New Study of Post-COVID Brain Issues Could Have ‘Huge Impact’ on WC

Nancy Grover

Sarasota, FL (WorkersCompensation.com) – More than one-third of patients develop a mental health and/or neurological condition six months after they’ve had COVID-19, according to a new study. Researchers from Oxford University looked at more than 236,000 post-COVID patients — mostly from the U.S., and found 34 percent had been diagnosed with a psychiatric or neurological condition half a year later.

Fourteen outcomes were identified; including ischaemic stroke, parkinsonism, Guillain-Barre syndrome, muscle disease, dementia, and several psychiatric conditions such as psychotic, mood and anxiety disorders. While the researchers could not identify a causal relationship between the symptoms and COVID-19, the very number of potentially-associated conditions could prove troublesome for the workers’ compensation system.

“This is one small study but a very alarming potential outcome that could have huge impact on workers’ compensation, SSDI and employee benefits,” said Mark Walls, VP of Communications and Strategic Analysis for Safety National, in a recent Twitter post.

The majority of COVID-19 workers’ compensation claims have been relatively small – often involving little or no medical treatment. At the other end of the spectrum have been a number of highly expensive claims for workers who are hospitalized and/or die. But there have been relatively few claims in the middle of that spectrum, and many industry stakeholders are concerned about whether that will develop.

“I’ve heard some people say we really don’t expect that to happen; if you look at past pandemics they tend to burn themselves out,” Walls said. “My concern is we’ve never had a global pandemic where the government has mandated it be covered under workers’ compensation. That to me is a game changer because there are lots of studies out there that show that the outcomes for workers’ compensation are worse than under group health for the same conditions, such as back or shoulder injuries, workers’ compensation consistently costs more for the same conditions. So along comes this pandemic and you can’t help but wonder will we see the same thing here?”

The Study

Writing in the Lancet Psychiatry journal, the researchers analyzed data from the TriNetX electronic health records network. The looked at patients who had a COVID-19 diagnoses and matched them with one group of patients diagnosed with influenza and another with patients who had respiratory tract infection – including influenza – in the same period.

“Among 236,379 patients diagnosed with COVID-19, the estimated incidence of a neurological or psychiatric diagnosis in the following 6 months was 33.62% with 12.84% receiving their first such diagnosis,” they wrote. The conditions were significantly more prevalent among the COVID-19 patients than those in either of the other two groups.

The researchers also looked at the incidence of symptoms in relation to the severity of COVID-19.

“Overall, COVID-19 was associated with increased risk of neurological and psychiatric outcomes, but the incidences and hazard ratios of these were greater in patients who had required hospitalisation, and markedly so in those who had required [ICU] admission or had developed encephalopathy, even after extensive propensity score matching for other factors (eg, age or previous cerebrovascular disease),” the study says. “However, the incidence and relative risk of neurological and psychiatric diagnoses were also increased even in patients with COVID-19 who did not require hospitalisation.”

Impact on WC

A concern among some in the workers’ compensation system is whether studies such as this will lead to a plethora of claims that may be unsubstantiated, yet presumed to be acceptable. They say some plaintiffs’ attorneys are already scrambling to figure out how to take advantage of the situation.

“I don’t think any of us would be surprised if next year we see ads on TV saying, ‘did you have COVID, are you experiencing these symptoms? Contact us,’” Walls said. “I’m hearing [claims] are already showing up on disability and SSDI.”

Studies such as this latest one raise significant questions, and create the potential for more development of these types of claims, he said. Workers who were diagnosed with COVID-19 and had little or no medical treatment could later claim their headaches, depression or other conditions were caused by the virus and file claims.

“Don’t be surprised if there’s litigation,” Walls said. “There is the potential for this to get much worse. There’s also the potential it just goes away … the bottom line is when you see a study like this it makes you pause.”

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