Is the Burden of Neurologic Disease Higher After Influenza or COVID-19?

People who have an influenza infection are more likely to need medical care for neurologic disorders within the next year than people who have a COVID-19 infection.
People who have an influenza infection are more likely to need medical care for neurologic disorders within the next year than people who have a COVID-19 infection. (Representational Image: Unsplash)
People who have an influenza infection are more likely to need medical care for neurologic disorders within the next year than people who have a COVID-19 infection. (Representational Image: Unsplash)
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People who have an influenza infection are more likely to need medical care for neurologic disorders within the next year than people who have a COVID-19 infection, according to a study published in the March 20, 2024, online issue of Neurology, the medical journal of the American Academy of Neurology. The study, funded by the American Academy of Neurology, looked at people who were hospitalized with either influenza or COVID-19. The study did not look specifically at outcomes associated with long COVID.

“It’s important to note that our study did not look at long COVID outcomes, and our results do not necessarily conflict with the findings in other research showing an increase in neurologic symptoms in people with long COVID,” said study author and Chair of the American Academy of Neurology’s Health Services Research Subcommittee Brian C. Callaghan, MD, MS, FAAN, of University of Michigan Health in Ann Arbor. “While the results were not what we expected to find, they are reassuring in that we found being hospitalized with COVID did not lead to more care for common neurologic conditions when compared to being hospitalized with influenza.”

For the study, researchers used healthcare claims data to compare 77,272 people who were hospitalized with COVID-19 to the same number of people who were hospitalized with influenza. Then they looked to see how many of those people had medical care within the following year for the any of the six most common neurologic disorders—migraine, epilepsy, stroke, neuropathy, movement disorders and dementia.

People who have an influenza infection are more likely to need medical care for neurologic disorders within the next year than people who have a COVID-19 infection. (Representational Image: Unsplash)
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People who had a COVID-19 infection were less likely to need care in the following year for common neurologic conditions than people who had an influenza infection. (Representational Image: Unsplash)
People who had a COVID-19 infection were less likely to need care in the following year for common neurologic conditions than people who had an influenza infection. (Representational Image: Unsplash)

The researchers also looked at the people without those conditions at the start of the study to see how many developed a new diagnosis for any of the six conditions during the following year.

People who had a COVID-19 infection were less likely to need care in the following year for common neurologic conditions than people who had an influenza infection. Of those with COVID, 2.0% received care for migraine compared to 3.2% of those with influenza, and 1.6% of those with COVID received care for epilepsy compared to 2.1% of those with influenza. For neuropathy, the numbers were 1.9% and 3.6%; movement disorders were 1.5% and 2.5%; stroke was 2.0% and 2.4%; and dementia was 2.0% and 2.3%.

Once researchers adjusted for other factors that could affect the need for care, such as age, sex and a number of other health conditions, they found that those with a COVID infection had a 35% lower risk of receiving care for migraine than people who had influenza. Those with COVID had a 22% lower risk of receiving care for epilepsy and a 44% lower risk of receiving care for neuropathy. They also had a 36% lower risk of receiving care for movement disorders, a 10% lower risk for stroke and a 7% lower risk for dementia.

People who have an influenza infection are more likely to need medical care for neurologic disorders within the next year than people who have a COVID-19 infection. (Representational Image: Unsplash)
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“Since COVID-19 has now infected the majority of adults in the US, it’s good news that it behaves similarly to other respiratory viruses with respect to these common neurologic conditions,”

Adam de Havenon, MD, MSc, Yale University in New Haven, Connecticut

When researchers looked to see who developed new neurologic conditions in the year after infection, they found that 2.8% of those with COVID developed one of the six neurologic conditions, compared to 4.9% of those who had influenza.

“Since COVID-19 has now infected the majority of adults in the US, it’s good news that it behaves similarly to other respiratory viruses with respect to these common neurologic conditions,” said study author Adam de Havenon, MD, MSc, of Yale University in New Haven, Connecticut, and a member of the American Academy of Neurology Health Services Research Subcommittee. “There was concern that the already limited access to neurologic care would further shrink if we had a dramatic increase in neurologic care after COVID-19 infection.”

A limitation of the study is that the data platform the researchers used is not a nationally representative sample, so the results cannot be broadly generalized to all COVID-19 survivors in the United States.

The study was supported by the American Academy of Neurology.

Learn more about brain health at Brainandlife.org, magazine focused on the intersection of neurologic disease and brain health. Follow Brain & Life® on Facebook, Twitter and Instagram.

When posting to social media channels about this research, we encourage you to use the hashtags #Neurology and #AANscience.

The American Academy of Neurology is the world's largest association of neurologists and neuroscience professionals, with over 40,000 members. The AAN’s mission is to enhance member career fulfillment and promote brain health for all. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer's disease, stroke, concussion, epilepsy, Parkinson's disease, multiple sclerosis, headache and migraine. (Newswise/RMP)

People who have an influenza infection are more likely to need medical care for neurologic disorders within the next year than people who have a COVID-19 infection. (Representational Image: Unsplash)
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