A third of severe Covid survivors develop a mental health condition


Patients who had been in intensive care were at the greatest risk (Picture: Getty Images)

Around one in three survivors of severe Covid-19 go on to develop a serious neurological or psychiatric condition, according to a new study.

In the six months after a diagnosis, there is a ‘robust’ increased risk of developing conditions like anxiety and depression.

The study, carried out by University of Oxford researchers and the largest of its kind, followed more than 230,000 Covid-19 patients, mostly in the US.

Published in The Lancet Psychiatry journal, it estimates that one in three Covid-19 survivors (34%) were diagnosed with a neurological or psychiatric condition within six months of being infected.

For 13% of people it was their first recorded neurological or psychiatric diagnosis, researchers found.

The findings found the more severe a coronavirus case, the higher incidence of a mental health diagnosis.

A neurological or psychiatric condition occurred in 39% of those who were admitted to hospital, 46% of those in intensive care, and 62% in those who had encephalopathy – described as ‘delirium and other altered mental states’ – during their Covid-19 infection.

Researchers also found a 44% greater risk of neurological and mental health diagnoses after Covid-19 than after flu, and a 16% greater risk than with other respiratory tract infections such as pneumonia.

The study’s authors predict there will be ‘substantial effects on health and social care systems are likely to occur’ and that ‘urgent’ research is needed.

Researchers said many of the mental health conditions could be from the stress of the pandemic, rather than direct physiological effects from Covid (Picture: Getty Images)

‘These are real-world data from a large number of patients,’ said Paul Harrison, professor of psychiatry at the University of Oxford and the study’s lead author.

‘They confirm the high rates of psychiatric diagnoses after Covid-19, and show that serious disorders affecting the nervous system (such as stroke and dementia) occur too.

‘While the latter are much rarer, they are significant, especially in those who had severe Covid-19.

‘Although the individual risks for most disorders are small, the effect across the whole population may be substantial for health and social care systems due to the scale of the pandemic and that many of these conditions are chronic.

‘As a result, health care systems need to be resourced to deal with the anticipated need, both within primary and secondary care services.’

The study looked at the incidence of 14 mental health disorders among 236,379 patients over the age of 10 who were infected with Covid-19 after January last year, in comparison to influenza patients.

In the Covid-19 group, researchers found anxiety disorders occurred among 17% of all patients, while 14% developed mood disorders, 7% had substance misuse disorders and 5% insomnia.

Meanwhile, the incidence of neurological conditions appeared lower, with 0.6% having a brain haemorrhage, 2.1% ischaemic stroke and 0.7% dementia.

The report’s lead author, Dr Max Taquet, said the rate of psychosis or dementia ‘increased quite dramatically’ with a more severe Covid-19 illness.

He highlighted that one in 14 patients (7%) with encephalopathy were found to have a psychosis diagnosis and one in 20 (5%) had dementia, compared to 1.4% and 0.7% of all patients with Covid-19 respectively.

Dr Taquet said another ‘concerning’ finding was that one in 50 patients (2%) with Covid-19 went on to have an ischaemic stroke within six months – where a blood clot affects the brain – which increased to one in 11 patients (9%) with encephalopathy.

But Paul Harrison warned that many of the diagnoses could be as a result of the stress of knowing a patient has Covid.

Another author on the study, Masud Husain, said there was very little evidence that coronavirus directly affects neurons.

He added there was a need to be ‘careful’ over whether conditions such as dementia and strokes were ‘a direct consequence of the virus or whether the effects of being ill on clotting, for example, on the immune system can have an effect’.


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