Washington University Study Shows SARS-CoV-2 Infections Increases Risk Of Various Neurological Issues Including Strokes, Cognitive Disorders And Encephalopathy!
: A new study by researchers from Department of Medicine, Washington University School of Medicine, St. Louis-USA and the Clinical Epidemiology Center at VA St. Louis Health Care System, St. Louis-USA has found that SARS-CoV-2 infections increases risk of various neurological issues including strokes, cognitive disorders and encephalopathy!
To date, the neurologic manifestations of acute COVID-19 are well characterized, but a comprehensive evaluation of post-acute neurologic sequelae at 1 year has not been undertaken.
The study team utilized the national healthcare databases of the US Department of Veterans Affairs to build a cohort of 154,068 individuals with COVID-19, 5,638,795 contemporary controls and 5,859,621 historical controls.
The team used inverse probability weighting to balance the cohorts, and estimate risks and burdens of incident neurologic disorders at 12 months following acute SARS-CoV-2 infection.
The study findings showed that in the post-acute phase of COVID-19, there was increased risk of an array of incident neurologic sequelae including ischemic and hemorrhagic stroke, cognition and memory disorders, peripheral nervous system disorders, episodic disorders (for example, migraine and seizures), extrapyramidal and movement disorders, mental health disorders, musculoskeletal disorders, sensory disorders, Guillain–Barré syndrome, and encephalitis or encephalopathy.
The study team estimated that the hazard ratio of any neurologic sequela was 1.42 (95% confidence intervals 1.38, 1.47) and burden 70.69 (95% confidence intervals 63.54, 78.01) per 1,000 persons at 12 months.
Alarmingly, the risks and burdens were elevated even in individuals who did not require hospitalization during acute COVID-19. Limitations include a cohort comprising mostly White males.
The study team concluded that the research findings provide evidence of increased risk of long-term neurologic disorders in individual who had COVID-19.
The study findings were published in the peer reviewed journal: Nature Medicine. https://www.nature.com/articles/s41591-022-02001-z
Individuals who have been exposed to the SARS-CoV-2 virus irrespective of whether they were initially asymptomatic or had mild, moderate or severe symptomatic conditions during infection should note that they are at a very high risk for strokes, seizures, memory, and movement disorders and a variety of neurological issues in the first year after infection.
Senior author Dr Ziyad Al-Aly, MD, a clinical epidemiologist at Washington University told Thailand Medical News
, “If you’ve had COVID-19, it may still be messing with your brain. According to our research findings, those who have been infected with the SARS-CoV-2 virus are at increased risk of developing a range of neurological conditions in the first year after the infection. A comprehensive analysis of federal health data reveals that such complications include strokes, cognitive and memory problems, anxiety, depression, and migraine headaches.”
He also warned that the post-COVID brain is associated with movement disorders, from tremors and involuntary muscle con
tractions to epileptic seizures, balance and coordination difficulties, and hearing and vision abnormalities as well as other symptoms similar to what is experienced with Parkinson’s disease.
Dr Al-Aly further added, “Our research provides a comprehensive assessment of the long-term neurologic consequences of COVID-19. Past studies have examined a narrower set of neurological outcomes, mostly in hospitalized patients. We evaluated 44 brain and other neurologic disorders among both non-hospitalized and hospitalized patients, including those admitted to the intensive care unit.”
He continued, “The research findings worryingly show the devastating long-term effects of COVID-19. These are part and parcel of long COVID. The virus is not always as benign as some individual assume it is.”
Dr Al-Aly said that overall, it is estimated that COVID-19 has contributed to more than 40 million new cases of neurological disorders worldwide but that number is growing exponentially.”
Worse, many individuals are not even aware that they had been exposed to the SARS-CoV-2 and are actually suffering neurological issues due to it!
Dr Al-Aly added, “We’re seeing brain problems in previously healthy individuals and those who have had mild infections. It doesn’t matter if you are young or old, female or male, or what your race is. It doesn’t matter if you smoked or not, or if you had other unhealthy habits or conditions.”
