One great thing about national health care is that researchers have access to an entire nation’s worth of data. In the U.S., research is fragmented and data sets are relatively small.
This truly gigantic data set from more than 8 million adults in England shows that any severe respiratory infection that causes hospitalization significantly raises the risk for new diagnosis of neuropsychiatric illnesses (anxiety disorder, depression, dementia, psychotic disorder, and bipolar disorder diagnoses). This included Covid-19 but the effect was just as strong from other severe acute respiratory infections (SARI).
Prepandemic data suggest that individuals with severe acute respiratory infections (SARI) have increased risks of subsequent neuropsychiatric illness and cognitive impairment compared with the general population. Early data from the U.S. observed this with Covid-19 as well. The new study shows that Covid-19 isn’t worse than SARI caused by flu, pneumonia or other SARI.
“Postacute outcomes associated with severe respiratory infections span physical, cognitive, and psychological domains; could be influenced by physiological perturbations, deconditioning, and other stressors; and are recognized under umbrella diagnostic entities such as the postintensive care syndrome, posthospitalization syndrome, and in some cases postviral syndrome.”
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/…
The study also compared the SARI patients to people who were hospitalized due to heart attacks. The data showed that the heart attack patients were twice as likely as the SARI patients to suffer from anxiety afterward, but the SARI patients were twice as likely as the heart attack patients to suffer from a diagnosis of new-onset dementia and/or psychosis.
Yikes!
It looks like any respiratory infection that is severe enough to land a person in the hospital also increases the risk of brain damage leading to mental illness of various types. Unfortunately, the article didn’t state the absolute risk, only the HR (Hazard Ratio, the risk of patients having SARI compared with those who didn’t). So I don’t know whether 1%, 10% or 50% of the patients had the problem because they didn’t say.
The practical takeaway is that infection control methods such as wearing a mask and hand-washing help control many viral contagions. That’s why the 2020 flu season had zippo-zero cases, to the astonishment of epidemiologists, since the shutdowns and other Covid-19 controls also prevented the flu from spreading.
Anyone at high risk of serious problems from Covid will also be at high risk from other SARIs. I didn’t realize this before, but will be extra-careful now.
The Macroeconomic impact of this is that treatment of people with brain disorders like dementia and psychosis is very expensive. Because of more effective treatment, fewer people are dying of Covid and SARIs but anyone who has been hospitalized – and that’s a lot of people – has this hazard.
Wendy