SARS-CoV-2 Infection and Risk of Postacute Psychiatric and Neurologic Diagnoses: A Nationwide Danish Cohort Study.

SARS-CoV-2 Infection and Risk of Postacute Psychiatric and Neurologic Diagnoses: A Nationwide Danish Cohort Study.

Publication date: Mar 12, 2024

The extent and burden of postacute psychiatric and neurologic manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are not yet fully understood. To evaluate the association between SARS-CoV-2 infection and postacute manifestations of psychiatric and neurologic disorders, we conducted a nationwide cohort study including the entire Danish population aged 12 years or older on March 1, 2020. Individuals were followed up for SARS-CoV-2 infection and diagnosis of subsequent psychiatric and neurologic disorders from March 1, 2020, to January 31, 2023, using the Danish nationwide coronavirus disease 2019 (COVID-19) test surveillance database and the Danish National Patient Registry. The main period of interest was 1-12 months after infection. Incidence rate ratios (IRRs) of new onset of 11 psychiatric and 30 neurologic disorders were calculated by comparing incidence rates of disorders between SARS-CoV-2-positive individuals and individuals without a positive test (nonpositive individuals). Stratified analyses were conducted according to COVID-19 vaccination status, variant period, age, sex, and severity of infection. Overall, 1,775,639 individuals in the study cohort (n = 3,239,008) were tested SARS-CoV-2 positive during follow-up. SARS-CoV-2-positive individuals compared with nonpositive individuals were at 24% reduced risk of any psychiatric disease (IRR 0. 76, 95% CI 0. 74-0. 78) in the postacute period. The risk of any neurologic disorder was slightly higher among SARS-CoV-2-positive individuals than among those without a positive test (IRR 1. 05, 95% CI 1. 04-1. 07). IRRs for specific disorders varied considerably from a 3. 9-fold increased risk of change in sense of smell or taste (IRR 3. 91, 95% CI 2. 77-5. 53) to a 29% reduced risk of dementia (IRR 0. 71, 95% CI 0. 65-0. 78). The severity of infection and vaccination status, more so than age, sex, and variant, were found to significantly influence the stratified IRRs. Compared with nonpositive individuals, hospitalized patients with COVID-19 were at a 2. 1-fold (IRR 2. 05, 95% CI 1. 78-2. 37) increased risk of psychiatric disorders and at a 2. 4-fold increased risk of neurologic disorders (IRR 2. 44, 95% CI 2. 29-2. 60). Our study does not support previous findings of substantial postacute neurologic and psychiatric morbidities among the general population of SARS-CoV-2-infected individuals, but does corroborate an elevated risk among the most severe cases with COVID-19.

Concepts Keywords
Coronavirus Cohort
Danish Cov
Psychiatric Covid
Taste Danish
Disorders
Individuals
Infection
Irr
Neurologic
Positive
Postacute
Psychiatric
Risk
Sars
Test

Semantics

Type Source Name
disease MESH SARS-CoV-2 Infection
pathway REACTOME SARS-CoV-2 Infection
disease VO Severe acute respiratory syndrome coronavirus 2
disease MESH infection
disease MESH neurologic disorders
disease VO population
disease VO vaccination
disease MESH psychiatric disease
disease MESH dementia
disease MESH morbidities

Original Article

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