It was noted that very few of the study participants were vaccinated for COVID-19. This is because the vaccines were not yet widely available during the time span of the study, which ran from March 2020 through early January 2021. Notably, the data also predates delta, omicron, and other COVID variants.
study team analyzed about 14 million de-identified medical records in a database maintained by the U.S. Department of Veterans Affairs. They are the nation’s largest integrated healthcare system, and patients included all ages, races, and sexes.
Subsequently, the study team created a controlled data set of 154,000 individuals who had tested positive for COVID-19 sometime from March 1, 2020, through January 15, 2021, and who had survived the first 30 days after infection.
All neurological outcomes in the COVID-19 data set were compared using statistical modeling with two other groups of people not infected with 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, before the pandemic which had left millions across the globe infected and killed by the SARS-CoV-2 virus.
Detailed brain health was analyzed by the study team over a year-long period.
The study findings showed that compared with those who had not been infected with the virus, neurological conditions were 7% more common in individual with COVID-19.
Simply extrapolating this percentage based on the number of COVID-19 cases in the U.S. translates to approximately 6.6 million Americans who have suffered brain impairments associated with the SARS-CoV-2 virus!
Importantly, one of the most common brain-related, long-COVID symptoms is memory problems, colloquially called brain fog. Individuals who contracted the virus were at a 77% increased risk of developing memory problems compared with those in the control groups.
Dr Al-Aly added, “These problems however resolve in some individuals but persist in many others. At this point, the proportion of people who get better versus those with long-lasting problems is unknown.”
Alarmingly, the study team noted an increased risk of Alzheimer’s disease among those infected with the virus. Compared with the control groups, there were two more cases of Alzheimer’s per 1,000 individuals with COVID-19!
Dr Al-Aly added, “It’s unlikely that someone who has had COVID-19 will just get Alzheimer’s out of the blue. Alzheimer’s takes years to manifest. But what we suspect is happening is that individuals who have a predisposition to Alzheimer’s may be pushed over the edge by COVID, meaning they’re on a faster track to develop the disease. It’s rare but concerning.”
It was also found that individuals who were infected with the SARS-CoV-2 coronavirus were 50% more likely to suffer from an ischemic stroke compared to the control groups.
An ischemic stroke typically occurs when a blood clot or other obstruction blocks an artery’s ability to supply blood and oxygen to the brain. Ischemic strokes account for the majority of all strokes, and can lead to difficulty speaking, vision problems, cognitive confusion, the loss of feeling on one side of the body, paralysis, permanent brain damage, and death.
Dr Al-Aly said, “There have been several studies by other researchers that have shown, in mice and humans, that SARS-CoV-2 can attack the lining of the blood vessels and then trigger a stroke or seizure. It helps explain how someone with no risk factors could suddenly have a stroke.”
Shockingly when compared to the uninfected, individual who had COVID-19 were 80% more likely to suffer from epilepsy or seizures, 43% more likely to develop mental health disorders such as anxiety or depression, and 35% more likely to experience mild to severe headaches. They were also 42% more likely to encounter movement disorders, which includes involuntary muscle contractions, tremors, and other Parkinson’s-like symptoms.
Also, it was found that COVID-19 sufferers were also 30% more likely to have eye problems such as blurred vision, dryness, and retinal inflammation. They were also 22% more likely to develop hearing abnormalities such as tinnitus, or ringing in the ears.
Dr Al-Aly concluded, “Our research findings adds to this growing body of evidence by providing a comprehensive account of the neurologic consequences of COVID-19 one year after infection.”
He stressed, “Long COVID’s effects on the brain and other systems emphasize the need for governments and health systems to develop policy, and public health and prevention strategies to manage the ongoing pandemic and devise plans for a post-COVID world. Given the colossal scale of the pandemic, meeting these challenges requires urgent and coordinated but, so far global, national, and regional response strategies are absent!”
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