Tackling mental health disorders among people who had recovered from COVID-19 should be a priority, a US study published today has said.
The new research, conducted by a team in St Louis, Missouri, found that COVID-19 is associated with an increased risk of mental health disorders, including anxiety, depression, substance use, and sleep disorders, up to one year after initial infection.
The findings, published in the latest edition of *The BMJ*, follow previous studies that tracked patients up to six months but only included only a small selection of mental health outcomes.
The research team, led by the Clinical Epidemiology Center, Research and Development Service, VA Saint Louis Health Care System, used data from the US Department of Veterans Affairs national healthcare databases to estimate the risks of mental health outcomes in people who survived at least 30 days after a positive PCR test result between March 2020 and January 2021.
They identified data for 153,848 individuals and matched them to two control groups without COVID-19: 5,637,840 contemporary controls and 5,859,251 historical controls who predated the pandemic.
Most participants were white men with an average age of 63 years.
The COVID-19 group was split into two groups – those who were admitted to hospital during the acute phase of infection and those who were not. Information was collected on potentially influential factors, such as age, race, sex, lifestyle, and medical history.
The COVID-19 and control groups were followed for one year to estimate the risks of prespecified mental health outcomes, including anxiety, depression and stress disorders, substance use disorders, neurocognitive decline, and sleep disorders.
Compared with the non-infected control group, people with COVID-19 had a 60% higher risk of any mental health diagnosis or prescription at one year, which was equivalent to an additional 64 per 1,000 people.
When the mental health disorders were examined separately, they found COVID-19 was associated with an additional 24 per 1,000 people with sleep disorders at one year; 15 per 1,000 with depressive disorders; 11 per 1,000 with neurocognitive decline; and four per 1,000 with any non-opioid substance use disorders.
Similar results were found when the COVID-19 group was compared with the historical control group.
The risks were highest in people admitted to hospital during the acute phase, but were evident even among those who were not admitted to hospital.
Individuals who had had COVID-19 were at higher risk of mental health disorders than people with seasonal influenza, while people admitted to hospital for COVID-19 had increased risks of mental health disorders compared with those admitted to hospital for any other reason.
Although this was an observational study that included mostly older white men, which means results may not apply to other groups, the research team say their findings suggest that people who survive the acute phase of COVID-19 have an increased risk of incident mental health disorders.
They add this should be tackled as a priority.
Xie Y, Xu E, Al-Aly Z. Risks of mental health outcomes in people with covid-19: cohort study
Editorial: Mental health after covid-19. *The BMJ*. February 2022. doi: 10.1136/bmj-2021-068993
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