THE NEGATIVE BUFFER is the story of six months ago. But the aftermath of Covid-19 on the mind is still there, with a non-negligible impact on the quality of life of 1 in 3 people, among those who have had to deal with the disease caused by Sars-CoV-2.
Covid, the other pandemic: the virus has brought 1 million new cases of mental distress
by Valeria Pini
The photograph taken by a group of psychiatrists from the University of Oxford in the largest of the studies conducted to evaluate the aftermath of Covid-19 on neurological and psychiatric health is worrying. Reading the conclusions of their work, published in the journal The Lancet Psychiatry , the consequences affected 34 percent of the more than 236,000 adults involved in the study. Up to 180 days after what is called complete recovery from the disease. That is the one that is obtained with the negativization of the swab examination.
The waste of Covid-19 on the mind
The researchers came to this conclusion after comparing the outcomes of those who had had Covid-19 with those of people affected by the flu or with other respiratory tract infections. Drawing on information from the US-based TriNetX network global database, psychiatrists compared the incidence of 14 neurological conditions (cerebral haemorrhage, ischemic stroke, parkinsonism, Guillain-Barré syndrome, neuritis, nerve, nerve root and plexuses, neuromuscular diseases, encephalitis, dementia) and psychiatric (psychosis, anxiety and mood disorders, insomnia, drug abuse) in the three patient samples. There was thus a clear difference in the numbers recorded between those who had survived the disease caused by Sars-CoV-2 and between all the other people involved in the study. Overall, one third of the veterans from Covid-19 manifested one or more of the aforementioned sequelae. And in more than ten percent of cases it was a first diagnosis, in subjects who until then had never had problems of this type. In particular, anxiety (17 percent) and mood (14 percent) disorders were the most frequent problems. This was followed by drug use (7 percent) and insomnia (5 percent). The most serious consequences are rare: from stroke (2.1 per cent) to dementia (0.7 per cent), detected with greater frequency among those who had been forced to hospitalization in intensive care.
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This is the photograph taken by the experts, which confirms and consolidates the results obtained during an observation that lasted three months and already published in the same journal. However, it is an overall vision, which does not affect the individual risk that those who fall ill with Covid-19 run. The consequences affected everyone: regardless of the degree of severity of the disease. That said, the likelihood was found to increase with the severity of the infection faced. Taking 34 percent as an average value, the data regarding the neurological and psychiatric consequences recorded after Covid-19 was higher among those who had had to resort to ordinary hospital care (38 percent), to intensive care (46 percent) and among those who had already developed encephalopathy (manifested by delirium) during the course of the infection (62 percent).
There are several possible causes
No assumptions are made in the work about the possible causes of the consequences on mental health. However, the mechanisms underlying these complications can be multiple. Explain Carlo Ferrarese, director of the neurological clinic of the San Gerardo hospital in Monza and full professor of neurology at the University of Milan Bicocca: “In a small percentage they can be linked to the penetration of the virus into the brain, while in most cases they are caused by alterations in coagulation triggered by the binding of the virus to the vessel wall. The damage to the nervous system following viral infection can also be caused by an excessive activation of the inflammatory and immune system. Precisely for this reason cortisone and anticoagulants, called to turn off the inflammation and to reduce blood clotting, are often used in severe forms of Covid-19 “.
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by Giuseppe del Bello
A final neurological problem concerns post-infectious neurological complications. In the post-Covid clinics activated in the centers most affected in the first phase, various problems emerged: protracted asthenia, concentration and memory disorders, which could be linked to small vascular or inflammatory damage to the nervous system (central and peripheral).
To shed light on these aspects, the Italian Society of Neurology launched the study “Neurocovid“. The goal is to document (after 3 and 6 months) all the possible neurological manifestations at the onset, during or after the disease. Then put them in relation to the severity of the infection, to changes in respiratory, circulatory and blood parameters. As well as anthropometric data, habits, lifestyles, the presence of other diseases and therapies taken by patients.
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by Valeria Pini
The research, ongoing until June, involves 50 Italian neurology departments. “The neurological manifestations of Covid-19 constitute one of the main challenges for public health: not only for the acute effects on the brain, but also for the long-term damage to brain health that could result from it – he concludes Paolo Calabresi, director of the neurology complex operating unit of the Gemelli Polyclinic in Rome -. These delayed manifestations may also be present in patients who have not shown neurological symptoms in the acute phase. This is why, now and in the future, it is important to activate a careful epidemiological surveillance of these people “.
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