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Functional Neurological Disorder Following COVID-19: Results From a Large International Electronic Health Record
Rok Berlot1,2,3, Livia Asan1,4, Timothy R Nicholson5
1Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
European Journal of Neurology
|December 5, 2025
Summary
Functional neurological disorder (FND) is more common after COVID-19 than other respiratory infections. Disease severity and individual vulnerability are key factors in FND development post-COVID-19.
Area of Science:
- Neurology
- Infectious Diseases
- Psychiatry
Background:
- COVID-19 is linked to increased neurological and psychiatric issues.
- Viral illnesses can trigger functional neurological disorder (FND).
- Factors contributing to FND post-COVID-19 require further investigation.
Purpose of the Study:
- Compare FND rates after COVID-19 versus other respiratory tract infections (RTIs).
- Assess the impact of COVID-19 severity on FND incidence.
- Characterize patients newly diagnosed with FND post-COVID-19.
Main Methods:
- Retrospective cohort study using the TriNetX electronic health record network.
- Analyzed 2,740,094 COVID-19 cases and 1846 post-COVID-19 FND cases.
- Compared FND incidence between COVID-19 and RTIs, and across varying COVID-19 severity.
Main Results:
- FND incidence was higher in hospitalized COVID-19 patients (OR 2.165) and those with emergency visits (OR 1.412).
- FND rates were elevated post-COVID-19 compared to other RTIs (OR 1.555 in early pandemic, OR 1.394 later).
- Newly diagnosed post-COVID-19 FND patients had more medical, neurological, and psychiatric comorbidities than migraine patients.
Conclusions:
- New-onset FND is more probable following COVID-19 than other RTIs.
- Illness severity and pre-existing patient vulnerability influence FND development.
- Further research into FND mechanisms post-COVID-19 is warranted.
