Exposure to phenytoin associates with a lower risk of post-COVID cognitive deficits: a cohort study
Post-COVID cognitive deficits (often referred to as ‘brain fog’) are common and have large impacts on patients’ level of functioning. No specific intervention exists to mitigate this burden. <br> This study tested the hypothesis, inspired by recent experimental research, that post-COVID cognit...
| Main Authors: | , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Oxford University Press
2022
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| _version_ | 1797108175470592000 |
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| author | Taquet, M Harrison, PJ |
| author_facet | Taquet, M Harrison, PJ |
| author_sort | Taquet, M |
| collection | OXFORD |
| description | Post-COVID cognitive deficits (often referred to as ‘brain fog’) are common and have large impacts on patients’ level of functioning. No specific intervention exists to mitigate this burden.
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This study tested the hypothesis, inspired by recent experimental research, that post-COVID cognitive deficits can be prevented by inhibiting receptor-interacting protein kinase. Using electronic health record data, we compared the cognitive outcomes of propensity score-matched cohorts of patients with epilepsy taking phenytoin (a commonly used receptor-interacting protein kinase inhibitor) versus valproate or levetiracetam at the time of COVID-19 diagnosis. Patients taking phenytoin at the time of COVID-19 were at a significantly lower risk of cognitive deficits in the 6 months after COVID-19 infection than a matched cohort of patients receiving levetiracetam (hazard ratio 0.78, 95% confidence interval 0.63–0.97, P = 0.024) or valproate (hazard ratio 0.73, 95% confidence interval 0.58–0.93, P = 0.011). In secondary analyses, results were robust when controlling for subtype of epilepsy, and showed specificity to cognitive deficits in that similar associations were not seen with other ‘long-COVID’ outcomes such as persistent breathlessness or pain. These findings provide pharmacoepidemiological support for the hypothesis that receptor-interacting protein kinase signaling is involved in post-COVID cognitive deficits. These results should prompt empirical investigations of receptor-interacting protein kinase inhibitors in the prevention of post-COVID cognitive deficits. |
| first_indexed | 2024-03-07T07:25:49Z |
| format | Journal article |
| id | oxford-uuid:7cecc795-4f84-4333-9999-4955ca4cddea |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:25:49Z |
| publishDate | 2022 |
| publisher | Oxford University Press |
| record_format | dspace |
| spelling | oxford-uuid:7cecc795-4f84-4333-9999-4955ca4cddea2022-11-11T18:47:30ZExposure to phenytoin associates with a lower risk of post-COVID cognitive deficits: a cohort studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:7cecc795-4f84-4333-9999-4955ca4cddeaEnglishSymplectic ElementsOxford University Press2022Taquet, MHarrison, PJPost-COVID cognitive deficits (often referred to as ‘brain fog’) are common and have large impacts on patients’ level of functioning. No specific intervention exists to mitigate this burden. <br> This study tested the hypothesis, inspired by recent experimental research, that post-COVID cognitive deficits can be prevented by inhibiting receptor-interacting protein kinase. Using electronic health record data, we compared the cognitive outcomes of propensity score-matched cohorts of patients with epilepsy taking phenytoin (a commonly used receptor-interacting protein kinase inhibitor) versus valproate or levetiracetam at the time of COVID-19 diagnosis. Patients taking phenytoin at the time of COVID-19 were at a significantly lower risk of cognitive deficits in the 6 months after COVID-19 infection than a matched cohort of patients receiving levetiracetam (hazard ratio 0.78, 95% confidence interval 0.63–0.97, P = 0.024) or valproate (hazard ratio 0.73, 95% confidence interval 0.58–0.93, P = 0.011). In secondary analyses, results were robust when controlling for subtype of epilepsy, and showed specificity to cognitive deficits in that similar associations were not seen with other ‘long-COVID’ outcomes such as persistent breathlessness or pain. These findings provide pharmacoepidemiological support for the hypothesis that receptor-interacting protein kinase signaling is involved in post-COVID cognitive deficits. These results should prompt empirical investigations of receptor-interacting protein kinase inhibitors in the prevention of post-COVID cognitive deficits. |
| spellingShingle | Taquet, M Harrison, PJ Exposure to phenytoin associates with a lower risk of post-COVID cognitive deficits: a cohort study |
| title | Exposure to phenytoin associates with a lower risk of post-COVID cognitive deficits: a cohort study |
| title_full | Exposure to phenytoin associates with a lower risk of post-COVID cognitive deficits: a cohort study |
| title_fullStr | Exposure to phenytoin associates with a lower risk of post-COVID cognitive deficits: a cohort study |
| title_full_unstemmed | Exposure to phenytoin associates with a lower risk of post-COVID cognitive deficits: a cohort study |
| title_short | Exposure to phenytoin associates with a lower risk of post-COVID cognitive deficits: a cohort study |
| title_sort | exposure to phenytoin associates with a lower risk of post covid cognitive deficits a cohort study |
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