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

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

BackgroundMental 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. MethodsWe 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. FindingsOverall, 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. InterpretationA 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. FundingZoe Limited, National Institute for Health Research, Chronic Disease Research Foundation, National Institutes of Health, Medical Research Council UK