COVID-19 survivors face more mental health risks a year later

As the COVID-19 pandemic has reached its third year, countless people have experienced varying degrees of uncertainty, isolation and mental health challenges. Now, those who have had COVID-19 have significantly higher odds of experiencing mental health problems, according to researchers at Washington University School of Medicine in St. Louis and the St. Louis Veterans Affairs Health System.

These disorders include anxiety, depression and suicidal ideation, opioid use disorder, illicit drug and alcohol use disorder, and sleep and cognitive impairment.

In a large comprehensive study of mental health outcomes in people infected with SARS-CoV-2, researchers found that the disorder was seen in both severely and mildly infected people within a year of recovering from the virus.

Overall, the study found that people with COVID-19 were more likely than people without the infection to develop mental health problems and lead to increased use of prescription medications to treat such problems, as well as increased risk of substance use disorders -- including opioids Drugs and non-opioid drugs such as alcohol and illegal drugs.

The findings about COVID-19 were published in BMJ on February 16, 2022

"We know from previous research and personal experience that the enormous challenges of the pandemic over the past two years have had a profound impact on our collective mental health," said Ziyad, senior author of the study and a clinical epidemiologist at the University of Washington. Dr. Al-Aly said, "Despite the suffering we've all suffered during the pandemic, people who have had COVID-19 are in a much worse state of mind. We need to acknowledge this reality and inflate into a greater spirit in these situations. Address these issues now, before the health crisis."

Since the pandemic began, more than 403 million people worldwide and 77 million people in the United States have been infected with the virus.

"From this perspective, COVID-19 infection likely contributed to more than 14.8 million new cases of mental health disorders globally and 2.8 million in the U.S.," Al-Aly noted. He referred to the study's Data - "Our calculations do not take into account the number of people who may be in the millions who suffer in silence due to mental health stigma or lack of resources or support. Additionally, we expect this problem to grow as cases appear to be increasing over time. Frankly, the scope of this mental health crisis is shocking, terrifying and sad. "

"Our goal is to provide a comprehensive analysis that will help improve our understanding of the long-term risks of mental health disorders in COVID-19 patients and guide their post-infection care," Al-Aly added, "so far To date, research on COVID-19 and mental health has been limited by up to 6 months of follow-up data and a narrow selection of mental health outcomes -- such as examining depression and anxiety, rather than substance use disorders."

The researchers analyzed de-identified medical records in a database maintained by the U.S. Department of Veterans Affairs, the nation's largest integrated health care system. The researchers created a controlled dataset that included health information for 153,848 adults who tested positive for COVID-19 sometime between March 1, 2020 and January 15, 2021 and were Survived the first 30 days of the disease. Few people in the study were vaccinated before they got COVID-19 because the vaccine had not been widely available until then.

Statistical modeling was used to compare the mental health outcomes of the COVID-19 dataset with two other groups of people who were not infected with the virus: a control group of more than 5.6 million patients who had not been infected with COVID-19 over the same time period; a A control group of more than 5.8 million people who were patients from March 2018 to January 2019, long before the pandemic began.

Most study participants were older white men. However, because of its size, the study also included more than 1.3 million women, more than 2.1 million black participants, and a large number of people of all ages.

Compared to controls without any infection, those infected with COVID-19 were 35% more likely to develop anxiety disorders and nearly 40% more likely to experience depression or stress-related illnesses that affect behavior and emotions. This coincides with a 55% increase in the use of antidepressants and a 65% increase in the use of benzodiazepines to treat anxiety.

Likewise, people who recovered from COVID-19 were 41% more likely to have sleep disturbances and 80% more likely to experience neurocognitive decline. The latter refers to forgetfulness, confusion, lack of focus and other impairments commonly known together as brain fog.

More worryingly, those with the virus were 34% more likely to have opioid use disorder, a non-opioid use involving alcohol or illicit drugs, compared to those without COVID-19 20% higher likelihood of obstacles. They were also 46 percent more likely to have suicidal thoughts.

Al-Aly said: “People need to know that if they have COVID-19 and are struggling mentally, they are not alone and they should seek immediate help and not be ashamed. It is critical that we recognize this now. One point, before the opioid crisis gets worse and we start losing more people to suicide, diagnosing it and addressing it."

In addition, he added: "Governments, public and private health insurance providers, and health systems need to be more aware of these issues to ensure we provide people with equitable resources for diagnosis and treatment."

To better understand whether the increased risk of mental health disorders is specific to the SARS-CoV-2 virus, the researchers also compared COVID-19 patients to 72,207 flu patients from October 2017 to February 2020, These included 11,924 hospitalized patients. Likewise, among those with mild and severe COVID-19 infections, the risk was significantly higher -- 27 percent and 45 percent.

"My hope is that this removes the claim that COVID-19 is like the flu, it's much more serious," Al-Aly said.

Because hospitalization can trigger anxiety, depression and other psychiatric conditions, the researchers compared people hospitalized with COVID-19 within the first 30 days of infection with those hospitalized for any other reason. People hospitalized with COVID-19 were 86 percent more likely to have a mental health disorder.

"Our findings suggest a specific link between SARS-Co-V-2 and mental health disorders," Al-Aly continued, "We're not sure why, but one of the main assumptions is that the virus can enter the brain , disrupting cellular and neuronal pathways that lead to mental health disorders...I am absolutely certain that urgent attention is needed to identify and treat COVID-19 survivors with mental health disorders."