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

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Kerstin Klaser, Ellen J. Thompson, Ha-Long Nguyen, Carole H. Sudre, Michela Antonelli, Ben Murray, Liane Dos Santos 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 & 5 more Tim Spector, Alexander Hammers, Emma L. Duncan, Sebastien Ourselin, Claire Steves

Original languageEnglish
JournalJournal of Neurology, Neurosurgery and Psychiatry
Published7 Sep 2021

King's Authors


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 (e.g., obesity, 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 413,148 individuals between February and April 2021; 26,998 had tested positive for SARS-CoV-2. We adjusted for physical and mental pre-pandemic comorbidities, 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. negative (26.1%) individuals. This association was small compared to 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) vs. 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 pre-pandemic.

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