People bedridden for seven days or more with Covid-19 showed a higher rate of depression and anxiety, compared to those who were infected but never bedridden, according to a new study published in The Lancet Public Health.
The findings suggest that, on the whole, non-hospitalized patients with a SARS-CoV-2 infection were more likely to experience depressive symptoms up to 16 months after diagnosis compared to those never infected.
While symptoms of depression and anxiety mostly subsided within two months for non-hospitalized patients, those bedridden for seven days or more continued to be 50-60 percent more likely to experience depression and anxiety up to 16-months.
The quicker recovery of physical Covid-19 symptoms may explain in part why mental health symptoms decline at a similar rate for those with a mild infection. However, patients with severe Covid-19 often experience inflammation which has previously been linked to chronic mental health effects, particularly depression.
“The higher occurrence of depression and anxiety among patients with Covid-19 who spent seven days or longer bedridden could be due to a combination of worrying about long-term health effects as well as the persistence of physical long Covid symptoms well beyond the illness that limit social contact and may result in a sense of helplessness,” said Ingibjorg Magnusdottir, from the University of Iceland.
To capture long-term mental health impacts, the researchers looked at symptom-prevalence of depression, anxiety, Covid-19 related distress, and poor sleep quality among people with and without a diagnosis of Covid-19 from 0-16 months (mean follow-up 5.65 months).
The analysis drew upon data from 247,249 people in seven cohorts across Denmark, Estonia, Iceland, Norway, Sweden, and the UK.
Overall, participants diagnosed with Covid-19 had a higher prevalence of depression and poorer sleep quality compared to individuals who were never diagnosed.
“Our research is among the first to explore mental health symptoms after a serious Covid-19 illness in the general population up to 16 months after diagnosis. It suggests that mental health effects aren’t equal for all Covid-19 patients and that time spent bedridden is a key factor in determining the severity of the impacts on mental health,” said Professor Unnur Anna Valdimarsdottir, from the varsity.
“As we enter the third year of the pandemic, increased clinical vigilance of adverse mental health among the proportion of patients with a severe acute disease of Covid-19 and follow-up studies beyond the first year after infections are critical to ensure timely access to care.”