COVID-19 survivors are at higher risk for mental illness up to 1 year after infection
COVID-19 survivors are at higher risk for mental illness up to 1 year after infection

COVID-19 survivors are at higher risk for mental illness up to 1 year after infection

February 17, 2022

3 min read

Information: Weich does not report any relevant financial information. Xie reports receiving financial support from the American Society of Nephrology and VA for the study. Please see the survey for all other authors’ relevant financial information.

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Veterans who survived COVID-19 had an increased risk of mental health, drug use and sleep disorders up to 1 year later, data showed.

Previous studies of long-term risks in COVID-19 survivors have looked at fewer results in shorter time frames, Yan XieMPH, a biostatistician at the Clinical Epidemiology Center in St. Louis Veterans Affairs Health Care System, and colleagues wrote in BMJ.

Reference: Xie Y, et al. BMJ. 2022; doi: 10.1136 / bmj-2021-068993.

“Improving our understanding of the long-term risk of mental illness in people with COVID-19 can help guide post-acute care strategies,” they wrote.

Xie and colleagues used the US Veterans Affairs health database to compare results between three cohorts. The first group consisted of 153,848 veterans who survived the first 30 days of COVID-19. Another group consisted of 5,637,840 veterans who used the VA health care system within the same time frame but who had no evidence of COVID-19. A third group included 5,859,251 veterans who received care in 2017. According to the researchers, all three cohorts were followed for 1 year. They had an average age of about 63 years, and most were white men who were overweight and never smoked.

The researchers found that after 1 year, those who survived acute COVID-19 had an increased risk of:

  • anxiety disorders (HR = 1.35; 95% CI, 1.3-1.39), with a risk difference of 11.06 per 1,000 persons (95% CI, 9.64-12.53);
  • depressive disorders (HR = 1.39; 95% CI, 1.34-1.43), with a risk difference of 15.12 per 1,000 persons (95% CI, 13.38-16.91);
  • stress and adjustment disorders (HR = 1.38; 95% CI, 1.34-1.43), with a risk difference of 13.29 per 1,000 persons (95% CI, 11.71-14.92);
  • opioid use disorder (HR = 1.34; 95% CI, 1.21-1.48), with a risk difference of 0.96 per 1,000 persons (95% CI, 0.59-1.37);
  • non-opioid drug use disorders (HR = 1.2; 95% CI, 1.15-1.26), with a risk difference of 4.34 per 1,000 persons (95% CI, 3.22-5.51);
  • accidental neurocognitive decline (HR = 1.8; 95% CI, 1.72-1.89), with a risk difference of 10.75 per 1,000 persons (95% CI, 9.65-11.91); and
  • sleep disorders (HR = 1.41; 95% CI, 1.38-1.45), with a risk difference of 23.8 per. 1,000 persons (95% CI, 21.65-26).

Xie and colleagues also reported that the acute COVID-19 survivors had a higher risk of:

  • accidental opioid prescriptions (HR = 1.76; 95% CI, 1.71-1.81), with a risk difference of 35.9 per 1,000 persons (95% CI, 33.61-38.25);
  • use of antidepressants (HR = 1.55; 95% CI, 1.5-1.6), with a risk difference of 21.59 per 1,000 persons (95% CI, 19.63-23.6);
  • benzodiazepine use (HR = 1.65; 95% CI, 1.58-1.72), with a risk difference of 10.46 per 1,000 persons (95% CI, 9.37-11.61); and
  • incident mental health diagnosis or prescription (HR = 1.6; 95% CI, 1.55-1.66), with a risk difference of 64.38 per 1,000 persons (95% CI, 58.9-70.01).

“The risk of examined results was increased even among people who were not hospitalized and was highest among those admitted to the hospital during the acute phase of COVID-19,” Xie and colleagues wrote. “The results were consistent with those in the historical control group.”

The analysis also showed that the risk of accidental mental illness was consistently higher in people with COVID-19 compared to those who had seasonal flu.

Xie and colleagues said their findings should be used to raise awareness of the greater risk of mental illness among survivors of acute COVID-19. They also recommended incorporating mental health care as a core component of treatment strategies.

In a related editorial office, Scott SoftMSc, MRCPsych, a professor in the Mental Health Research Unit of the School of Health and Related Research at the University of Sheffield in England, wrote that it is time to “reflect on what we have learned” about the mental health consequences of COVID-19 as well as “what we have to do next time and what we still do not know. ”

“We continue to generate more heat than light as we reflect on the usual biopsychosocial suspects without cutting through to crucial insights or effective interventions,” he wrote.

Areas of focus should include examining the consequences of long-term COVID, addressing health and social care disorders among those with severe mental illness, and assessing the effectiveness of non-pharmacological and pharmacological mental health interventions, according to Weich.


Study suggests increased risk of mental illness after COVID-19 infection. Published February 16, 2022. Accessed February 17, 2022.

Weich S. BMJ. 2022;

Xie Y, et al. BMJ. 2022; doi: 10.1136 / bmj-2021-068993.

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