People who have had COVID-19 are at an elevated risk of developing neurological conditions within the first year after infection, according to a detailed analysis of federal data by researchers at Washington University School of Medicine in St. Louis. Movement disorders, memory problems, strokes, and seizures are among the complications. Credit: Sara Moser/Washington University School of Medicine
Strokes, seizures, memory, and movement disorders are among problems that develop in the first year after infection.
If you’ve had <span class="glossaryLink" aria-describedby="tt" data-cmtooltip="
COVID-19
First identified in 2019 in Wuhan, China, Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has spread globally, resulting in the 2019–20 coronavirus pandemic.
” data-gt-translate-attributes=”["attribute":"data-cmtooltip", "format":"html"]”>COVID-19, it may still be messing with your brain. According to new research, those who have been infected with the <span class="glossaryLink" aria-describedby="tt" data-cmtooltip="
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the official name of the virus strain that causes coronavirus disease (COVID-19). Previous to this name being adopted, it was commonly referred to as the 2019 novel coronavirus (2019-nCoV), the Wuhan coronavirus, or the Wuhan virus.
” data-gt-translate-attributes=”["attribute":"data-cmtooltip", "format":"html"]”>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.
“Our study provides a comprehensive assessment of the long-term neurologic consequences of COVID-19.” — Ziyad Al-Aly, MD
In addition, the post-COVID brain is associated with movement disorders, from tremors and involuntary muscle contractions 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.
The findings, by researchers at Washington University School of Medicine in St. Louis and the Veterans Affairs St. Louis Health Care system, were published on September 22 in the journal Nature Medicine.
“Our study provides a comprehensive assessment of the long-term neurologic consequences of COVID-19,” said senior author Ziyad Al-Aly, MD, a clinical epidemiologist at Washington University. “Past studies have examined a narrower set of neurological outcomes, mostly in hospitalized patients. We evaluated 44 brain and other neurologic disorders among both nonhospitalized and hospitalized patients, including those admitted to the intensive care unit. The results 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 people think it is.”
Al-Aly said that overall, COVID-19 has contributed to more than 40 million new cases of neurological disorders worldwide.
A comprehensive analysis of federal data by researchers at Washington University School of Medicine in St. Louis shows people who have had COVID-19 are at an elevated risk of developing neurological conditions within the first year after infection. Movement disorders, memory problems, strokes, and seizures are among the complications. Credit: Sara Moser/Washington University School of Medicine
Other than having a COVID-19 infection, specific risk factors for long-term neurological problems are lacking. “We’re seeing brain problems in previously healthy individuals and those who have had mild infections,” Al-Aly said. “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.”
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.
“Overall, COVID-19 has contributed to more than 40 million new cases of neurological disorders worldwide.”
A previous study led by Al-Aly that was published in Nature Medicine found that vaccines slightly reduce — by about 20% — the risk of long-term brain problems. “It is definitely important to get vaccinated but also important to understand that they do not offer complete protection against these long-term neurologic disorders,” Al-Aly said.
The scientists 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.
Next, the research team created a controlled data set of 154,000 people 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. 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 as left millions across the globe infected and killed by the SARS-CoV-2 virus.
Ziyad Al-Aly, MD, has led multiple studies on long COVID as a clinical epidemiologist at Washington University School of Medicine in St. Louis and the Veterans Affairs St. Louis Health Care system. His research has included the devastating effects of the virus on the heart, kidneys, and mental health. Credit: Matt Miller/Washington University School of Medicine
Brain health was analyzed by the scientists over a year-long period. Compared with those who had not been infected with the virus, neurological conditions were 7% more common in people with COVID-19. Extrapolating this percentage based on the number of COVID-19 cases in the U.S. translates to approximately 6.6 million people who have suffered brain impairments associated with the SARS-CoV-2 virus.
One of the most common brain-related, long-COVID symptoms is memory problems — colloquially called brain fog. People who contracted the virus were at a 77% increased risk of developing memory problems compared with those in the control groups. “These problems resolve in some people but persist in many others,” Al-Aly said. “At this point, the proportion of people who get better versus those with long-lasting problems is unknown.”
Interestingly, the research team noted an increased risk of <span class="glossaryLink" aria-describedby="tt" data-cmtooltip="
Alzheimer’s
Alzheimer's disease is a disease that attacks the brain, causing a decline in mental ability that worsens over time. It is the most common form of dementia and accounts for 60 to 80 percent of dementia cases. There is no current cure for Alzheimer's disease, but there are medications that can help ease the symptoms.
” data-gt-translate-attributes=”["attribute":"data-cmtooltip", "format":"html"]”>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 people with COVID-19. “It’s unlikely that someone who has had COVID-19 will just get Alzheimer’s out of the blue,” Al-Aly said. “Alzheimer’s takes years to manifest. But what we suspect is happening is that people 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.”
Also, people who had the virus were 50% more likely to suffer from an ischemic stroke compared to the control groups. This is 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.
“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,” Al-Aly said. “It helps explain how someone with no risk factors could suddenly have a stroke.”
Overall, compared to the uninfected, people 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.
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.
“Our study adds to this growing body of evidence by providing a comprehensive account of the neurologic consequences of COVID-19 one year after infection,” Al-Aly said.
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, Al-Aly said. “Given the colossal scale of the pandemic, meeting these challenges requires urgent and coordinated — but, so far, absent — global, national, and regional response strategies,” he said.
Reference: “Long-term neurologic outcomes of COVID-19” by Evan Xu, Yan Xie and Ziyad Al-Aly, 22 September 2022, Nature Medicine. DOI: 10.1038/s41591-022-02001-z
This research was funded by the U.S. Department of Veterans Affairs; the American Society of Nephrology; and KidneyCure. The data that support the findings of this study are available from the U.S. Department of Veterans Affairs. VA data are made freely available to researchers behind the VA firewall with an approved VA study protocol.
VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.
Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.
In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.
The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.
Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”
Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”
This report by The Canadian Press was first published Sept. 16, 2024
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
