The neurologic manifestations of acute COVID-19 are well characterized, but a comprehensive evaluation of postacute neurologic sequelae at 1 year has not been undertaken. Here we use the national healthcare databases of the US Department of Veterans Affairs to build a cohort of 154,068 individuals with COVID-19, 5,638,795 contemporary controls and 5,859,621 historical controls; we use inverse probability weighting to balance the cohorts, and estimate risks and burdens of incident neurologic disorders at 12 months following acute SARS-CoV-2 infection. Our results show that in the postacute phase of COVID-19, there was increased risk of an array of incident neurologic sequelae including ischemic and hemorrhagic stroke, cognition and memory disorders, peripheral nervous system disorders, episodic disorders (for example, migraine and seizures), extrapyramidal and movement disorders, mental health disorders, musculoskeletal disorders, sensory disorders, Guillain–Barré syndrome, and encephalitis or encephalopathy. We estimated that the hazard ratio of any neurologic sequela was 1.42 (95% confidence intervals 1.38, 1.47) and burden 70.69 (95% confidence intervals 63.54, 78.01) per 1,000 persons at 12 months. The risks and burdens were elevated even in people who did not require hospitalization during acute COVID-19. Limitations include a cohort comprising mostly White males. Taken together, our results provide evidence of increased risk of long-term neurologic disorders in people who had COVID-19.

急性 COVID-19 的神经系统表现具有很好的特征，但尚未对 1 年的急性神经系统后遗症进行综合评估。在这里，我们使用美国退伍军人事务部的国家医疗保健数据库建立了一个队列，其中包含 154,068 名 COVID-19 患者、5,638,795 名当代对照和 5,859,621 名历史对照；我们使用逆概率加权来平衡队列，并估计急性 SARS-CoV-2 感染后 12 个月内发生神经系统疾病的风险和负担。我们的研究结果表明，在 COVID-19 的急性后期，发生一系列神经系统后遗症的风险增加，包括缺血性和出血性中风、认知和记忆障碍、周围神经系统障碍、发作性疾病（例如偏头痛和癫痫发作） , 锥体外系和运动障碍、精神健康障碍、肌肉骨骼疾病、感觉障碍、格林-巴利综合征和脑炎或脑病。我们估计在 12 个月时每 1,000 人的任何神经系统后遗症的风险比为 1.42（95% 置信区间 1.38，1.47）和负担 70.69（95% 置信区间 63.54，78.01）。即使在急性 COVID-19 期间不需要住院的人群中，风险和负担也会增加。局限性包括主要由白人男性组成的队列。综上所述，我们的结果提供了证据，证明 COVID-19 患者患长期神经系统疾病的风险增加。我们估计在 12 个月时每 1,000 人的任何神经系统后遗症的风险比为 1.42（95% 置信区间 1.38，1.47）和负担 70.69（95% 置信区间 63.54，78.01）。即使在急性 COVID-19 期间不需要住院的人群中，风险和负担也会增加。局限性包括主要由白人男性组成的队列。综上所述，我们的结果提供了证据，证明 COVID-19 患者患长期神经系统疾病的风险增加。我们估计在 12 个月时每 1,000 人的任何神经系统后遗症的风险比为 1.42（95% 置信区间 1.38，1.47）和负担 70.69（95% 置信区间 63.54，78.01）。即使在急性 COVID-19 期间不需要住院的人群中，风险和负担也会增加。局限性包括主要由白人男性组成的队列。综上所述，我们的结果提供了证据，证明 COVID-19 患者患长期神经系统疾病的风险增加。