TY - JOUR
T1 - Acute COVID-19 severity and mental health morbidity trajectories in patient populations of six nations
T2 - an observational study
AU - Magnúsdóttir, Ingibjörg
AU - Lovik, Anikó
AU - Unnarsdóttir, Anna Bára
AU - McCartney, Daniel
AU - Ask, Helga
AU - Kõiv, Kadri
AU - Christoffersen, Lea Arregui Nordahl
AU - Johnson, Sverre Urnes
AU - Hauksdóttir, Arna
AU - Fawns-Ritchie, Chloe
AU - Helenius, Dorte
AU - González-Hijón, Juan
AU - Lu, Li
AU - Ebrahimi, Omid V.
AU - Hoffart, Asle
AU - Porteous, David J.
AU - Fang, Fang
AU - Jakobsdóttir, Jóhanna
AU - Lehto, Kelli
AU - Andreassen, Ole A.
AU - Pedersen, Ole B.V.
AU - Aspelund, Thor
AU - Valdimarsdóttir, Unnur Anna
N1 - Publisher Copyright:
Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.
This work was primarily supported with grants from Nordforsk (CovidMent, 105668) and Horizon2020 (CoMorMent, 847776). HA was supported by the Research Council of Norway (RCN 324 620), the MoBa COVID-19 data collection was supported by RCN (312 721), and OAA was supported by RCN (273 291, 223 273). Generation Scotland received core support from the Chief Scientist Office of the Scottish Government Health Directorates (CZD/16/6) and the Scottish Funding Council (HR03006) and is currently supported by the Wellcome Trust
(216767/Z/19/Z). Recruitment to the CovidLife study was facilitated by SHARE—the Scottish Health Research Register and Biobank. DBDS data collection was funded by the Independent Research Fund Denmark (0214-00127B). SHARE is supported by NHS Research Scotland, the Universities of Scotland and the Chief Scientist Office of the Scottish Government. The research in the Estonian Biobank was supported by the EU through the European Regional Development Fund
(project number 2014-2020.4.01.15-0012), and the Estonian Research Council through grant number PSG615, the programme Mobilitas Pluss (MOBTP142), funding of Estonian subproject of NordForsk project number 105668, and National Programme for Addressing Socio-Economic Challenges through Research and Development (RITA), supported by the Estonian Government and European Regional Development Fund (RITA1/02-112).
PY - 2022/5
Y1 - 2022/5
N2 - Background: Long-term mental and physical health consequences of COVID-19 (long COVID) are a persistent public health concern. Little is still known about the long-term mental health of non-hospitalised patients with COVID-19 with varying illness severities. Our aim was to assess the prevalence of adverse mental health symptoms among individuals diagnosed with COVID-19 in the general population by acute infection severity up to 16 months after diagnosis. Methods: This observational follow-up study included seven prospectively planned cohorts across six countries (Denmark, Estonia, Iceland, Norway, Sweden, and the UK). Participants were recruited from March 27, 2020, to Aug 13, 2021. Individuals aged 18 years or older were eligible to participate. In a cross-sectional analysis, we contrasted symptom prevalence of depression, anxiety, COVID-19-related distress, and poor sleep quality (screened with validated mental health instruments) among individuals with and without a diagnosis of COVID-19 at entry, 0-16 months from diagnosis. In a cohort analysis, we further used repeated measures to estimate the change in mental health symptoms before and after COVID-19 diagnosis. Findings: The analytical cohort consisted of 247 249 individuals, 9979 (4·0%) of whom were diagnosed with COVID-19 during the study period. Mean follow-up was 5·65 months (SD 4·26). Participants diagnosed with COVID-19 presented overall with a higher prevalence of symptoms of depression (prevalence ratio [PR] 1·18 [95% CI 1·03-1·36]) and poorer sleep quality (1·13 [1·03-1·24]) but not symptoms of anxiety (0·97 [0·91-1·03]) or COVID-19-related distress (1·05 [0·93-1·20]) compared with individuals without a COVID-19 diagnosis. Although the prevalence of depression and COVID-19-related distress attenuated with time, individuals diagnosed with COVID-19 but never bedridden due to their illness were consistently at lower risk of depression (PR 0·83 [95% CI 0·75-0·91]) and anxiety (0·77 [0·63-0·94]) than those not diagnosed with COVID-19, whereas patients who were bedridden for more than 7 days were persistently at higher risk of symptoms of depression (PR 1·61 [95% CI 1·27-2·05]) and anxiety (1·43 [1·26-1·63]) than those not diagnosed throughout the study period. Interpretation: Severe acute COVID-19 illness-indicated by extended time bedridden-is associated with long-term mental morbidity among recovering individuals in the general population. These findings call for increased vigilance of adverse mental health development among patients with a severe acute disease phase of COVID-19. Funding: Nordforsk, Horizon2020, Wellcome Trust, and Estonian Research Council.
