Anxiety and depression symptoms after COVID-19 infection: results from the COVID Symptom Study app

Kerstin Klaser; Ellen J Thompson; Long H Nguyen; Carole H Sudre; Michela Antonelli; Benjamin Murray; Liane S Canas; Erika Molteni; Mark S Graham; Eric Kerfoot; Liyuan Chen; Jie Deng; Anna May; Christina Hu; Andy Guest; Somesh Selvachandran; David A Drew; Marc Modat; Andrew T Chan; Jonathan Wolf; Tim D Spector; Alexander Hammers; Emma L Duncan; Sebastien Ourselin; Claire J Steves

doi:10.1101/2021.07.07.21260137

Anxiety and depression symptoms after COVID-19 infection: results from the COVID Symptom Study app

Kerstin Klaser, Ellen J Thompson, Long H Nguyen, Carole H Sudre, Michela Antonelli, Benjamin Murray, Liane S Canas, Erika Molteni, Mark S Graham, Eric Kerfoot, Liyuan Chen, Jie Deng, Anna May, Christina Hu, Andy Guest, Somesh Selvachandran, David A Drew, Marc Modat, Andrew T Chan, Jonathan WolfTim D Spector, Alexander Hammers, Emma L Duncan, Sebastien Ourselin, Claire J Steves

Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
MRC Unit for Lifelong Health and Ageing
MRC Unit for Lifelong Health and Ageing, Department of Population Science & Experimental Medicine, University College London, WC1E 6HX, London, UK.
Univ London, Birkbeck University London, University College London, University of London Royal Veterinary College, University of London, St Georges University London, Imperial College London, Kings College London, Royal Holloway University London, Queen Mary University London, Div Populat Hlth Sci & Educ
Zoe Ltd

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Abstract

BACKGROUND: Mental health issues have been reported after SARS-CoV-2 infection. However, comparison to prevalence in uninfected individuals and contribution from common risk factors (eg, obesity and comorbidities) have not been examined. We identified how COVID-19 relates to mental health in the large community-based COVID Symptom Study. METHODS: We assessed anxiety and depression symptoms using two validated questionnaires in 413148 individuals between February and April 2021; 26998 had tested positive for SARS-CoV-2. We adjusted for physical and mental prepandemic comorbidities, body mass index (BMI), age and sex. FINDINGS: Overall, 26.4% of participants met screening criteria for general anxiety and depression. Anxiety and depression were slightly more prevalent in previously SARS-CoV-2-positive (30.4%) vs SARS-CoV-2-negative (26.1%) individuals. This association was small compared with the effect of an unhealthy BMI and the presence of other comorbidities, and not evident in younger participants (≤40 years). Findings were robust to multiple sensitivity analyses. Association between SARS-CoV-2 infection and anxiety and depression was stronger in individuals with recent (<30 days) versus more distant (>120 days) infection, suggesting a short-term effect. INTERPRETATION: A small association was identified between SARS-CoV-2 infection and anxiety and depression symptoms. The proportion meeting criteria for self-reported anxiety and depression disorders is only slightly higher than prepandemic.

Original language	English
Pages (from-to)	1254-1258
Number of pages	5
Journal	Journal of Neurology, Neurosurgery and Psychiatry
Volume	92
Issue number	12
Early online date	28 Sept 2021
DOIs	https://doi.org/10.1101/2021.07.07.21260137 https://doi.org/10.1136/jnnp-2021-327565
Publication status	Published - 16 Nov 2021

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Klaser, K., Thompson, E. J., Nguyen, L. H., Sudre, C. H., Antonelli, M., Murray, B., Canas, L. S., Molteni, E., Graham, M. S., Kerfoot, E., Chen, L., Deng, J., May, A., Hu, C., Guest, A., Selvachandran, S., Drew, D. A., Modat, M., Chan, A. T., ... Steves, C. J. (2021). Anxiety and depression symptoms after COVID-19 infection: results from the COVID Symptom Study app. Journal of Neurology, Neurosurgery and Psychiatry, 92(12), 1254-1258. https://doi.org/10.1101/2021.07.07.21260137, https://doi.org/10.1136/jnnp-2021-327565

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title = "Anxiety and depression symptoms after COVID-19 infection: results from the COVID Symptom Study app",

abstract = "BACKGROUND: Mental health issues have been reported after SARS-CoV-2 infection. However, comparison to prevalence in uninfected individuals and contribution from common risk factors (eg, obesity and comorbidities) have not been examined. We identified how COVID-19 relates to mental health in the large community-based COVID Symptom Study. METHODS: We assessed anxiety and depression symptoms using two validated questionnaires in 413148 individuals between February and April 2021; 26998 had tested positive for SARS-CoV-2. We adjusted for physical and mental prepandemic comorbidities, body mass index (BMI), age and sex. FINDINGS: Overall, 26.4% of participants met screening criteria for general anxiety and depression. Anxiety and depression were slightly more prevalent in previously SARS-CoV-2-positive (30.4%) vs SARS-CoV-2-negative (26.1%) individuals. This association was small compared with the effect of an unhealthy BMI and the presence of other comorbidities, and not evident in younger participants (≤40 years). Findings were robust to multiple sensitivity analyses. Association between SARS-CoV-2 infection and anxiety and depression was stronger in individuals with recent (<30 days) versus more distant (>120 days) infection, suggesting a short-term effect. INTERPRETATION: A small association was identified between SARS-CoV-2 infection and anxiety and depression symptoms. The proportion meeting criteria for self-reported anxiety and depression disorders is only slightly higher than prepandemic.",

author = "Kerstin Klaser and Thompson, {Ellen J} and Nguyen, {Long H} and Sudre, {Carole H} and Michela Antonelli and Benjamin Murray and Canas, {Liane S} and Erika Molteni and Graham, {Mark S} and Eric Kerfoot and Liyuan Chen and Jie Deng and Anna May and Christina Hu and Andy Guest and Somesh Selvachandran and Drew, {David A} and Marc Modat and Chan, {Andrew T} and Jonathan Wolf and Spector, {Tim D} and Alexander Hammers and Duncan, {Emma L} and Sebastien Ourselin and Steves, {Claire J}",

note = "Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.",

year = "2021",

month = nov,

day = "16",

doi = "10.1101/2021.07.07.21260137",

language = "English",

volume = "92",

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journal = "Journal of Neurology, Neurosurgery and Psychiatry",

