Acute COVID-19 severity and 16-month mental morbidity trajectories in patient populations of six nations

  1. Ingibj枚rg Magn煤sd贸ttir
  2. Anik贸 Lovik
  3. Anna B谩ra Unnarsd贸ttir
  4. Daniel McCartney
  5. Helga Ask
  6. Kadri K玫iv
  7. Lea Arregui Nordahl Christoffersen
  8. Sverre Urnes Johnson
  9. Andrew McIntosh
  10. Anna K. K盲hler
  11. Archie Campbell
  12. Arna Hauksd贸ttir
  13. Chloe Fawns-Ritchie
  14. Christian Erikstrup
  15. Dorte Helenius
  16. Drew Altschul
  17. Edda Bjork Thordardottir
  18. El铆as Ey镁贸rsson
  19. Emma M. Frans
  20. Gunnar T贸masson
  21. Harpa Lind J贸nsd贸ttir
  22. Harpa R煤narsd贸ttir
  23. Henrik Hjalgrim
  24. Hr枚nn Har冒ard贸ttir
  25. Juan Gonz谩lez-Hij贸n
  26. Karina Banasik
  27. Khoa Manh Dinh
  28. Li Lu
  29. Lili Milani
  30. Lill Trogstad
  31. Maria Didriksen
  32. Omid V. Ebrahimi
  33. Patrick F. Sullivan
  34. Per Minor Magnus
  35. Qing Shen
  36. Ragnar Nesv氓g
  37. Reedik M盲gi
  38. Run贸lfur P谩lsson
  39. Sisse Rye Ostrowski
  40. Thomas Werge
  41. Asle Hoffart
  42. David J Porteous
  43. Fang Fang
  44. J贸hanna Jakobsd贸ttir
  45. Kelli Lehto
  46. Ole A Andreassen
  47. Ole B. V. Pedersen
  48. Thor Aspelund
  49. Unnur Anna Valdimarsd贸ttir
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Abstract

BACKGROUND

The aim of this multinational study was to assess the development 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

Participants consisted of 247 249 individuals from seven cohorts across six countries (Denmark, Estonia, Iceland, Norway, Scotland, and Sweden) recruited from April 2020 through August 2021. We used multivariable Poisson regression to contrast symptom-prevalence of depression, anxiety, COVID-19 related distress, and poor sleep quality among individuals with and without a diagnosis of COVID-19 at entry to respective cohorts by time (0-16 months) from diagnosis. We also applied generalised estimating equations (GEE) analysis to test differences in repeated measures of mental health symptoms before and after COVID-19 diagnosis among individuals ever diagnosed with COVID-19 over time.

FINDINGS

A total of 9979 individuals (4%) were diagnosed with COVID-19 during the study period and presented overall with a higher symptom burden of depression (prevalence ratio [PR] 1·18, 95% confidence interval [95% CI] 1·03-1·36) and poorer sleep quality (1·13, 1·03-1·24) but not with higher levels of symptoms of anxiety or COVID-19 related distress compared with individuals without a COVID-19 diagnosis. While the prevalence of depression and COVID-19 related distress attenuated with time, the trajectories varied significantly by COVID-19 acute infection severity. Individuals diagnosed with COVID-19 but never bedridden due to their illness were consistently at lower risks of depression and anxiety (PR 0·83, 95% CI 0·75-0·91 and 0·77, 0·63-0·94, respectively), while patients bedridden for more than 7 days were persistently at higher risks of symptoms of depression and anxiety (PR 1·61, 95% CI 1·27-2·05 and 1·43, 1·26-1·63, respectively) throughout the 16-month study period.

CONCLUSION

Acute infection severity is a key determinant of long-term mental morbidity among COVID-19 patients.

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