatry, Год журнала: 2022, Номер 9(10), С. 815 - 827

Опубликована: Авг. 17, 2022

COVID-19 is associated with increased risks of neurological and psychiatric sequelae in the weeks months thereafter. How long these remain, whether they affect children adults similarly, SARS-CoV-2 variants differ their risk profiles remains unclear.In this analysis 2-year retrospective cohort studies, we extracted data from TriNetX electronic health records network, an international network de-identified health-care approximately 89 million patients collected hospital, primary care, specialist providers (mostly USA, but also Australia, UK, Spain, Bulgaria, India, Malaysia, Taiwan). A any age diagnosed between Jan 20, 2020, April 13, 2022, was identified propensity-score matched (1:1) to a contemporaneous other respiratory infection. Matching done on basis demographic factors, factors for severe illness, vaccination status. Analyses were stratified by group (age <18 years [children], 18-64 [adults], ≥65 [older adults]) date diagnosis. We assessed 14 diagnoses after infection compared comparator cohort. The trajectories represented time-varying hazard ratios (HRs) summarised using 6-month constant HRs (representing earlier phase follow-up, which have not yet been well characterised children), horizon each outcome (ie, time at HR returns 1), equal incidence two cohorts. estimated how many people died or diagnosis during follow-up group. Finally, cohorts directly before emergence alpha (B.1.1.7), delta (B.1.617.2), omicron (B.1.1.529) variants.We 1 487 712 recorded study period, whom 284 437 (185 748 children, 856 588 adults, 242 101 older adults; overall mean 42·5 [SD 21·9]; 741 806 [57·8%] female 542 192 [42·2%] male) adequately number another outcomes whole differed substantially. While most had significantly greater than 6 (with exception encephalitis; Guillain-Barré syndrome; nerve, nerve root, plexus disorder; parkinsonism), horizons varied greatly. Risks common disorders returned baseline 1-2 (mood 43 days, anxiety 58 days) subsequently reached comparison 457 417 days). By contrast, cognitive deficit (known as brain fog), dementia, psychotic disorders, epilepsy seizures still end period. Post-COVID-19 adults: infection, mood (HR 1·02 [95% CI 0·94-1·10) (1·00 [0·94-1·06]) did deficit, insomnia, intracranial haemorrhage, ischaemic stroke, (HRs ranging 1·20 [1·09-1·33] 2·16 [1·46-3·19]). Unlike finite (75 (491 sizeable proportion who received diagnosis, either cohort, died, especially those dementia seizures. Risk similar just versus variant (n=47 675 cohort). Just (vs before) (n=44 835 cohort), seizures, observed, compounded death rate. With (n=39 845 there lower rate variant, remained similar.This studies individuals showed that transient, no excess infections. In disorder, persisted throughout. differing suggest different pathogenesis outcomes. Children more benign profile do sustained higher some concern. fact waves indicates burden system might continue even are less respects. Our findings relevant understanding individual-level population-level can help inform our responses them.National Institute Health Care Research Oxford Biomedical Centre, Wolfson Foundation, MQ Mental Research.

Язык: Английский

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How COVID-19 shaped mental health: from infection to pandemic effects

Nature Medicine, Год журнала: 2022, Номер 28(10), С. 2027 - 2037

Опубликована: Окт. 1, 2022

Язык: Английский

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New insights from the last decade of research in psychiatric genetics: discoveries, challenges and clinical implications

World Psychiatry, Год журнала: 2023, Номер 22(1), С. 4 - 24

Опубликована: Янв. 14, 2023

Psychiatric genetics has made substantial progress in the last decade, providing new insights into genetic etiology of psychiatric disorders, and paving way for precision psychiatry, which individual profiles may be used to personalize risk assessment inform clinical decision‐making. Long recognized heritable, recent evidence shows that disorders are influenced by thousands variants acting together. Most these commonly occurring, meaning every a each disorder, from low high. A series large‐scale studies have discovered an increasing number common rare robustly associated with major disorders. The most convincing biological interpretation findings implicates altered synaptic function autism spectrum disorder schizophrenia. However, mechanistic understanding is still incomplete. In line their extensive epidemiological overlap, appear exist on continua share large degree one another. This provides further support notion current diagnoses do not represent distinct pathogenic entities, ongoing attempts reconceptualize nosology. also influences range behavioral somatic traits diseases, including brain structures, cognitive function, immunological phenotypes cardiovascular disease, suggesting shared potential importance. Current polygenic score tools, predict susceptibility illness, yet provide clinically actionable information. likely improve coming years, they eventually become part practice, stressing need educate clinicians patients about use misuse. review discusses key possible applications, suggests future directions.

Язык: Английский

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Psychiatric and neurological complications of long COVID

Journal of Psychiatric Research, Год журнала: 2022, Номер 156, С. 349 - 360

Опубликована: Окт. 20, 2022

Язык: Английский

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Oxidative Stress and Hyper-Inflammation as Major Drivers of Severe COVID-19 and Long COVID: Implications for the Benefit of High-Dose Intravenous Vitamin C

