For a study, researchers sought to quantify the risks of new-onset neuropsychiatric conditions and new neuropsychiatric medication prescriptions following discharge from a COVID-19-related hospitalization and compare them to risks following discharge from other severe acute respiratory infections (SARI) during the COVID-19 pandemic.
Adults (≥18 years old) were identified in this cohort study from QResearch primary care. They linked electronic health record databases in England, including national SARS-CoV-2 testing, hospital episode statistics, intensive care admissions data, and mortality registers, from January 24, 2020, to July 7, 2021. New neuropsychiatric diagnoses (anxiety, dementia, psychosis, depression, bipolar disorder) or first prescription for relevant drugs (antidepressants, hypnotics/anxiolytics, antipsychotics) during the first 12 months after hospital release. Using flexible parametric survival models, hazard ratios (HR) with 95% CIs were calculated.
In this cohort analysis of 8.38 million individuals (4.18 million women, 4.20 million men; mean [SD] age 49.18 [18.45] years), 16,679 (0.02%) survived a hospital admission for SARI, and 32,525 (0.03%) survived a hospital admission for COVID-19. Survivors of SARI and COVID-19 hospitalization had a greater likelihood of later neuropsychiatric diagnoses than the general population. For example, the HR for anxiety in SARI survivors was 1.86 (95% CI, 1.56-2.21) and 2.36 (95% CI, 2.03-2.74); the HR for dementia in SARI survivors was 2.55 (95 % CI, 2.17-3.00) and 2.63 in COVID-19 infection (95% CI, 2.21-3.14). Similar findings were reported for all drugs studied; for example, the HR for initial antidepressant prescriptions in SARI survivors was 2.55 (95% CI, 2.24-2.90), and for COVID-19 infection survivors were 3.24. (95% CI, 2.91-3.61). Apart from a decreased probability of antipsychotic prescriptions in the former, no significant changes were identified when directly comparing the COVID-19 group to the SARI group (HR, 0.80; 95 % HCI, 0.69-0.92).
The neuropsychiatric effects of severe COVID-19 infection were found to be comparable to those of other SARI in this cohort investigation. This discovery might influence post-discharge care for persons who have survived SARI.
Reference: jamanetwork.com/journals/jamapsychiatry/fullarticle/2792404
