Long-term Neurologic Outcomes of COVID-19 (preprint)

ABSTRACT

The neurologic manifestations during the acute phase of COVID-19 are well characterized, but a comprehensive evaluation of the risks and burdens of post-acute neurologic disorders at 1-year after the initial infection has not been yet undertaken. Here we use national healthcare databases from the US Department of Veterans Affairs to build a cohort of 154,068 individuals with COVID-19 as well as two sets of control cohorts with 5,638,795 (contemporary controls) and 5,859,621 (historical controls) individuals to estimate risks and burdens of a set of pre-specified incident neurologic disorders at 12 months. Our results show that in the post-acute phase of COVID-19, there was increased risk of an array of neurologic disorders including stroke, cognition and memory disorders, peripheral nervous system disorders, episodic disorders (e.g., migraine and seizure), extrapyramidal and movement disorders, musculoskeletal disorders, sensory disorders, and other disorders including Guillain-Barré, and encephalitis or encephalopathy. The risks and burdens were significantly elevated even in people who did not require hospitalization during the acute phase of COVID-19. Taken together, our results provide evidence of increased risk of broad array of long-term neurologic disorders in people with COVID-19. This evidence will inform the management of the ongoing pandemic and guide post-acute COVID-19 clinical care and health care systems planning.