A study found that serious COVID-19 illness is linked to an increase in the risk of long-term adverse mental health implications, such as depression and anxiety.
The study, published in The Lancet Public Health journal on Tuesday (15 March) looked at symptom-prevalence of depression, anxiety, COVID-19 related distress, and poor sleep quality among people with and without COVID-19 diagnosis.
The analysis, including almost 250,000 individuals across Denmark, Estonia, Iceland, Norway, Sweden, and the UK, found that acute COVID-19 illness severity was associated with mental morbidities up to 16 months after diagnosis. Additionally, the researchers found that the mental health burden was stronger for those never infected than those with mild symptoms.
Study author Unnur Anna Valdimarsdóttir, professor of the University of Iceland, said: “It suggests that mental health effects aren’t equal for all COVID-19 patients and that time spent bedridden is a key factor in determining the severity of the impacts on mental health.”
Bedridden patients were mostly affected
Patients who were bedridden for seven days or more had higher rates of depression and anxiety, compared to people who were infected but never bedridden.
Additionally, despite most mental health symptoms among recovering COVID-19 patients subsiding within two months after diagnosis, bedridden patients were more likely to experience depression and anxiety over the whole 16-month study period. Over this time, patients who were bedridden for seven days or more continued to be 50-60% more likely to experience higher depression and anxiety compared to people never infected.
Co-author Ingibjörg Magnúsdóttir, a researcher at the University of Iceland, explained that “the higher occurrence of depression and anxiety among patients with COVID-19 who spent seven days or longer bedridden could be due to a combination of worrying about long-term health effects as well as the persistence of physical long COVID symptoms well beyond the illness that limit social contact and may result in a sense of helplessness”.
She added that “equally, inflammatory responses among patients with a severe diagnosis may contribute to more persistent mental health symptoms”.
Mental health of not infected individuals
“In contrast, the fact that individuals with a mild COVID-19 infection can return to normal lives sooner and only experience a benign infection likely contributes to the lower risk of negative mental health effects we observed,” Magnúsdóttir said.
Moreover, patients with a mild COVID-19 infection turned out to be less likely to experience symptoms of depression and anxiety in comparison to those who were not diagnosed with COVID-19 at all.
The authors state that one explanation for this could be that after the mild illness people could return to normal lives while those still not infected were still anxious about the risk of infection and social isolation burden.
Valdimarsdóttir concluded that “as we enter the third year of the pandemic, increased clinical vigilance of adverse mental health among the proportion of patients with a severe acute disease of COVID-19 and follow-up studies beyond the first year after infections are critical to ensure timely access to care.”
[Edited by Nathalie Weatherald]