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Illness severity and risk of mental morbidities among patients recovering from COVID-19 : A cross-sectional study in the Icelandic population

Illness severity and risk of mental morbidities among patients recovering from COVID-19 : A cross-sectional study in the Icelandic population


Title: Illness severity and risk of mental morbidities among patients recovering from COVID-19 : A cross-sectional study in the Icelandic population
Author: Saevarsdóttir, Karen Sól
Hilmarsdóttir, Hildur Ýr
Magnúsdóttir, Ingibjörg
Hauksdóttir, Arna   orcid.org/0000-0002-4253-1059
Thordardottir, Edda Bjork
Gudjónsdóttir, Ásdís Braga
Tomasson, Gunnar
Rúnarsdóttir, Harpa
Jónsdóttir, Harpa Lind
Gudmundsdóttir, Berglind
... 16 more authors Show all authors
Date: 2021-07-23
Language: English
Scope: e049967
University/Institute: University of Iceland
Department: Faculty of Medicine
Internal Medicine and Emergency Services
Faculty of Psychology
Mental Health Services
Cancer Center
Other departments
Office of Division of Clinical Services I
Series: BMJ Open; 11(7)
ISSN: 2044-6055
DOI: https://doi.org/10.1136/bmjopen-2021-049967
Subject: COVID-19; Faraldsfræði; Lýðheilsa; Geðheilsa; COVID-19; epidemiology; mental health; public health; SARS-CoV-2; Anxiety/epidemiology; Cross-Sectional Studies; Depression/epidemiology; Humans; Iceland/epidemiology; Morbidity; Medicine (all)
URI: https://hdl.handle.net/20.500.11815/3103

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Citation:

Saevarsdóttir , K S , Hilmarsdóttir , H Ý , Magnúsdóttir , I , Hauksdóttir , A , Thordardottir , E B , Gudjónsdóttir , Á B , Tomasson , G , Rúnarsdóttir , H , Jónsdóttir , H L , Gudmundsdóttir , B , Pétursdóttir , G , Petersen , P H , Kristinsson , S Y , Love , T J , Hansdóttir , S , Hardardóttir , H , Gudmundsson , G , Eythorsson , E , Gudmundsdóttir , D G , Sigbjörnsdóttir , H , Haraldsdóttir , S , Möller , A D , Palsson , R , Jakobsdóttir , J , Aspelund , T & Valdimarsdottir , U 2021 , ' Illness severity and risk of mental morbidities among patients recovering from COVID-19 : A cross-sectional study in the Icelandic population ' , BMJ Open , vol. 11 , no. 7 , e049967 , pp. e049967 . https://doi.org/10.1136/bmjopen-2021-049967

Abstract:

Objective To test if patients recovering from COVID-19 are at increased risk of mental morbidities and to what extent such risk is exacerbated by illness severity. Design Population-based cross-sectional study. Setting Iceland. Participants A total of 22 861 individuals were recruited through invitations to existing nationwide cohorts and a social media campaign from 24 April to 22 July 2020, of which 373 were patients recovering from COVID-19. Main outcome measures Symptoms of depression (Patient Health Questionnaire), anxiety (General Anxiety Disorder Scale) and posttraumatic stress disorder (PTSD; modified Primary Care PTSD Screen for DSM-5) above screening thresholds. Adjusting for multiple covariates and comorbidities, multivariable Poisson regression was used to assess the association between COVID-19 severity and mental morbidities. Results Compared with individuals without a diagnosis of COVID-19, patients recovering from COVID-19 had increased risk of depression (22.1% vs 16.2%; adjusted relative risk (aRR) 1.48, 95% CI 1.20 to 1.82) and PTSD (19.5% vs 15.6%; aRR 1.38, 95% CI 1.09 to 1.75) but not anxiety (13.1% vs 11.3%; aRR 1.24, 95% CI 0.93 to 1.64). Elevated relative risks were limited to patients recovering from COVID-19 that were 40 years or older and were particularly high among individuals with university education. Among patients recovering from COVID-19, symptoms of depression were particularly common among those in the highest, compared with the lowest tertile of influenza-like symptom burden (47.1% vs 5.8%; aRR 6.42, 95% CI 2.77 to 14.87), among patients confined to bed for 7 days or longer compared with those never confined to bed (33.3% vs 10.9%; aRR 3.67, 95% CI 1.97 to 6.86) and among patients hospitalised for COVID-19 compared with those never admitted to hospital (48.1% vs 19.9%; aRR 2.72, 95% CI 1.67 to 4.44). Conclusions Severe disease course is associated with increased risk of depression and PTSD among patients recovering from COVID-19.

Description:

Funding Information: Funding This study was supported by grants from the Icelandic government and NordForsk (Mental morbidity trajectories in COVID-19 across risk populations of five nations, grant 105668, Dr. UV). The funding sources had no role in the design and implementation of the study; in data collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Publisher Copyright: ©

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