Chronic COVID-19 symptoms, also called “long COVID,” present not only ongoing physical issues, but also a higher risk for depression and anxiety. The finding comes from an observational study on nonhospitalized patients with COVID-19 who experienced symptoms up to 16 months after diagnosis. Researchers published their large observational study in Lancet Public Health.

While public health officials have learned much about the lingering physical symptoms of long COVID, they know less about the ongoing mental health impact. To help the medical community better understand the association between long COVID and mental health, researchers conducted an observational study that included 7 cohorts from 6 countries: Denmark, Estonia, Iceland, Norway, Sweden, and the United Kingdom.

They evaluated the date of diagnosis, days bedridden due to COVID-19, and symptoms reports up to 16 months from diagnosis. They also used various mental health assessments to assess depression and anxiety. The analytical cohort included 247,249 individuals. Of those, 4% tested positive for COVID-19 during the study period.

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The researchers found that the longer patients were bedridden, the higher the odds of symptoms of depression and anxiety. The results show a clear link between COVID-19 distress and time from diagnosis. The prevalence ratio (PR) for depressive symptoms was 1.30 (95% CI 1.07–1.59) and COVID-19-related distress was 1.20 (1.09–1.33) within 2 months after diagnosis but was not statistically significant beyond 2 months after diagnosis.

Compared with COVID-19-negative patients, patients bedridden for 7 days or longer showed persistent symptoms of depression (PR 1.66 [95% CI 1.11–2.47] at 0 to 2 months after diagnosis; 1.53 [1.26–1.86] at more than 2 months to 6 months after diagnosis; and 1.60 [1.17–2.81] at more than 6 months to 16 months after diagnosis). Anxiety symptoms were present at a comparable rate: (PR 1.47 [95% CI 0.80–2.72] at 0 to 2 months after diagnosis; 1.46 [1.20–1.79] at more than 2 to 6 months after diagnosis; and 1.47 [1.19–1.81] at more than 6 months to 16 months after diagnosis.

The study had a few limitations. COVID-19 diagnosis and mental health symptoms were self-reported. In addition, most participants reported symptoms between March and June 2020 when a lot of fear and uncertainty existed around COVID-19. However, it was a large study that included over 10,000 COVID-19-positive individuals from 6 European countries.

The results of the study improve the understanding of the impact of long COVID on mental health. “These findings motivate continued clinical vigilance and follow-up studies beyond the first year among individuals with the most severe symptomology after COVID-19 infections,” the researchers conclude.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures


Magnúsdóttir I, Lovik A, Unnarsdóttir AB, et al. Acute COVID-19 severity and mental health morbidity trajectories in patient populations of six nations: an observational study Lancet Public Health. 2022;S2468-2667(22)00042-1. doi:10.1016/S2468-2667(22)00042-1

This article originally appeared on Psychiatry Advisor