Association of COVID-19 with neurodegenerative and neurological disorders in vaccinated and unvaccinated people
- 1University of Bristol
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.
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BibTeX
@misc{mason2026association,
title = {{Association of COVID-19 with neurodegenerative and neurological disorders in vaccinated and unvaccinated people}},
author = {H. Mason and M. Zou and E. Eyles and J. I. C. Coronado and P. Madley-Dowd and M. Al Arab and Y. Wei and G. Cezard and T. M. Palmer and A. Green and A. J. Walker and S. Davy and L. Fisher and A. Mehrkar and S. Bacon and B. Goldacre and N. Chaturvedi and J. A. C. Sterne and R. Denholm and E. Coulthard and V. Walker},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.30.26366919},
url = {https://www.medrxiv.org/content/10.64898/2026.10.30.26366919v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Association of COVID-19 with neurodegenerative and neurological disorders in vaccinated and unvaccinated people
AU - H. Mason
AU - M. Zou
AU - E. Eyles
AU - J. I. C. Coronado
AU - P. Madley-Dowd
AU - M. Al Arab
AU - Y. Wei
AU - G. Cezard
AU - T. M. Palmer
AU - A. Green
AU - A. J. Walker
AU - S. Davy
AU - L. Fisher
AU - A. Mehrkar
AU - S. Bacon
AU - B. Goldacre
AU - N. Chaturvedi
AU - J. A. C. Sterne
AU - R. Denholm
AU - E. Coulthard
AU - V. Walker
PY - 2026
DA - 2026/10/30
PB - medRxiv
DO - 10.64898/2026.10.30.26366919
UR - https://www.medrxiv.org/content/10.64898/2026.10.30.26366919v1
AB - 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.
ER -