AB - Background: Long-term mental and physical health consequences of COVID-19 (long COVID) are a persistent public health concern. Little is still known about the long-term mental health of non-hospitalised patients with COVID-19 with varying illness severities. Our aim was to assess the prevalence of adverse mental health symptoms among individuals diagnosed with COVID-19 in the general population by acute infection severity up to 16 months after diagnosis. Methods: This observational follow-up study included seven prospectively planned cohorts across six countries (Denmark, Estonia, Iceland, Norway, Sweden, and the UK). Participants were recruited from March 27, 2020, to Aug 13, 2021. Individuals aged 18 years or older were eligible to participate. In a cross-sectional analysis, we contrasted symptom prevalence of depression, anxiety, COVID-19-related distress, and poor sleep quality (screened with validated mental health instruments) among individuals with and without a diagnosis of COVID-19 at entry, 0-16 months from diagnosis. In a cohort analysis, we further used repeated measures to estimate the change in mental health symptoms before and after COVID-19 diagnosis. Findings: The analytical cohort consisted of 247 249 individuals, 9979 (4·0%) of whom were diagnosed with COVID-19 during the study period. Mean follow-up was 5·65 months (SD 4·26). Participants diagnosed with COVID-19 presented overall with a higher prevalence of symptoms of depression (prevalence ratio [PR] 1·18 [95% CI 1·03-1·36]) and poorer sleep quality (1·13 [1·03-1·24]) but not symptoms of anxiety (0·97 [0·91-1·03]) or COVID-19-related distress (1·05 [0·93-1·20]) compared with individuals without a COVID-19 diagnosis. Although the prevalence of depression and COVID-19-related distress attenuated with time, individuals diagnosed with COVID-19 but never bedridden due to their illness were consistently at lower risk of depression (PR 0·83 [95% CI 0·75-0·91]) and anxiety (0·77 [0·63-0·94]) than those not diagnosed with COVID-19, whereas patients who were bedridden for more than 7 days were persistently at higher risk of symptoms of depression (PR 1·61 [95% CI 1·27-2·05]) and anxiety (1·43 [1·26-1·63]) than those not diagnosed throughout the study period. Interpretation: Severe acute COVID-19 illness-indicated by extended time bedridden-is associated with long-term mental morbidity among recovering individuals in the general population. These findings call for increased vigilance of adverse mental health development among patients with a severe acute disease phase of COVID-19. Funding: Nordforsk, Horizon2020, Wellcome Trust, and Estonian Research Council.
UR - http://www.scopus.com/inward/record.url?scp=85129781421&partnerID=8YFLogxK
U2 - 10.1016/S2468-2667(22)00042-1
DO - 10.1016/S2468-2667(22)00042-1
M3 - Article
C2 - 35298894
AN - SCOPUS:85129781421
SN - 2468-2667
VL - 7
SP - e406-e416
JO - Lancet Public Health
JF - Lancet Public Health
IS - 5
ER -