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Klaser, K , Thompson, EJ, Nguyen, LH, Sudre, CH , Antonelli, M , Murray, B , Canas, LS , Molteni, E , Graham, MS , Kerfoot, E, Chen, L, Deng, J, May, A, Hu, C, Guest, A, Selvachandran, S, Drew, DA, Modat, M, Chan, AT, Wolf, J, Spector, TD , Hammers, A , Duncan, EL , Ourselin, S & Steves, CJ 2021, 'Anxiety and depression symptoms after COVID-19 infection: results from the COVID Symptom Study app', Journal of Neurology, Neurosurgery and Psychiatry, vol. 92, no. 12, pp. 1254-1258. https://doi.org/10.1101/2021.07.07.21260137, https://doi.org/10.1136/jnnp-2021-327565

TY - JOUR

T1 - Anxiety and depression symptoms after COVID-19 infection

T2 - results from the COVID Symptom Study app

AU - Klaser, Kerstin

AU - Thompson, Ellen J

AU - Nguyen, Long H

AU - Sudre, Carole H

AU - Antonelli, Michela

AU - Murray, Benjamin

AU - Canas, Liane S

AU - Molteni, Erika

AU - Graham, Mark S

AU - Kerfoot, Eric

AU - Chen, Liyuan

AU - Deng, Jie

AU - May, Anna

AU - Hu, Christina

AU - Guest, Andy

AU - Selvachandran, Somesh

AU - Drew, David A

AU - Modat, Marc

AU - Chan, Andrew T

AU - Wolf, Jonathan

AU - Spector, Tim D

AU - Hammers, Alexander

AU - Duncan, Emma L

AU - Ourselin, Sebastien

AU - Steves, Claire J

PY - 2021/11/16

Y1 - 2021/11/16

N2 - BACKGROUND: Mental health issues have been reported after SARS-CoV-2 infection. However, comparison to prevalence in uninfected individuals and contribution from common risk factors (eg, obesity and comorbidities) have not been examined. We identified how COVID-19 relates to mental health in the large community-based COVID Symptom Study. METHODS: We assessed anxiety and depression symptoms using two validated questionnaires in 413148 individuals between February and April 2021; 26998 had tested positive for SARS-CoV-2. We adjusted for physical and mental prepandemic comorbidities, body mass index (BMI), age and sex. FINDINGS: Overall, 26.4% of participants met screening criteria for general anxiety and depression. Anxiety and depression were slightly more prevalent in previously SARS-CoV-2-positive (30.4%) vs SARS-CoV-2-negative (26.1%) individuals. This association was small compared with the effect of an unhealthy BMI and the presence of other comorbidities, and not evident in younger participants (≤40 years). Findings were robust to multiple sensitivity analyses. Association between SARS-CoV-2 infection and anxiety and depression was stronger in individuals with recent (<30 days) versus more distant (>120 days) infection, suggesting a short-term effect. INTERPRETATION: A small association was identified between SARS-CoV-2 infection and anxiety and depression symptoms. The proportion meeting criteria for self-reported anxiety and depression disorders is only slightly higher than prepandemic.

AB - BACKGROUND: Mental health issues have been reported after SARS-CoV-2 infection. However, comparison to prevalence in uninfected individuals and contribution from common risk factors (eg, obesity and comorbidities) have not been examined. We identified how COVID-19 relates to mental health in the large community-based COVID Symptom Study. METHODS: We assessed anxiety and depression symptoms using two validated questionnaires in 413148 individuals between February and April 2021; 26998 had tested positive for SARS-CoV-2. We adjusted for physical and mental prepandemic comorbidities, body mass index (BMI), age and sex. FINDINGS: Overall, 26.4% of participants met screening criteria for general anxiety and depression. Anxiety and depression were slightly more prevalent in previously SARS-CoV-2-positive (30.4%) vs SARS-CoV-2-negative (26.1%) individuals. This association was small compared with the effect of an unhealthy BMI and the presence of other comorbidities, and not evident in younger participants (≤40 years). Findings were robust to multiple sensitivity analyses. Association between SARS-CoV-2 infection and anxiety and depression was stronger in individuals with recent (<30 days) versus more distant (>120 days) infection, suggesting a short-term effect. INTERPRETATION: A small association was identified between SARS-CoV-2 infection and anxiety and depression symptoms. The proportion meeting criteria for self-reported anxiety and depression disorders is only slightly higher than prepandemic.

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DO - 10.1101/2021.07.07.21260137

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SN - 0022-3050

VL - 92

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JO - Journal of Neurology, Neurosurgery and Psychiatry

JF - Journal of Neurology, Neurosurgery and Psychiatry

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ER -

Anxiety and depression symptoms after COVID-19 infection: results from the COVID Symptom Study app

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