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

2025; Nature Portfolio; Volume: 15; Issue: 1 Linguagem: Inglês

10.1038/s41598-024-80833-0

2045-2322

Rajish Sanjit Kumar Shil, Adam Seed, Franklyn Egbe, Brendan Sargent, Greta K. Wood, Yun Huang, Katherine Dodd, James B Lilleker, Thomas A. Pollak, Sylviane Defres, Thomas M. Jenkins, Nicholas Davies, David A. Cousins, Michael S. Zandi, Thomas Jackson, Laura Benjamin, Ava Easton, Tom Solomon, John R. Bradley, Patrick F. Chinnery, Craig P. Smith, Timothy RJ Nicholson, Alan Carson, Rhys H. Thomas, Mark Ellul, Nicholas Wood, Gerome Breen, Benedict Michael, John P. Aggleton, Ali M. Aggleton, Ammar Al‐Chalabi, Christopher Allen, Jay Amin, Chérie Armour, Mark R. Baker, Suzanne Barret, Neil Basu, Rahul Batra, Alex Berry, Laura Benjamin, Richard A.I. Bethlehem, Bethan Blackledge, Sarah A. Boardman, John R. Bradley, David P. Breen, Gerome Breen, Judith Breuer, Matthew R. Broome, Edward T. Bullmore, Matthew Butler, Alan Carson, Hannah Castell, Jonathan Cavanagh, Patrick F. Chinnery, David Christmas, David M. Christmas, Jonathan R. I. Coleman, Alaistair Coles, Ceryce Collie, Nadine Cossette, David A. Cousins, Colm Cunningham, Alastair Darby, Anthony S. David, Nicholas Davies, Sylviane Defres, Katherine Dodd, Alex Dregan, Eugene Duff, Cordelia Dunai, Ava Easton, Franklyn Egbe, Mark Ellul, Nikos Evangelou, Bethany Facer, Peter M. Fernandes, Richard Francis, Ian Galea, Afagh Garjani, Lily George, Valentina Giunchiglia, Kiran Glen, Rebecca Gregory, Michael J. Griffiths, Victoria Grimbly, Alexander Grundmann, Savini Gunatilake, Shahd Hamid, Adam Hampshire, Marc Hardwick, Jade Harris, Ewan M. Harrison, Neil A. Harrison, Paul J. Harrison, Monika Hartmann, Peter J. Hellyer, Claire Hetherington, Orla Hilton, Julian A. Hiscox, Eva Maria Hodel, Angela E. Holland, Matthew Hotopf, Yun Huang, Stella Hughes, Masud Husain, Sarosh R. Irani, Thomas Jackson, Thomas Jackson, Peter Jezzard, Johan Zvrskovec, Gursharan Kalsi, Simon S. Keller, Nathalie Kingston, Sandar Kyaw, E. Charles Leek, Gabriella Lewis, James B Lilleker, Michael P. Lunn, Claire MacIver, Daniel Madarshahian, Parisa Mansoori, Naomi Martin, Gavin McDonnell, Emily McGlinchey, Stephen McKeever, Ryan McIlwaine, Andrew M. McIntosh, David Menon, Benedict Michael, Karla L. Miller, Dina Monssen, Christopher M. Morris, Ciaran Mulholland, Akshay Gopinathan Nair, Edward Needham, Virginia Newcombe, Nathalie Nicholas, Timothy R. Nicholson, Ronan O’Malley, Obioma Orazulume, Marlies Ostermann, Stella‐Maria Paddick, Alish B. Palmos, Arvind H. Patel, Sharon J. Peacock, Sophie Pendered, Sarah Pett, Thomas A. Pollak, Angela Roberts, Henry C. Rogers, Silvia Rota, Rustam Al‐Shahi Salman, Merna Samuel, Brendan Sargent, Stephen Sawcer, Adam Seed, Malcolm G. Semple, Pamela J. Shaw, Rajish Sanjit Kumar Shil, Adam Sieradzki, Bhagteshwar Singh, Craig P. Smith, Jacqueline Smith, Stephen M. Smith, Tom Solomon, Leonie S. Taams, Arina Tamborska, John‐Paul Taylor, Kukatharmini Tharmaratnam, Rhys H. Thomas, Emma C. Thomson, William Trender, Zain-Ul-Abideen Ahmad, Jonathan Underwood, Rachel Upthegrove, Tonny Veenith, Annalena Venneri, Angela Vincent, Daniel J. van Wamelen, Guy Williams, Steven Williams, Sui H. Wong, Greta K. Wood, Nicholas Wood, Michael S. Zandi, Fernando Zelaya, Kathleen Stirrups, Laura Cocking, Rose Eichenberger, David Clapham, Hannah Stark,

Tryptophan and brain disorders

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.