Two studies have given insight into how COVID-19 symptoms are associated with the probability of subsequent depressive symptoms or psychiatric disorders.
The first study by researchers at Massachusetts General Hospital in Boston has found that some COVID-19 patients who suffer from prolonged symptoms after recovery, including anxiety, mood disorders, sleep problems, and fatigue, are also at a greater risk for depression.
The study looked at more than 3,900 Americans with prior COVID-19 illness surveyed through online questionnaires between May 2020 and January 2021. Participants were asked to indicate the presence or absence of specific symptoms and self-report the overall severity of COVID-19 infection. The participants then completed a screen for symptoms of depression with those scoring higher than 10 considered to be suffering from depressive symptoms. The average length of time since initial COVID-19 symptoms was four months.
A total of 2046 participants (52.4%) met the criteria for symptoms of major depressive disorder. The results of the study demonstrated that depressive symptoms were more prevalent in younger patients, men, and those who self-reported their COVID-19 infections to be more severe.
However the study’s authors acknowledge that they did not control participants for prior history of depressive episodes, so they cannot attribute these symptoms to new onset of depression or determine whether those with preexisting depressive symptoms could have a greater risk of contracting COVID-19.
The second study from the University of Oxford which looks more broadly at the development of psychiatric disorders including anxiety and depression post-COVID-19 diagnosis sheds some light on these questions. The study analyses the electronic health records of 69 million Americans, 62,354 of whom had a diagnosis of COVID-19. Nearly 6 percent of individuals diagnosed with COVID-19 developed a psychiatric disorder for the first time ever within 90 days, compared to 3.4 percent of patients who didn’t have COVID-19. Psychiatric diagnoses after recovering from COVID-19 were two times higher than being diagnosed with a psychiatric condition after recovering from influenza.
These numbers demonstrate the significant neuropsychiatric consequences of COVID-19 infection in some patients compared to other health events. In addition to this study, a report in the mainstream press from STAT cites that experts predict 1 in 3 patients recovering from COVID-19 could experience neurological or psychological after-effects of their infections.
Finally, patients with pre-existing psychiatric disorders were 65 percent more likely to be diagnosed with COVID-19. While this is just one study, the sample size is significant and highlights how psychiatric disorders like other chronic diseases such as obesity and diabetes can leave our population especially vulnerable to future epidemics and pandemics like COVID-19.
Both studies contribute to a growing body of evidence that implores us to consider the potential neuropsychiatric consequences of COVID-19 infection. Efforts should be made to establish a primary care doctor for patients who are diagnosed with COVID-19 who can guide them through all elements of the recovery process. Follow-up care for post-COVID-19 patients should include psychiatric screenings and pathways to treatment and care if patients develop symptoms of depression or another psychiatric disorder. The overall numbers in the second study could be higher due to the barriers in accessing care and treatment. We need to begin to build the mental health treatment infrastructure that will serve all the influx of patients who have developed one or more mental illnesses as a direct or indirect consequence of COVID-19.