New-onset and persistent neurological and psychiatric sequelae of COVID-19 compared to influenza: A retrospective cohort study in a large New York City healthcare network

Andrei L. Iosifescu, Wouter S. Hoogenboom, Alexandra J. Buczek, Roman Fleysher, Tim Q. Duong

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Neurological and neuropsychiatric manifestations of post-acute SARS-CoV-2 infection (neuro-PASC) are common among COVID-19 survivors, but it is unknown how neuro-PASC differs from influenza-related neuro-sequelae. This study investigated the clinical characteristics of COVID-19 patients with and without new-onset neuro-PASC, and of flu patients with similar symptoms. Methods: We retrospectively screened 18,811 COVID-19 patients and 5772 flu patients between January 2020 and June 2021 for the presence of new-onset neuro-sequelae that persisted at least 2 weeks past the date of COVID-19 or flu diagnosis. Results: We observed 388 COVID-19 patients with neuro-PASC versus 149 flu patients with neuro-sequelae. Common neuro-PASC symptoms were anxiety (30%), depression (27%), dizziness (22%), altered mental status (17%), chronic headaches (17%), and nausea (11%). The average time to neuro-PASC onset was 138 days, with hospitalized patients reporting earlier onset than non-hospitalized patients. Neuro-PASC was associated with female sex and older age (p < 0.05), but not race, ethnicity, most comorbidities, or COVID-19 disease severity (p > 0.05). Compared to flu patients, COVID-19 patients were older, exhibited higher incidence of altered mental status, developed symptoms more quickly, and were prescribed psychiatric drugs more often (p < 0.05). Conclusions: This study provides additional insights into neuro-PASC risk factors and differentiates between post-COVID-19 and post-flu neuro-sequelae.

Original languageEnglish (US)
JournalInternational Journal of Methods in Psychiatric Research
DOIs
StateAccepted/In press - 2022

Keywords

  • COVID-19
  • influenza
  • neuropsychiatry
  • new-onset symptoms

ASJC Scopus subject areas

  • Psychiatry and Mental health

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