Risk of neurological and psychiatric diagnoses in COVID-19 survivors: A multicenter retrospective cohort study using electronic health records

Table 1 Baseline characteristics for the coronavirus disease 2019 cohort and control cohort (n = 8874), n (%)

	Patients exposed to COVID-191 (n = 4437)	Patients never exposed to COVID-19 (n = 4437)	P value2
Age (mean)	49.91	46.02	0.0093
Gender
Male	1946 (43.86)	1946 (43.86)
Female	2491 (56.14)	2491 (56.14)
Hospital region
Western region	1468 (33.08)	1468 (33.08)
Eastern region	522 (11.76)	522 (11.76)
Central region	2402 (54.13)	2402 (54.13)
Northern region	42 (0.94)	42 (0.94)
Southern region	3 (0.06)	3 (0.06)
Comorbidities
Type 1 diabetes			< 0.0001
Yes	119 (2.68)	62 (1.40)
No	4318 (97.32)	4375 (98.60)
Type 2 diabetes			< 0.0001
Yes	1394 (31.42)	706 (15.91)
No	3043 (68.58)	3731 (84.09)
Obesity and overweight			< 0.0001
Yes	442 (9.96)	221 (4.98)
No	3995 (90.04)	4216 (95.02)
Hypertension			< 0.0001
Yes	1551 (34.96)	724 (16.32)
No	2886 (65.04)	3713 (83.68)
Heart diseases			< 0.0001
Yes	714 (16.09)	263 (5.93)
No	3723 (83.91)	4174 (94.07)
Cancers			< 0.0001
Yes	313 (7.05)	167 (3.76)
No	4124 (92.95)	4270 (96.24)
Chronic kidney disease			< 0.0001
Yes	402 (9.06)	131 (2.95)
No	4035 (90.94)	4306 (97.05)
Chronic liver disease			< 0.0001
Yes	177 (3.99)	67 (1.51)
No	4260 (96.01)	4370 (98.49)
Systemic lupus erythematosus			0.04
Yes	30 (0.68)	16 (0.36)
No	4407 (99.32)	4421 (99.64)
Chronic lower respiratory diseases			< 0.0001
Yes	1228 (27.68)	537 (12.1)
No	3209 (72.32)	3900 (87.9)
Disorders in immune mechanism			0.01
Yes	22 (0.50)	8 (0.18)
No	4415 (99.50)	4429 (99.82)
Psoriasis			0.0002
Yes	57 (1.28)	24 (0.54)
No	4380 (98.72)	4413 (99.46)

¹Coronavirus disease 2019 infection by years; 2020 (613; 13.82%), 2021 (2514; 56.66%), 2022 (1289; 29.05%), 2023 (21; 0.47%).

²χ² test and Fisher’s exact test for frequency less than 30.

³t-test was used to examine the numeric normally distributed age.

COVID-19: Coronavirus disease 2019.

Table 2 Major outcomes for the whole coronavirus disease 2019 cohort, and for the non-coronavirus disease 2019 control cohort, n (%)

