Psychological distress and its impact on the onset of lasting neurological symptoms during the pandemic: evidence from the Italian Twin Registry.

Introduction: Neurocognitive disorders are typical of older people. Psychological distress increased during the pandemic, particularly in young people. Although often underestimated, the impact of psychological distress on neurological disorders should be considered. As part of a longitudinal study conducted by the Italian Twin Registry (ITR) on the health effects of COVID-19 pandemic, we explored the onset of lasting neurological symptoms in relation with pre-existing psychological symptoms and/or SARS-Cov-2 infection.

Methods: Online surveys on adult subjects of the ITR: in June 2020 we investigated symptoms of depression, anxiety and post-traumatic distress and, in December 2021, the onset of six persisting neurocognitive symptoms. SARS-CoV-2 infection was examined in both surveys. Associations of psychological symptoms and of viral infection with subsequent neurological manifestations were tested through logistic regression analysis.

Results: Among 1,784 participants (mean age 46.6), 42.8% reported neurological symptoms and 15.7% SARS-Cov-2 infection. Odds of neurological manifestations increased in participants with depressive or anxiety symptoms (ORs: 1.44 to 3.72), and in those with COVID-19 (ORs: 1.73 to 2.32). Anxiety symptoms explained more cases of cognitive symptoms (26.9% to 37.9%) than COVID-19 (9.1% to 15.5%). Smell/taste changes were strongly associated with viral infection (OR: 43.2).

Conclusions: During the pandemic, widespread psychological distress contributed more than COVID-19 to the appearance of some cognitive symptoms in a relatively young population. Our findings indicates that preservation of neurological well-being cannot ignore mental health interventions.