Anxiety and depression symptoms after COVID-19 infection: results from the COVID Symptom Study app

  1. Kerstin Klaser
  2. Ellen J. Thompson
  3. Long H. Nguyen
  4. Carole H. Sudre
  5. Michela Antonelli
  6. Benjamin Murray
  7. Liane S. Canas
  8. Erika Molteni
  9. Mark S. Graham
  10. Eric Kerfoot
  11. Liyuan Chen
  12. Jie Deng
  13. Anna May
  14. Christina Hu
  15. Andy Guest
  16. Somesh Selvachandran
  17. David A Drew
  18. Marc Modat
  19. Andrew T. Chan
  20. Jonathan Wolf
  21. Tim D. Spector
  22. Alexander Hammers
  23. Emma L. Duncan
  24. Sebastien Ourselin
  25. Claire J. Steves
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Abstract

Background

Mental health issues have been reported after SARS-CoV-2 infection. However, comparison to prevalence in uninfected individuals and contribution from common risk factors (e.g., obesity, comorbidities) have not been examined. We identified how COVID-19 relates to mental health in the large community-based COVID Symptom Study.

Methods

We assessed anxiety and depression symptoms using two validated questionnaires in 413,148 individuals between February and April 2021; 26,998 had tested positive for SARS-CoV-2. We adjusted for physical and mental pre-pandemic comorbidities, BMI, age, and sex.

Findings

Overall, 26.4% of participants met screening criteria for general anxiety and depression. Anxiety and depression were slightly more prevalent in previously SARS-CoV-2 positive (30.4%) vs. negative (26.1%) individuals. This association was small compared to the effect of an unhealthy BMI and the presence of other comorbidities, and not evident in younger participants (≤40 years). Findings were robust to multiple sensitivity analyses. Association between SARS-CoV-2 infection and anxiety and depression was stronger in individuals with recent (<30 days) vs. more distant (>120 days) infection, suggesting a short-term effect.

Interpretation

A small association was identified between SARS-CoV-2 infection and anxiety and depression symptoms. The proportion meeting criteria for self-reported anxiety and depression disorders is only slightly higher than pre-pandemic.

Funding

Zoe Limited, National Institute for Health Research, Chronic Disease Research Foundation, National Institutes of Health, Medical Research Council UK

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