Mental health outcomes following COVID-19 infection: Evidence from 11 UK longitudinal population studies

  1. Ellen J. Thompson
  2. Jean Stafford
  3. Bettina Moltrecht
  4. Charlotte F. Huggins
  5. Alex S. F. Kwong
  6. Richard J. Shaw
  7. Paola Zaninotto
  8. Kishan Patel
  9. Richard J. Silverwood
  10. Eoin McElroy
  11. Matthias Pierce
  12. Michael J. Green
  13. Ruth C. E. Bowyer
  14. Jane Maddock
  15. Kate Tilling
  16. S. Vittal Katikireddi
  17. George B. Ploubidis
  18. David J. Porteous
  19. Nic Timpson
  20. Nish Chaturvedi
  21. Claire J. Steves
  22. Praveetha Patalay
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Abstract

Background

Evidence on associations between COVID-19 illness and mental health is mixed. We examined longitudinal associations between COVID-19 and mental health while considering: 1) pre-pandemic mental health, 2) time since infection; 3) subgroup differences; and 4) confirmation of infection via self-reported test, and serology data.

Methods

Using data from 11 UK longitudinal studies, involving 54,442 participants, with 2 to 8 repeated measures of mental health and COVID-19 between April 2020 and April 2021, we standardised continuous mental health scales within each study across time. We investigated associations between COVID-19 (self-report, test-confirmed, serology-confirmed) and mental health using multilevel generalised estimating equations. We examined whether associations varied by age, sex, ethnicity, education and pre-pandemic mental health. Effect-sizes were pooled in random-effects meta-analyses.

Outcomes

Pooled estimates of the standardized difference in outcome between those with and without self-reported COVID-19 suggested associations with subsequent psychological distress (0.10 [95%CI: 0.06; 0.13], I2=42.8%), depression (0.08 [0.05; 0.10], I2=20.8%), anxiety (0.08 [0.05; 0.10], I2=0%), and lower life satisfaction (−0.06 [-0.08; -0.04], I2=29.2%). Associations did not vary by time since infection until 3+ months and were present in all age groups, with some evidence of stronger effects in those aged 50+. Self-reported COVID-19, whether suspected or test-confirmed and irrespective of serology status, was associated with poorer mental health.

Interpretation

Self-reporting COVID-19 was longitudinally associated with deterioration in mental health and life satisfaction. Our findings have important implications for mental health service provision, given the substantial prevalence of COVID-19 in the UK and worldwide.

Funding

MRC and NIHR

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