New research indicates influenza may cause more long-term neurological problems than COVID-19 in hospitalized patients.
In a study published in April 2024, researchers compared patients who had been hospitalized for COVID-19 versus patients who had been hospitalized for influenza, for post-infection long-term neurological sequalae. They compared the incidence of migraine headaches, epilepsy, neuropathy, movement disorders, stroke and dementia.
It was reported that during a year of follow-up, post-infection neurologic diagnoses were observed in 2.79% of the COVID-19 group versus 4.91% of the influenza group.
They looked at 438,581 individuals, half in each cohort. The influenza group contracted all six disorders in higher numbers than the COVID-19 group. All six differences in incidence rates were statistically significant. For example, neuropathy occurred in 1.89% of COVID-19 survivors and 3.61% of influenza survivors. Stroke occurred in 1.97% of COVID-19 patients and 2.4% of influenza patients.
The authors were surprised by the results as their hypothesis was that COVID-19 would cause higher levels of disease than influenza. These results differ from other studies that have reported higher rates of post-infectious sequalae in COVID patients. The researchers suggested that other studies looked at shorter lengths of time and in reviewing the data for this study found that early after a hospitalization, COVID risk might be higher than influenza, but not at one year.
One weakness of the study is the use of ICD codes to identify subjects and diagnoses, which might misclassify patients. Another is that, especially at the beginning of the COVID-19 pandemic, previously healthy patients might have been more likely to need hospitalization and less likely to suffer neurological sequalae than chronically debilitated influenza patients needing hospitalization.
Comments:
Although these results were the reverse of some other studies, in this study of hospitalized patients, post-infectious neurological sequalae at one year were higher with influenza infection than COVID-19. This study serves as a reminder that both influenza and COVID-19 can have serious long-term negative health effects for some of the patients who contract those diseases.
References
de HavenonA et al. Burden of Neurologic Health Care and Incident Neurologic Diagnoses in the Year After COVID-19 or Influenza Hospitalization. Neurology. April 23, 2024 102 (8). First published on line March 20.2024. Retrieved from: https://www.neurology.org/doi/10.1212/WNL.0000000000209248
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