Long-term Impact of Invasive Meningococcal Disease in Australian Adolescents and Young Adults

BACKGROUND: Limited data exist on the long-term impact of invasive meningococcal disease (IMD) contracted during adolescence and early adulthood. This study aimed to determine the long-term outcomes on neurocognitive, psychological and quality of life (QoL) outcomes in adolescents and young adults. METHODS: IMD survivors 15-25 years old (2-10 years post-IMD hospitalization) and non-IMD age-matched control participants were recruited across mainland Australian states (2016-2023) and completed neurocognitive, psychological, QoL and physical assessments. RESULTS: A total of 41 IMD cases (93% serogroup B and 73% females) and 51 control participants (57% females) were enrolled in the study. There was no clinically significant difference in Full-Scale IQ between IMD cases (106, SD 11) and control participants [109, SD 14, adjusted difference -4, (95% confidence interval, -10 to 3), P = 0.2]. Mean QoL scores for IMD cases (0.80, SD 0.21) and control participants (0.90, SD 0.09) were similar [adjusted difference -0.06, (95% confidence interval, -0.13 to 0.02), P = 0.2]. Mathematical reasoning was poorer in cases than in controls ( P = 0.02). IMD cases had significantly higher rates of psychological symptoms than controls (58% vs. 31%, P = 0.01), including posttraumatic stress disorder symptoms (10% vs. 0%, P = 0.03) and alcohol dependence (18% vs. 2%, P = 0.04). Physician-assessed physical sequelae were present in 15% of IMD survivors (50% severe). CONCLUSIONS: While long-term outcomes for adolescents and young adult IMD survivors show no significant impact on intellectual functioning or overall QoL, they experienced substantial psychological and physical sequelae. The impact on mental health underscores the need for comprehensive postdischarge psychological follow-up and care for IMD survivors, in addition to care for physical sequelae.