Persistent mental health issues 16 months post severe COVID-19 illness

A large new study offers the first investigation of persistent mental health problems in non-hospitalized COVID-19 patients up to 16 months after an initial infection. The findings reveal that COVID-19 led to an increased risk of depression and anxiety after acute illness if the illness was severe enough to keep patients bedridden for more than seven days.

“Our research is one of the first to explore mental health symptoms after severe COVID-19 illness in the general population up to 16 months after diagnosis,” explained Unnur Anna Valdimarsdóttir, an author of the new study. “It suggests that mental health effects are not the same for all COVID-19 patients and that time spent bedridden is a key factor in determining the severity of mental health impacts.”

The study analyzed data from almost 250,000 people in Sweden, Iceland, Denmark, Estonia, Norway and the United Kingdom. Just under 10,000 of them received a positive diagnosis of COVID-19 and the researchers were more interested in tracking persistent symptoms of depression, anxiety, COVID. Distress related to -19 and poor sleep quality.

Overall, the study found that COVID-19 led to an 18 percent increase in the prevalence of depression and a 13 percent increase in poor sleep quality compared to a cohort of people with no history of SARS infection. -CoV-2. Rates of COVID-related anxiety or distress were generally similar between the infected and uninfected cohorts.

The study also found that the severity of the initial illness was significantly correlated with the persistence of mental health problems. About a quarter of people with COVID-19 experienced illness severe enough to keep them bedridden for seven days or more. Anxiety and depression were up to 60 percent more common in those who were bedridden for a week because of COVID-19 compared to the uninfected control group.

Those with mild or asymptomatic COVID-19 were observed to recover quickly from any signs of mental health distress within one to two months of their acute illness. Interestingly, long-term follow-up found that those mild or asymptomatic cases ultimately showed a lower prevalence of mental health symptoms compared to the uninfected cohort. Co-senior author Fang Fang, from the Karolinska Institute, hypothesizes that this finding might be supported by a sense of relief in those who only experience a mild infection.

“It is possible that the termination of the COVID-19 infection with low or asymptomatic symptoms will result in some relief among these people who can now return to their normal lives,” Fang said. “This could be one of the reasons for the lower prevalence of mental health symptoms seen in this group relative to those in the population who are still concerned about being infected and thus avoid social interactions.”

The researchers indicate that it is also possible that pre-existing psychological and physiological vulnerabilities contribute to both the severity of acute COVID-19 and the persistence of mental health problems. As co-author Aniko Lovik pointed out, the study findings are likely due to some sort of combination of inflammation brought on by coronavirus infection and psychological worries or anxieties.

“While we cannot fully explain these associations, some contributing factors may be a combination of concern about long-term health effects and the persistence of physical symptoms that limit social contact and fuel a sense of helplessness,” Lovik said. . “It is also possible that severe COVID-19 triggers inflammatory processes that have previously been linked to an increased risk of mental health problems.”

The new findings follow another recent study looking at persistent mental health problems in 150,000 US patients with COVID-19 up to one year after initial infection. That study also found that patients with COVID-19 were 50 percent more likely to experience mental health problems compared to those without COVID.

Co-author of the new study, Unnur Anna Valdimarsdóttir, said that although these findings indicate that mild cases of COVID-19 are unlikely to experience long-term persistent mental health problems, doctors and patients need to remain vigilant as researchers continue. understanding the chronic effects of this new disease

“As we enter the third year of the pandemic, increased clinical surveillance of adverse mental health among the proportion of patients with severe acute illness from COVID-19 and follow-up studies beyond the first year after infections are fundamental to guarantee timely access to care,” added Valdimarsdóttir.

The new study was published in the journal The Lancet Public Health.

Sources: Karolinska Institute, the lancet