We investigated whether SARS-CoV-2 infection is associated with short- and long-term neuropsychiatric sequelae. We used population-based cohorts from the Korean nationwide cohort (discovery; n = 10,027,506) and the Japanese claims-based cohort (validation; n = 12,218,680) to estimate the short-term (<30 days) and long-term (≥30 days) risks of neuropsychiatric outcomes after SARS-CoV-2 infection compared with general population groups or external comparators (people with another respiratory infection). Using exposure-driven propensity score matching, we found that both the short- and long-term risks of developing neuropsychiatric sequelae were elevated in the discovery cohort compared with the general population and those with another respiratory infection. A range of conditions including Guillain-Barré syndrome, cognitive deficit, insomnia, anxiety disorder, encephalitis, ischaemic stroke and mood disorder exhibited a pronounced increase in long-term risk. Factors such as mild severity of COVID-19, increased vaccination against COVID-19 and heterologous vaccination were associated with reduced long-term risk of adverse neuropsychiatric outcomes. The time attenuation effect was the strongest during the first six months after SARS-CoV-2 infection, and this risk remained statistically significant for up to one year in Korea but beyond one year in Japan. The associations observed were replicated in the validation cohort. Our findings contribute to the growing evidence base on long COVID by considering ethnic diversity.

我们研究了 SARS-CoV-2 感染是否与短期和长期神经精神后遗症相关。我们使用来自韩国全国队列（发现；n = 10,027,506）和日本基于索赔的队列（验证；n = 12,218,680）的基于人群的队列来估计短期（<30 天）和长期（≥30 天）天）与普通人群或外部比较者（患有另一种呼吸道感染的人）相比，SARS-CoV-2感染后神经精神结果的风险。使用暴露驱动的倾向评分匹配，我们发现与一般人群和患有其他呼吸道感染的人群相比，发现队列中发生神经精神后遗症的短期和长期风险均升高。格林-巴利综合征、认知缺陷、失眠、焦虑症、脑炎、缺血性中风和情绪障碍等一系列疾病的长期风险显着增加。 COVID-19 的轻度严重程度、增加针对 COVID-19 的疫苗接种和异源疫苗接种等因素与不良神经精神结局的长期风险降低相关。时间衰减效应在 SARS-CoV-2 感染后的前六个月内最强，这种风险在韩国长达一年内保持统计显着性，但在日本则超过一年。观察到的关联在验证队列中得到了重复。通过考虑种族多样性，我们的研究结果为长期新冠肺炎的证据基础做出了贡献。