COVID-19 survivors face increased mental health risks up to a year on from their infection, new research has revealed.
As the COVID-19 pandemic stretches into its third year, countless people have experienced varying degrees of uncertainty, isolation and psychological challenges.
However, those who have had COVID-19 have a significantly higher chance of experiencing mental health problems, according to researchers at Washington University School of Medicine in St. Louis and the Veterans Affairs St. Louis Health Care System.
Overall, the study found that people who had COVID-19 were 60 per cent more likely to suffer from mental health problems than those who were not infected.
Such disorders include anxiety, depression, and suicide ideation, as well as opioid use disorder, illicit drug and alcohol use disorders, and disturbances in sleep and cognition.
In a large, comprehensive study of mental health outcomes in people with SARS-CoV-2 infections, researchers found that such disorders arose within a year after recovery from the virus in people who had serious as well as mild infections.
“We know from previous studies and personal experiences that the immense challenges of the past two years of the pandemic have had a profound effect on our collective mental health,” said senior author Ziyad Al-Aly, MD, a clinical epidemiologist at Washington University.
“But while we’ve all suffered during the pandemic, people who have had COVID-19 fare far worse mentally. We need to acknowledge this reality and address these conditions now before they balloon into a much larger mental health crisis.”
Compared with those in the control groups without any infections, people who contracted COVID-19 were 35 per cent more likely to suffer from anxiety disorders and nearly 40 per cent more likely to experience depression or stress-related disorders that can affect behaviour and emotions.
This coincided with a 55 per cent increase in the use of antidepressants and a 65 per cent growth in the use of benzodiazepines to treat anxiety.
Similarly, people who had recovered from COVID-19 were 41 per cent more likely to have sleep disorders and 80 per cent more likely to experience neurocognitive decline, which includes forgetfulness, confusion, a lack of focus, and other impairments commonly known together as ‘brain fog’.
Compared with people without COVID-19, those infected with the virus were 34 per cent more likely to develop opioid use disorders and 20 per cent more likely to develop nonopioid substance use disorders involving alcohol or illegal drugs. They were also 46 per cent more likely to have suicidal thoughts.
“Our findings suggest a specific link between SARS-Co-V-2 and mental health disorders,” Dr Al-Aly continued.
“We’re not certain why this is, but one of the leading hypotheses is that the virus can enter the brain and disturb cellular and neuron pathways, leading to mental health disorders.
“What I’m absolutely certain about is that urgent attention is needed to identify and treat COVID-19 survivors with mental health disorders.”
More than 403 million people globally have been infected with the virus since the pandemic started.
“To put this in perspective, COVID-19 infections likely have contributed to more than 14.8million new cases of mental health disorders worldwide and 2.8million in the U.S.,” Dr Al-Aly said, referring to data from the study.
“Our calculations do not account for the untold number of people, likely in the millions, who suffer in silence due to mental health stigma or a lack of resources or support.
“Further, we expect the problem to grow because cases seem to be increasing over time. Frankly, the scope of this mental health crisis is jarring, frightful and sad.
“Our goal was to provide a comprehensive analysis that will help improve our understanding of the long-term risk of mental health disorders in people with COVID-19 and guide their post-infection health care.
“To date, studies on COVID-19 and mental health have been limited by a maximum of six months of follow-up data and by a narrow selection of mental health outcomes — for example, examining depression and anxiety but not substance use disorders.”
The researchers analysed de-identified medical records in a database maintained by the U.S. Department of Veterans Affairs, the nation’s largest integrated health-care delivery system and created a controlled dataset that included health information of 153,848 adults who had tested positive for COVID-19 sometime from March 1, 2020, through Jan. 15, 2021, and who had survived the first 30 days of the disease.
Few people in the study were vaccinated prior to developing COVID-19, as vaccines were not yet widely available at the time of enrolment.
Statistical modelling was used to compare mental health outcomes in the COVID-19 dataset with two other groups of people not infected with the virus: a control group of more than 5.6million patients who did not have COVID-19 during the same time frame; and a control group of more than 5.8million people who were patients from March 2018 through January 2019, well before the pandemic began.
The majority of study participants were older white males. However, because of its large size, the study included more than 1.3million females, more than 2.1million black participants, and large numbers of people of various ages.
“People need to know that if they have had COVID-19 and are struggling mentally, they’re not alone, and they should seek help immediately and without shame,” Dr Al-Aly said.
“It’s critical that we recognise this now, diagnose it and address it before the opioid crisis snowballs and we start losing more people to suicide.
“There needs to be greater recognition of these issues by governments, public and private health insurance providers, and health systems to ensure that we offer people equitable access to resources for diagnosis and treatment,” he added.
