Do people experience more anxiety, depression and distress after COVID?

A recent study posted to the medRxiv* preprint server analyzed mental health outcomes after the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. 

Study: Mental health outcomes following COVID-19 infection: Evidence from 11 UK longitudinal population studies. Image Credit: Danielala / ShutterstockStudy: Mental health outcomes following COVID-19 infection: Evidence from 11 UK longitudinal population studies. Image Credit: Danielala / Shutterstock

Background

SARS-CoV-2 infection could lead to symptomatic or asymptomatic CoV disease 2019 (COVID-19). Following early proof from case reports and investigations of other severe CoV infections, mental illness is becoming more widely recognized as a possible complication of SARS-CoV-2 infection. Nevertheless, longitudinal research in this area is scarce, and few studies have attempted to separate the impacts of COVID-19 from the pandemic's broader mental health implications. As a result, the mental health effects of SARS-CoV-2 infection on the general public are yet unknown.

Notably, the existing longitudinal evidence on the link between SARS-CoV-2 infection and mental health is contradictory. Thus, more longitudinal studies are needed to explain the earlier mixed findings, assess the strength of any correlations, and determine if they are continued long-term after COVID-19.

About the study

In the current research, the scientists evaluated longitudinal connections between COVID-19 and mental health, taking into account 1) time after SARS-CoV-2 infection, 2) mental health before the pandemic, 3) mode of COVID-19 confirmation, and 4) subgroup variations.

The team examined the mental health repercussions of COVID-19 until April 2021 using data from 11 United Kingdom (UK) longitudinal analyses. First, they assessed whether those who have self-reported COVID-19 had higher degrees of psychological distress, anxiety, depression, and inferior life satisfaction than people without SARS-CoV-2 infection. Further, the investigators explored whether relationships changed depending on the time following COVID-19 to evaluate if the effects lasted over the acute disease stage.

In addition, the team analyzed whether there were differences in correlations based on gender, age, education, pre-pandemic mental health, and ethnicity. Furthermore, they evaluated whether SARS-CoV-2 infection and mental health were associated differently in those who had 1) suspected versus test-confirmed COVID-19 and 2) self-reported versus serology-detected SARS-CoV-2 infection.

The team unified continuous mental health measures within each trial over time using information from 11 UK longitudinal investigations encompassing 54,442 subjects and two to eight repeated measurements of COVID-19 and mental health from April 2020 to April 2021. They analyzed the correlations between mental health and test-confirmed, self-reported, or serology-confirmed COVID-19 employing multilevel generalized estimating equations (GEE). Further, random-effects meta-analyses combined effect sizes.

Results and discussions

According to the study results, COVID-19 was linked to a decline in mental health outcomes among the UK population. The findings showed links between COVID-19 and mental health worsening despite adjusting for general effects of timing during the initial year of the pandemic, contributing to the mixed data that had previously been available. The authors found no modification in this connection in the initial few months after SARS-CoV-2 infection. 

There were no disparities in ethnicity, sex, pre-pandemic mental health, or education in subgroup analysis, whereas correlations were higher in the elderly population. Although SARS-CoV-2 infection was linked to poor mental health in people of all ages, some data suggested that the correlations were higher in those aged ≥50 years. 

The team found identical relationships for both confirmed and suspected COVID-19 with mental health outcomes, implying that the connections might be linked to disease experience rather than virus exposure, emphasizing the importance of psychosocial processes. Self-reported COVID-19 paired with either positive or negative serology was linked with poor mental health.

On the other hand, positive serology lacking self-reported SARS-CoV-2 infection was not correlated to worse mental health. Likewise, the scientists found no indication of variations in mental health outcomes between those with negative and positive serology in another exploratory analysis.

Conclusions

Overall, the study findings demonstrated that COVID-19 self-reporting was associated with a decline in life satisfaction and mental health over time. The confined attenuation in the association between COVID-19 and mental health outcomes over time since infection and results from serology-confirmed COVID-19 suggested that the observed impacts may not be specific to SARS-CoV-2 infection. On the contrary, they might represent the mental health consequences of COVID-19 during the pandemic, or other variables might justify them. 

The team mentioned that long-term studies investigating recovery in SARS-CoV-2-associated mental health problems were needed to determine the length of symptoms encountered after COVID-19. Moreover, the authors stated that given the high incidence of SARS-CoV-2 infections in the UK and globally, the current findings have significant implications for mental health care provision.

*Important notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Journal reference:
  • Mental health outcomes following COVID-19 infection: Evidence from 11 UK longitudinal population studies; Ellen J Thompson, Jean Stafford, Bettina Moltrecht, Charlotte F Huggins, Alex S F Kwong, Richard J Shaw, Paola Zaninotto, Kishan Patel, Richard J Silverwood, Eoin McElroy, Matthias Pierce, Michael J Green, Ruth Bowyer, Jane Maddock, Kate Tilling, Srinivasa Vittal Katikireddi, George B Ploubidis, Professor D Porteous, Nicholas J Timpson, Nish Chaturvedi, Claire Steves, Praveetha Patalay. medRxiv preprint 2022. DOI: https://doi.org/10.1101/2022.05.11.22274964, https://www.medrxiv.org/content/10.1101/2022.05.11.22274964v1
Shanet Susan Alex

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Shanet Susan Alex

Shanet Susan Alex, a medical writer, based in Kerala, India, is a Doctor of Pharmacy graduate from Kerala University of Health Sciences. Her academic background is in clinical pharmacy and research, and she is passionate about medical writing. Shanet has published papers in the International Journal of Medical Science and Current Research (IJMSCR), the International Journal of Pharmacy (IJP), and the International Journal of Medical Science and Applied Research (IJMSAR). Apart from work, she enjoys listening to music and watching movies.

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