{
  "abstract": "Introduction: COVID-19 has been linked to neuropathology, neurological symptoms, and diagnoses of neurological illnesses. Evidence regarding the long-term impact of COVID-19 on neurodegenerative and neurological disorders is still limited. Methods: We investigated associations of COVID-19 with neurodegenerative and neurological disorders by vaccination status in both hospitalised patients and the general population in the largest and longest study to date. We used OpenSAFELY-TPP to access linked electronic health records from 18.3 million adults registered with English GPs. We defined three cohorts with up to 5.5 years follow-up: pre-vaccination (exposed to COVID-19 January 2020-June 2021), and vaccinated and unvaccinated (exposed June-December 2021). We estimated adjusted hazard ratios (aHRs) comparing the incidence of cognitive impairment and dementia after diagnosis of COVID-19 with before or without COVID-19. We also studied Parkinson's disease, restless leg syndrome, rapid eye movement sleep disorder, motor neuron disease, multiple sclerosis, and migraine. Results: Incidence of most outcomes was elevated during weeks 0-4 after COVID-19 (cognitive impairment/dementia aHRs; pre-vaccination: 4.02 (3.74-4.32)/5.05 (4.63-5.52), vaccinated: 2.24 (2.05-2.45)/2.05 (1.77-2.37), unvaccinated: 4.38 (3.45-5.55)/8.69 (6.13-12.32)). Incidence remained elevated up to 4 years after COVID-19, especially in those hospitalised with COVID-19 (cognitive impairment/dementia aHRs; pre-vaccination: 1.49 (1.35-1.64)/ 1.39 (1.21-1.60), vaccinated: 1.27 (1.04-1.54)/1.32 (1.02-1.71), unvaccinated: 1.55 (1.11-2.16)/1.48 (1.00-2.20)). Conclusion: Incidence of cognitive impairment and dementia were elevated shortly after COVID-19. Incidence of cognitive impairment remained elevated in the longer term, particularly among unvaccinated individuals and/or those hospitalised with COVID-19. These patients may require additional assessment during routine care to evaluate persistent or new cognitive concerns.",
  "abstract_shown": true,
  "affiliations": [
    "University of Bristol"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 21,
  "authors": [
    {
      "name": "H. Mason"
    },
    {
      "name": "M. Zou"
    },
    {
      "name": "E. Eyles"
    },
    {
      "name": "J. I. C. Coronado"
    },
    {
      "name": "P. Madley-Dowd"
    },
    {
      "name": "M. Al Arab"
    },
    {
      "name": "Y. Wei"
    },
    {
      "name": "G. Cezard"
    },
    {
      "name": "T. M. Palmer"
    },
    {
      "name": "A. Green"
    },
    {
      "affs": [
        0
      ],
      "name": "A. J. Walker"
    },
    {
      "name": "S. Davy"
    },
    {
      "name": "L. Fisher"
    },
    {
      "name": "A. Mehrkar"
    },
    {
      "name": "S. Bacon"
    },
    {
      "name": "B. Goldacre"
    },
    {
      "name": "N. Chaturvedi"
    },
    {
      "name": "J. A. C. Sterne"
    },
    {
      "name": "R. Denholm"
    },
    {
      "name": "E. Coulthard"
    },
    {
      "affs": [
        0
      ],
      "name": "V. Walker"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/a8wtwkxhjcyh6.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.10.30.26366919",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.10.30.26366919v1.full",
  "id": "a8wtwkxhjcyh6",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.10.30.26366919v1",
  "language": null,
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "epidemiology"
    ],
    [
      "openalex",
      "2728|Long-Term Effects of COVID-19"
    ]
  ],
  "openalex": "W7225058142",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.10.30.26366919v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-30",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/a8wtwkxhjcyh6.ris",
  "sources": [
    {
      "first_seen": "2026-11-02T12:20:44Z",
      "native_id": "10.64898/2026.10.30.26366919",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.10.30.26366919v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:epidemiology",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Association of COVID-19 with neurodegenerative and neurological disorders in vaccinated and unvaccinated people",
  "title_text": "Association of COVID-19 with neurodegenerative and neurological disorders in vaccinated and unvaccinated people",
  "type": "preprint",
  "updated_at": "2026-11-03T00:20:20Z",
  "url": "https://research.draconitic.com/paper/a8wtwkxhjcyh6",
  "venue": "medRxiv",
  "versions": []
}