Patients with neurological or psychiatric complications of COVID-19 have worse long-term functional outcomes: COVID-CNS—A multicentre case–control study

It is established that patients hospitalised with COVID-19 often have ongoing morbidity affecting activity of daily living (ADL), employment, and mental health. However, little is known about the relative outcomes in patients with COVID-19 neurological or psychiatric complications. We conducted a UK multicentre case-control study of patients hospitalised with COVID-19 (controls) and those who developed COVID-19 associated acute neurological or psychiatric complications (cases). Among the 651 patients, [362 (55%) cases and 289 (45%) controls], a higher proportion of cases had impairment in ADLs (199 [68.9%] vs 101 [51.8%], OR 2.06, p < 0.0002) and reported symptoms impacting employment (159 [58.2%] vs 69 [35.6%] OR 2.53, p < 0.0001). There was no significant difference in the proportion with depression or anxiety between case and control groups overall. For cases, impairment of ADLs was associated with increased risk in female sex, age > 50 years and hypertension (OR 5.43, p < 0.003, 3.11, p = 0.02, 3.66, p = 0.04). Those receiving either statins or angiotensin converting enzyme (ACE) inhibitors had a lower risk of impairment in ADLs (OR 0.09, p = 0.0006, 0.17, p = 0.03). Patients with neurological or psychiatric complications of COVID-19 had worse functional outcomes than those with respiratory COVID-19 alone in terms of ADLs and employment. Female sex, age > 50 years, and hypertension were associated with worse outcomes, and statins or ACE inhibitors with better outcomes.

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Publication Details

Journal
Scientific Reports
Published
2025-01-27
DOI
https://doi.org/10.1038/s41598-024-80833-0
Citations
5
Primary Topic
Long-Term Effects of COVID-19
Type
article
Field-Weighted Citation Impact
6.95

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article

Patients with neurological or psychiatric complications of COVID-19 have worse long-term functional outcomes: COVID-CNS—A multicentre case–control study

Alish Palmos, Eugene Duff, Greta K. Wood, Matthew H. Hotopf et al.
5 citations
Scientific Reports
Long-Term Effects of COVID-19
6.95
article

Patients with neurological or psychiatric complications of COVID-19 have worse long-term functional outcomes: COVID-CNS—A multicentre case–control study

Alish Palmos, Eugene Duff, Greta K. Wood, Matthew H. Hotopf, Silvia Rota, Emma C. Thomson, David P. Breen, David Christmas, Tonny Veenith, Nikos Evangelou, Sylviane Defres, Daniel Madarshahian, Franklyn Egbe, Timothy R. Nicholson, Kiran Glen, Yun Huang, Andrew Mark McIntosh, Gerome D. Breen, Tom Solomon, Stella‐Maria Paddick, Monika Hartmann, Claire MacIver, Chérie Armour, Anthony S. David, Marc Hardwick, Patrick Francis Chinnery, Nadine Cossette, Sharon J. Peacock, Richard A. I. Bethlehem, Kukatharmini Tharmaratnam, Mark Ellul, Thomas Jackson, Sandar Kyaw, Claire Hetherington, Peter M. Fernandes, William R. Trender, Leonie S. Taams, James B Lilleker, Julian A. Hiscox, Katherine Dodd, Nicholas Davies, Colm Cunningham, E. Charles Leek, Nathalie Kingston, Obioma Orazulume, Michael S. Zandi, Hannah Stark, Fernando Zelaya, Emily McGlinchey, Matthew R. Broome, David Clapham, Rustam Al‐Shahi Salman, Guy Williams, Benedict Michael, Alex Berry, Masud Husain, Matthew Butler, Ammar Al‐Chalabi, Adam Hampshire, Ian Galea, Alaistair Coles, Alastair Darby, Brendan Sargent, Thomas Pollak, Stephen McKeever, Edward Needham, Edward Thomas Bullmore, Dina Monssen, Valentina Giunchiglia, Steven Williams, Sarosh R. Irani, Richard Francis, Jonathan Cavanagh, Daniel J. van Wamelen, Hannah Castell, Alan Carson, Paul J. Harrison, Laura Cocking, Neil Andrew Harrison, Arvind H. Patel, Laura Benjamin, Nathalie Nicholas, Ava Easton, Kathleen Stirrups, Bhagteshwar Singh, Malcolm Gracie Semple, Gursharan Kalsi, Johan Zvrskovec, Rachel Upthegrove, David Krishna Menon, Angela E. Holland, Rhys Huw Thomas, Ewan M. Harrison, Ciaran C. Mulholland, Afagh Garjani, Angela Vincent, John P. Aggleton, Nicholas William Wood, Stephen M. Smith, Virginia Newcombe, Simon S. Keller, Angela Roberts, Alex Dregan, Henry C. Rogers, Naomi Martin, Ceryce Collie, Judith Breuer, Marlies Ostermann, Jay Amin, Michael Peter Lunn, Bethan Blackledge, John R. Bradley, Rajish Sanjit Kumar Shil, Karla L. Miller, Sui H. Wong, Michael J. Griffiths, Arina Tamborska, Peter John Hellyer, Stephen Sawcer, Christopher Allen, Thomas M. Jenkins, David A. Cousins, Eva Maria Hodel, Peter Jezzard, Cordelia Dunai, Akshay Gopinathan Nair, Jonathan R. I. Coleman, Mark R. Baker, Shahd Hamid, Christopher M. Morris, Rose Eichenberger, Rahul Batra, Zain-Ul-Abideen Ahmad, Jonathan Underwood, Bethany Facer, Pamela J. Shaw, Sarah A. Boardman, Annalena Venneri, Timothy RJ Nicholson, John‐Paul Taylor, Sophie Pendered, Adam Seed, Orla Hilton, Savini Gunatilake, David M. Christmas, Parisa Mansoori, Craig P. Smith, Neil Basu, Alexander Grundmann, Rebecca Gregory, Jacqueline Smith, Ryan McIlwaine, Lily George, Jade Harris, Sarah Pett, Gabriella Lewis, Merna Samuel, Adam Sieradzki, Ronan O’Malley, Gavin McDonnell, Victoria Grimbly, Stella Hughes, Ali M. Aggleton, Suzanne Barret
article en
5 citations

