Study Examines Long-Term Post-COVID-19 Effects on Mental Health

Mental health disorders and other conditions are a long-term concern for some patients after battling COVID-19, according to a team of Veterans Affairs (VA) researchers.

In a pair of studies published in Nature Medicine and the British Medical Journal, investigators found that in 1 of the 2 studies surrounding COVID-19’s chronic effects, people who had mental health disorders but were not hospitalized while infected with COVID-19 could see even more serious mental health problems in the weeks and months following the acute stage. Although biologic changes may occur in the body that affect the brain, nonbiologic changes, such as social isolation, can also be a part of it but the reasons are not completely clear, according to the study.

Although COVID-19 has mild or moderate symptoms for many people, the first phase can be the “tip of the iceberg,” according to principal study investigator Ziyad Al-Aly, MD.

“Those who go on to experience serious chronic consequences—effects that commonly last a lifetime—are the ones who will bear the scars of this pandemic,” Al-Aly said in the press release.

Previous studies by Al-Aly have discovered that long COVID-19 can affect every organ system.

“People return to their doctor with fatigue, brain fog, amnesia, strokes, new-onset diabetes, kidney disease, heart disease, and more,” Al-Aly said in the press release.

The researchers compared mental health risks for those who had COVID-19 and survived the first 30 days of infection with the same health outcomes among those who were not infected. After analyzing a study period of approximately 1 year, the researchers noted elevated risks for issues such as anxiety, depression, stress disorders, opioid use, substance use disorders, and sleep conditions.

“We’ve all suffered some sort of distress from this pandemic—maybe a measure of anxiety or difficulty sleeping,” Al-Aly said in the press release. “But these challenges are magnified, especially in those who were admitted to the hospital during the acute part of their COVID battle but also in many who experienced only mild or moderate symptoms.”

The findings by the type of mental health issue were:

• Anxiety: 35% higher risk in the COVID-19 group
• Depression: 39% higher risk
• Sleep disorder: 41% higher risk
• Opioid use: 76% higher risk
• Opioid use disorder: 34% higher risk
• Non-opioid substance use disorders: 20% higher risk.

The researchers looked at medical records in a database within VA, which included nearly 154,000 patients who had tested positive for COVID-19 between March 2020 and January 2021. The team then compared patients’ health information with data from more than 11 million people who had not had COVID-19, approximately half of whom were from the same time frame and the other half were from a pre-pandemic time period.

“A strength of our research was the large number of patients and the ability to leverage the breadth and depth of the VA’s electronic health records system,” Al-Aly said in the press release. “We brought together public health experts from across disciplines, successfully marrying the medical and research perspectives.”

The researchers emphasize that the best defense against COVID-19 is to take steps such as getting vaccinated and boosted, wearing high-quality masks, and washing your hands regularly.

REFERENCE

VA research spells out COVID's down-the-road risks for cardiovascular and mental health. US Department of Veterans Affairs. February 16, 2022. Accessed February 18, 2022. https://www.research.va.gov/currents/0222-VA-research-spells-out-COVIDs-down-the-road-risks-for-cardiovascular-and-mental-health.cfm