Frontiers in Pharmacology, Год журнала: 2022, Номер 13

Опубликована: Апрель 29, 2022

Oxidative stress is a pivotal point in the pathophysiology of COVID-19 and presumably also Long-COVID. Inflammation oxidative are mutually reinforcing each other, thus contributing to systemic hyperinflammatory state coagulopathy which cardinal pathological mechanisms severe stages. patients, like other critically ill patients e.g. with pneumonia, very often show deficiency antioxidant vitamin C. So far, it has not been investigated how long this lasts or whether COVID symptoms suffer from deficiencies. A C deficit serious consequences because one most effective antioxidants, but co-factor many enzymatic processes that affect immune nervous system, blood circulation energy metabolism. Because its anti-oxidative, anti-inflammatory, endothelial-restoring, immunomodulatory effects supportive intravenous (iv) use supraphysiological doses so far 12 controlled observational studies altogether 1578 inpatients COVID-19. In these an improved oxygenation, decrease inflammatory markers faster recovery were observed. addition, early treatment iv high dose seems reduce risks courses disease such as pneumonia mortality. Persistent inflammation, thrombosis dysregulated response (auto-immune phenomena and/or persistent viral load) seem be major contributors inflammation involved development progression fatigue neuro-psychiatric various diseases by disrupting tissue (e.g. autoantibodies), flow thrombosis) neurotransmitter metabolism excitotoxicity). oncological diseases, infections autoimmune associated fatigue, cognitive disorders, pain depression similar Long-COVID, was shown significantly relieve symptoms. Supportive acute might therefore risk

Язык: Английский

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Long-Term Consequences of COVID-19 at 6 Months and Above: A Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health, Год журнала: 2022, Номер 19(11), С. 6865 - 6865

Опубликована: Июнь 3, 2022

We aimed to review the data available evaluate long-term consequences of coronavirus disease 2019 (COVID-19) at 6 months and above. searched relevant observational cohort studies up 9 February 2022 in Pubmed, Embase, Web Science. Random-effects inverse-variance models were used Pooled Prevalence (PP) its 95% confidence interval (CI) consequences. The Newcastle–Ottawa quality assessment scale was assess included studies. A total 40 involving 10,945 cases severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection included. Of patients, 63.87% had least one consequence month follow-up, which decreased 58.89% 12 months. most common symptoms fatigue or muscle weakness (PP 6–12 m = 54.21%, PP ≥ 34.22%) mild dyspnea (Modified Medical Research Council Dyspnea Scale, mMRC 0, 74.60%, 80.64%). Abnormal computerized tomography (CT; 55.68%, 43.76%) lung diffuse function impairment, i.e., a carbon monoxide diffusing capacity (DLCO) < 80% 49.10%, 31.80%). Anxiety depression 33.49%, 35.40%) pain discomfort 33.26%, 35.31%) problems that affected patients’ life. Our findings suggest significant impact on health life due COVID-19, as waves ASRS-CoV-2 infections emerge, effects COVID-19 will not only increase difficulty care for survivors setting public policy but also might lead another crisis following current pandemic, would global burden disease.

Язык: Английский

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The Influence of the COVID-19 Pandemic on Social Anxiety: A Systematic Review

International Journal of Environmental Research and Public Health, Год журнала: 2023, Номер 20(3), С. 2362 - 2362

Опубликована: Янв. 29, 2023

The COVID-19 pandemic has resulted in negative mental health outcomes throughout the world, and its impact on social interactions relationships is likely to be evident problematic anxiety. This systematic review qualitatively synthesized data from studies that have reported effects of A search Web Science Core Collection, Embase, PsychINFO, Scopus, EBSCOhost, Cochrane Central Register Controlled Trials, Proquest Central—Dissertations Theses was conducted, with thirty-three meeting inclusion criteria. results suggest anxiety been heightened general population due pandemic, women low-income earners being especially vulnerable. Other contributing factors include impaired coping strategies, lower socio-emotional well-being, limited support networks, contraction SARS-CoV-2 virus. Individuals a Social Anxiety Disorder diagnosis may at risk deterioration general. Limitations literature reviewed predominance cross-sectional study designs, which limit causal inferences are limited. Additionally, associations inflated as many not accounted for mediating variables. Taken together, research suggests anxiety, either pre-pandemic or arising environment, contributed variety related

Язык: Английский

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The long-term health outcomes, pathophysiological mechanisms and multidisciplinary management of long COVID

Signal Transduction and Targeted Therapy, Год журнала: 2023, Номер 8(1)

Опубликована: Ноя. 1, 2023

Abstract There have been hundreds of millions cases coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome 2 (SARS-CoV-2). With the growing population recovered patients, it crucial to understand long-term consequences and management strategies. Although COVID-19 was initially considered an illness, recent evidence suggests that manifestations including but not limited those cardiovascular, respiratory, neuropsychiatric, gastrointestinal, reproductive, musculoskeletal systems may persist long after phase. These persistent manifestations, also referred as COVID, could impact all patients with across full spectrum illness severity. Herein, we comprehensively review current literature on highlighting its epidemiological understanding, vaccinations, organ-specific sequelae, pathophysiological mechanisms, multidisciplinary In addition, psychological psychosomatic factors underscored. Despite these findings diagnostic therapeutic strategies based previous experience pilot studies remain inadequate, well-designed clinical trials should be prioritized validate existing hypotheses. Thus, propose primary challenges concerning biological knowledge gaps efficient remedies well discuss corresponding recommendations.

Язык: Английский

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The global prevalence of depression, anxiety, and sleep disorder among patients coping with Post COVID-19 syndrome (long COVID): a systematic review and meta-analysis

BMC Psychiatry, Год журнала: 2024, Номер 24(1)

Опубликована: Фев. 6, 2024

Post COVID-19 syndrome, also known as "Long COVID," is a complex and multifaceted condition that affects individuals who have recovered from SARS-CoV-2 infection. This systematic review meta-analysis aim to comprehensively assess the global prevalence of depression, anxiety, sleep disorder in coping with syndrome.

Язык: Английский

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Short- and long-term neuropsychiatric outcomes in long COVID in South Korea and Japan

Nature Human Behaviour, Год журнала: 2024, Номер 8(8), С. 1530 - 1544

Опубликована: Июнь 25, 2024

Язык: Английский

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