Abstract

It is established that patients hospitalised with COVID-19 often have ongoing morbidity affecting activity of daily living (ADL), employment, and mental health. However, little is known about the relative outcomes in patients with COVID-19 neurological or psychiatric complications. We conducted a UK multicentre case-control study of patients hospitalised with COVID-19 (controls) and those who developed COVID-19 associated acute neurological or psychiatric complications (cases). Among the 651 patients, [362 (55%) cases and 289 (45%) controls], a higher proportion of cases had impairment in ADLs (199 [68.9%] vs 101 [51.8%], OR 2.06, p < 0.0002) and reported symptoms impacting employment (159 [58.2%] vs 69 [35.6%] OR 2.53, p < 0.0001). There was no significant difference in the proportion with depression or anxiety between case and control groups overall. For cases, impairment of ADLs was associated with increased risk in female sex, age > 50 years and hypertension (OR 5.43, p < 0.003, 3.11, p = 0.02, 3.66, p = 0.04). Those receiving either statins or angiotensin converting enzyme (ACE) inhibitors had a lower risk of impairment in ADLs (OR 0.09, p = 0.0006, 0.17, p = 0.03). Patients with neurological or psychiatric complications of COVID-19 had worse functional outcomes than those with respiratory COVID-19 alone in terms of ADLs and employment. Female sex, age > 50 years, and hypertension were associated with worse outcomes, and statins or ACE inhibitors with better outcomes.

Scientific ReportsVol. 15(1)
Queen's University Belfast (GB), Belfast Health and Social Care Trust (GB), NHS Lothian (GB), University of Nottingham (GB), University of Liverpool (GB), University of Dundee (GB), King's College London (GB), South London and Maudsley NHS Foundation Trust (GB), Trinity College Dublin (IE), Curtin University (AU), University of Cambridge (GB), Aintree University Hospitals NHS Foundation Trust (GB), Manchester Academic Health Science Centre (GB), Royal Stoke University Hospital (GB), Royal Victoria Infirmary (GB), Charing Cross Hospital (GB), Cambridge University Hospitals NHS Foundation Trust (GB), John Radcliffe Hospital (GB), Edinburgh Royal Infirmary (GB), Walton Centre (GB), Stroke Association (GB), Warneford Hospital (GB), University of Manchester (GB), Northern Health and Social Care Trust (GB), National Institute for Health and Care Research (GB), University of Oxford (GB), MRC Clinical Trials Unit at UCL (GB), MRC Laboratory for Molecular Cell Biology (GB), Institute of Mental Health (GB), Sheffield Teaching Hospitals NHS Foundation Trust (GB), Salford Royal Hospital (GB), Arthritis UK (GB), UK Dementia Research Institute (GB), Wellcome Centre for Mitochondrial Research (GB), St John of God Hospital (AU), Encephalitis Society (GB), Newcastle Hospitals - Campus for Ageing and Vitality (GB), National Hospital for Neurology and Neurosurgery (GB), Liverpool Womens NHS Foundation Trust (GB), Health Protection Research Unit in Emerging and Zoonotic Infections at University of Liverpool (GB), University of Southampton (GB), NIHR BioResource, University College London (GB), Imperial College London (GB), University of Glasgow (GB), MRC Mitochondrial Biology Unit (GB), Cardiff University (GB), University of Birmingham (GB), Newcastle University (GB), University of Sheffield (GB), University of Edinburgh (GB)
NHS Blood and Transplant, UK Research and Innovation, National Institute for Health Research Health Protection Research Unit, International Seafood Sustainability Foundation, National Institute for Health and Care Research, Department of Health and Social Care, Imperial College London, University of Oxford, Public Health England, University College London Hospitals NHS Foundation Trust, NIHR BioResource, Medical Research Council, University College London Hospitals Biomedical Research Centre
Openalex Percentile: Top 4%
Long-Term Effects of COVID-19
6.95
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