A retrospective multicohort study using propensity score matching examined 2-year risks of 14 psychiatric and neurologic disorders in patients hospitalized with infections across 10 body systems and 4 age groups (2014–2018), comparing them to patients hospitalized for non-infectious causes and to the general population, using data from 62 US health care organizations.
Infections were associated with increased risk across nearly all disorder-infection combinations (116 of 140 tests had RMTL ratio >1). The highest relative risk was for encephalitis (e.g., cardiac infections: RMTL ratio 6.54; 95% CI, 3.78–11.31); the largest absolute risk difference was for cognitive deficits (e.g., cardiac infections: 19.08% vs 6.71%, difference 12.37%). Infectious encephalitides ranked as the top risk factor for 7 of 14 disorders and top 3 for 12 of 14. Children showed increased risks but with significantly lower absolute risk differences than adults.
Retrospective observational design limits causal inference. Outcomes relied on diagnostic codes from electronic health records, which may undercount or misclassify psychiatric and neurologic diagnoses. The study could not fully adjust for unmeasured confounders despite propensity score matching.
Clinicians should monitor patients of all ages who are hospitalized with any infection for emerging psychiatric and neurologic symptoms over the following 2 years, with heightened vigilance for encephalitis and cognitive deficits—especially in adults. Infectious encephalitis carries the broadest and greatest excess risk for brain health conditions and warrants particularly close follow-up.
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