Neurological issues after COVID - This insightful study is frustrating as well

Video Topic: Detailed discussion on a recent study about the long-term neurological outcomes in COVID-19 patients.
Study Title: "Long-term Neurologic Outcomes of COVID-19" (also known as Long COVID)
Publication Date: September 22, 2022
Published In: Nature
Lead Researchers: Evan Shu, Jan Ji, and Zayad Ali
Affiliation: Washington University School of Medicine in St. Louis and Veterans Affairs St. Louis Healthcare System

Data Source: U.S. Department of Veterans Affairs national healthcare database
Participants: Over 5.8 million, including 154,068 individuals with COVID-19 and control groups from contemporary and historical cohorts
Study Period: March 1, 2020, to January 15, 2021
Follow-up Duration: Up to December 2021 (around 12 months from the date of infection)
Methodology: Inverse probability and various statistical analyses to evaluate the data

Increased Risk of Neurological Issues: COVID-19 patients had a 1.42 times higher risk of experiencing neurological issues compared to control groups.
Hazard Ratio: The study found a hazard ratio of 1.42, indicating that individuals who had COVID-19 faced a 1.42 times higher risk of experiencing neurological issues compared to the control groups.
Burden of Neurological Disorders: The researchers estimated an additional burden of 70.69 individuals per 1000 people experiencing neurological outcomes in a span of 12 months post-COVID-19 infection.
Hospitalization Not a Determining Factor: Interestingly, the increased risk and burden were noted even in individuals who were not hospitalized during their acute phase of COVID-19, highlighting that severe initial symptoms are not a prerequisite for long-term neurological effects.

The study detailed an increased incidence in a range of neurological disorders in individuals post-COVID-19 infection, including but not limited to:

Ischemic Stroke: A significant increase in cases of ischemic strokes was noted among COVID-19 patients compared to the contemporary group which was not infected.
Hemorrhagic Stroke: COVID-19 patients also showed a higher incidence of hemorrhagic strokes.
Transient Ischemic Attacks (TIA): The study reported an increased number of TIAs, a temporary blockage of blood flow to the brain, among the patients.

Memory Problems: Individuals recovering from COVID-19 reported memory problems at a higher rate compared to the control groups.
Alzheimer's Disease: The study noted an increase in the incidence of Alzheimer's disease among the COVID-19 cohort.

Peripheral Neuropathy: COVID-19 patients experienced a higher rate of peripheral neuropathy, a condition resulting from damage to the peripheral nerves.
Paresthesias: An increased incidence of paresthesias, which involves abnormal sensations in the skin, was noted.
Bell's Palsy: The study found a higher number of Bell's palsy cases, a sudden weakness in the facial muscles, among COVID-19 patients.

Migraines: COVID-19 patients reported experiencing migraines at a higher rate compared to the control groups.
Seizures: An increased incidence of seizures was noted among individuals who had recovered from COVID-19.

Mental Health Disorders: The study reported a higher incidence of various mental health disorders, including major depressive disorders and anxiety, among COVID-19 patients.
Musculoskeletal Disorders: COVID-19 patients experienced a higher rate of musculoskeletal disorders, including joint pain and myalgia.
Sensory Disorders: The study noted an increased incidence of sensory disorders, including hearing and vision abnormalities, loss of smell and taste, among COVID-19 patients.
Effects on Non-Hospitalized Patients: Even individuals not hospitalized during their acute COVID-19 phase exhibited an elevated risk of long-term neurological disorders.

Main Criticism: Lack of data on the vaccination status of participants during the follow-up period, which extended into a time when vaccines were widely available.
Missed Opportunity: The presenter emphasized that including vaccination data could have offered valuable insights into the neurological outcomes in vaccinated individuals post-COVID-19 infection.
Call for Further Analysis: The presenter suggests that the study could have been more beneficial with an analysis correlating the neurological outcomes with the vaccination status, helping in understanding the protection offered by vaccines or the duration of such protection.

Subgroup Analysis: The study conducted detailed subgroup analyses based on various factors such as age, race, sex, and different health conditions but missed including vaccination status in this analysis.
Flu Vaccine Analysis: Interestingly, the study included an analysis concerning flu vaccination but did not perform a similar analysis for COVID-19 vaccines.

Study Contribution: Despite the criticism, the presenter acknowledges the study's contribution to understanding the long-term neurological outcomes in COVID-19 patients.
Future Expectations: The presenter expresses a desire to see future studies incorporate vaccination data to provide a more comprehensive view of post-COVID-19 neurological outcomes.