Covid-19 survivors face greater risk of mental health problems, study finds

Covid-19 survivors face a heightened risk of psychiatric disorders, a large-scale study has found.

The study, which included researchers from the University of Oxford as well as researchers from Spain and China, used data from the UK Biobank to compare people who had tested positive for Covid-19 with people who hadn’t.

The researchers divided the cohort into three groups: individuals with SARS-CoV-2 infection (26,101 participants), contemporary controls without infection (380,337 participants), and historical controls predating the pandemic (390,621 participants).

The study, published in Nature Human Behaviour, tracked the incidence of psychiatric diagnoses and psychotropic prescription usage over the course of a year. Initial analyses showed there were significant health disparities between the Covid-19 group and the contemporary controls.

Increase in sleep disorders

The researchers found a heightened risk of psychiatric disorders among Covid-19 survivors, including psychotic, mood and anxiety disorders. They also found notable increases in prescriptions for antipsychotics, antidepressants, benzodiazepines, mood stabilizers, and opioids. Depression, anxiety and post-traumatic stress disorder were also more prevalent among those who had contracted Covid. Among those with a Covid diagnosis, there was also an increase in substance use disorders and sleep disorders.

The link between Covid infection and mental illness was even stronger for individuals who were hospitalised with Covid.

These trends were found consistently across different demographic groups.

However, the risks were reduced in fully vaccinated individuals, possibly highlighting the protective effect of vaccination against the development of new psychiatric disorders and the progression of existing ones.

Comparisons with the historical control group reinforced the study’s initial findings, showing a broad increase in mental health risks for Covid survivors.

Junqing Xie, a postdoctoral researcher at Oxford and co-author of the study, said, “These findings, however, were biased towards patients who had sought testing for Covid-19 in the first two years of the pandemic and didn’t allow for those with an asymptomatic infection or new variants such as omicron.”

The research also indicated that breakthrough infections – namely infections that occurred in people who had received the vaccination –  did not increase the risk of mental health diagnoses compared to the vaccinated (uninfected) participants, but there was still a sign of increased risk for more psychotropic medications.

Need for early identification of disorders

Junqing said: “Given the existing large number of Covid-19 survivors, the increasing number of reinfections worldwide accompanying the loosening of Covid-19 restrictions, and the waning public’s appetite for boosters, the infection-triggered psychiatric disorders may translate into an enormous global burden of mental health on top of others.

“Our study therefore underscores the need for policymakers and health systems to develop priorities and long-term strategies for the early identification and treatment of affected individuals, especially in vulnerable survivors of Covid-19, to mitigate psychiatric disorders and enhance well-being post-pandemic.”

The findings of the research are in line with previous studies reporting an increased risk of neurological and psychiatric disorders in individuals admitted to hospital for Covid and those with mild or asymptomatic disease during three to 12 months after infection.

The researchers note, however, that these previous studies were based on electronic health record (EHR) or registry data that are less representative of the general population and therefore more vulnerable to latent bias, confounding and the impact of the disruptions in healthcare services during the pandemic.  They argue that their own research, based on a prospective cohort based on the general population, is more likely to be reliable.