Long-term neurologic outcomes of COVID-19
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Abstract
The neurologic manifestations of acute COVID-19 are well characterized, but a comprehensive evaluation of postacute neurologic sequelae at 1 year has not been undertaken. Here we use 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; we use 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. Our results show that in the postacute 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. We 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. The risks and burdens were elevated even in people who did not require hospitalization during acute COVID-19. Limitations include a cohort comprising mostly White males. Taken together, our results provide evidence of increased risk of long-term neurologic disorders in people who had COVID-19.
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There appears to be an increased risk of MDD as well as other mental disorders after COVID-19.
“There also appears to be an increased risk of MDD as well as other mental disorders121.”
From Comorbidity between major depressive disorder and physical diseases: a comprehensive review of epidemiology, mechanisms and management (2023) · cites this paper as [121]
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- Authors
- Xu, E., Xie, Y., & Al-Aly, Z.
- Affiliations
- VA St. Louis Health Care System (US)
- Venue
- Nature Medicine
- Published
- 2022-09-22
- Volume
- 28
- Issue
- 11
- Pages
- 2406-2415
- ISSN
- 1078-8956 (ISSN-L)
- 1546-170X
- PMC
- PMC9671811
- OpenAlex
- W4296806570
- Cited by
- 530
- References
- 54
- Citations by year
- 2026: 61 · 2025: 107 · 2024: 168 · 2023: 166 · 2022: 27 · 2020: 1
- FWCI
- 61.58
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Nature Medicine (publishedVersion, cc-by)
- Research Square (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Digital Commons@Becker (Washington University School of Medicine) (submittedVersion, cc-by)
- Funders
- U.S. Department of Veterans Affairs
- American Society of Nephrology
- Topics
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
- Keywords
- COVID-19 pandemic, SARS-CoV-2, long-term neurologic outcome, stroke, cognitive impairment, Guillain-Barré syndrome, encephalitis, migraine, seizures, movement disorders, mental illness, peripheral nerve disorders, veterans
- MeSH terms
- COVID-19, SARS-CoV-2, Brain Diseases, Humans, Male, Nervous System Diseases, Guillain-Barre Syndrome
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