	Total (n = 8874)	Patients exposed to COVID-19 (n = 4437)	Patients never exposed to COVID-19 (n = 4437)	P value1
Neurological disorders
Cognitive deficit				< 0.0001
Yes	483 (5.44)	350 (7.89)	133 (3.00)
No	8391 (94.55)	4087 (92.11)	4304 (97.00)
Myoneural junction				0.03
Yes	216 (2.43)	92 (2.07)	124 (2.79)
No	8658 (97.56)	4345 (97.93)	4313 (97.21)
Ischaemic stroke				0.002
Yes	344 (3.87)	200 (4.51)	144 (3.25)
No	8530 (96.12)	4237 (95.49)	4293 (96.75)
Nerve plexus disorder				< 0.0001
Yes	1964 (22.13)	1075 (24.23)	889 (20.04)
No	6910 (77.86)	3362 (75.77)	3548 (24.23)
Insomnia
Yes	884 (9.96)	574 (12.94)	310 (6.99)	< 0.0001
No	7990 (90.03)	3863 (87.06)	4127 (93.01)
Parkinsonism				0.08
Yes	196 (2.21)	110 (2.48)	86 (1.94)
No	8678 (97.79)	4327 (97.52)	4351 (98.06)
Substance use disorder				0.06
Yes	58 (0.65)	36 (0.81)	22 (0.50)
No	8816 (99.34)	4401 (99.19)	4415 (99.50)
Intracranial hemorrhage				0.23
Yes	213 (2.4)	98 (2.21)	115 (2.59)
No	8661 (97.6)	4339 (97.79)	4322 (97.41)
Guillain-Barré syndrome				0.63
Yes	39 (0.44)	18 (0.41)	21 (0.47)
No	8835 (99.56)	4419 (99.59)	4416 (99.53)
Epilepsy				< 0.0001
Yes	2723 (30.68)	1080 (24.34)	1643 (37.03)
No	6151 (96.31)	3357 (75.66)	2794 (62.97)
Encephalopathy				0.52
Yes	86 (0.96)	46 (1.04)	40 (0.90)
No	8788 (99.03)	4397 (98.96)	4391 (99.10)
Dementia				< 0.0001
Yes	481 (5.42)	367 (8.27)	114 (2.57)
No	8394 (94.57)	4070 (91.73)	4323 (97.43)
Psychiatric disorders
Mood disorder				< 0.0001
Yes	2123 (23.92)	1149 (25.90)	974 (21.95)
No	6751 (76.07)	3288 (74.10)	3463 (78.05)
Psychotic disorder				0.05
Yes	382 (4.3)	172 (3.88)	210 (4.73)
No	8492 (95.69)	4265 (96.12)	4227 (95.27)
Anxiety disorder
Yes	259 (2.92)	139 (3.13)	120 (2.70)
No	8615 (97.08)	4298 (96.87)	4317 (97.30)

¹χ² test and Fisher’s exact test for frequency less than 30.

COVID-19: Coronavirus disease 2019.

Table 3 Odds ratio for risk of neurological and psychiatric disorders among coronavirus disease 2019 patients

	OR (COVID-19 vs no COVID-19)	95%CI	P value
Neurological disorders
Cognitive deficit			0.0001
Yes	1.54	1.23-1.91
No	Reference1	Reference1
Myoneural junction			0.13
Yes	0.8	0.6-1.07
No	Reference1	Reference1
Ischaemic stroke			0.006
Yes	0.72	0.56-0.91
No	Reference1	Reference1
Nerve plexus disorder			0.02
Yes	1.13	1.01-1.25
No	Reference1	Reference1
Insomnia			< 0.0001
Yes	0.54	0.46-0.63
No	Reference1	Reference1
Parkinsonism			0.002
Yes	0.61	0.44-0.83
No	Reference1	Reference1
Substance use disorder			0.01
Yes	1.95	1.12-3.38
No	Reference1	Reference1
Intracranial hemorrhage			0.0005
Yes	0.59	0.44-0.79
No	Reference1	Reference1
Guillain-Barré syndrome			0.83
Yes	0.93	0.48-1.79
No	Reference1	Reference1
Epilepsy			< 0.0001
Yes	0.79	0.72-0.88
No	Reference1	Reference1
Encephalopathy			0.79
Yes	1.06	0.68-1.65
No	Reference1	Reference1
Dementia			0.23
Yes	1.16	0.91-1.49
No	Reference1	Reference1
Psychiatric disorders
Mood disorder			0.003
Yes	1.16	1.05-1.29
No	Reference1	Reference1
Psychotic disorder			0.09
Yes	0.83	0.67-1.03
No	Reference1	Reference1
Anxiety disorder
Yes	1.39	1.07-1.79	0.01
No	Reference1	Reference1

¹Reference group.

OR: Odds ratio; CI: Confidence interval; COVID-19: Coronavirus disease 2019.