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Long-term symptoms of anxiety and depression among individuals with severe COVID-19

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New findings in a study of almost 250 thousand individuals from six countries, including Iceland, indicates that long-term mental health of recovering COVID-19 patients may be determined by the severity of the acute COVID-19 infection. The study is conducted under the leadership of scientists at the Centre of Public Health Sciences, University of Iceland, and results were published today in The Lancet Public Health. 

The COVIDMENT collaboration includes scientists and research institutions from Iceland Denmark, Estonia, Norway, Sweden, and the UK with the overarching aim to advance current understanding of the impact of the COVID-19 pandemic on population mental health as well as within particular risk groups such as those diagnosed with COVID-19.  

The study that was published yesterday, is based on extensive cohort studies within the six participating countries incorporating almost 250 thousand individuals that responded to questionnaires on mental health symptoms, including almost 10 thousand individuals diagnosed with COVID-19 until August 2021, or up to 16 months post diagnosis.

The results show that the overall prevalence of symptoms of depression and low sleep quality was somewhat higher among individuals diagnosed with COVID-19.  Yet, the prevalence of symptoms varied considerably according to the severity of the acute COVID-19 illness, i.e. the number of days bedridden due to the virus. Twenty-two percent of the individuals with COVID-19 were bedridden for one week or longer and the prevalence of anxiety and depression among these individuals was persistently 50-60% higher up to 16 months after diagnosis compared to those that had not been diagnosed with the disease. „Previous research has mostly focused on mental health of hospitalized COVID-19 patients and shorter follow-up after diagnosis. These findings indicate that the severity of the COVID-19 illness in the general population may be an important determinant of long-term mental health symptoms,“ says Ingibjörg Magnúsdóttir, doctoral student at the University of Iceland and first author of the study.

On the other hand, the results show that individuals with COVID-19 but never bedridden had somewhat lower prevalence of mental health symptoms than those not diagnosed with COVID-19. „It is possible that the completion of low- or asymptomatic COVID-19 infection results in a certain relief among these individuals that can now return to their normal lives. This may be one of the reasons for the lower prevalence of mental health symptoms observed in this group compared to the population still worried about being infected and, therefore, still reducing social interactions,“ says Unnur A. Valdimarsdóttir, professor and senior author of the paper.

In short, the results indicate that COVID-19 illness severity may be an important determinant of long-term mental health symptoms which calls for more studies and clinical vigilance of these symptoms among patients most severely affected during the acute phase of COVID-19. 

The article can be accessed at The Lancet Public Health website.

Further information on the COVIDMENT project.