“We need to reframe our thinking about SARS-CoV-2,” the virus that causes COVID-19 infections, says the study’s senior author, Ziyad Al-Aly, MD, the chief of research and development at the VA Saint Louis Health Care System and a clinical epidemiologist at Washington University in Saint Louis. “It is compellingly clear that SARS-CoV-2 is much worse than the flu,” Dr. Al-Aly says. “It results in a higher risk of post-viral illness and can affect nearly every organ system — including the brain." The study examined one year of data on 154,848 people who survived COVID-19, comparing their mental health outcomes with two groups: a cohort of 5.6 million people who didn’t get a COVID-19 diagnosis during this year and a prepandemic cohort of 5.8 million individuals. Overall, people who got COVID-19 were 60 percent more likely to have a new mental health diagnosis or prescription for psychological issues during the year after their infection than individuals who didn’t get COVID-19 over that same time frame. This translated into 64 extra cases of mental illness for every 1,000 people. For every 1,000 people, COVID-19 was also associated with 24 additional cases of sleep disorders, 15 extra cases of depression, 11 additional cases of neurocognitive decline, and 4 extra cases of substance use disorders, the study found. While the risks were highest for people hospitalized with severe COVID-19 infections, even those with milder cases had an increased risk of mental illness. And, when people got COVID-19, they were 44 percent more likely to be diagnosed with a mental health condition over the next year than were people who were diagnosed with seasonal flu. In particular, individuals who got COVID-19 infections were 44 percent more likely to develop anxiety disorders, 32 percent more apt to become depressed, 51 percent more likely to experience stress and adjustment disorders, and 26 percent more likely to struggle with substance misuse than their counterparts who had the flu. All the people in the study received care through the U.S. Department of Veterans Affairs; most were male and they were 63 years old on average. The COVID-19 patients tested positive for the virus between March 2020 and January 2021. Because the study population was older and mostly male, it’s possible the results may not be generalizable to other people with COVID-19, researchers note. Even so, the results offer fresh evidence that the pandemic has taken a toll on mental health. In 2020 alone, there were an additional 53.2 million cases of major depression and 76.2 million cases of anxiety diagnosed worldwide that wouldn’t have occurred in the absence of the pandemic, according to a study published in The Lancet in 2021. This study included population-wide estimates for mental health disorders but did not examine whether or not people had a COVID-19 diagnosis. Another study in The Lancet followed roughly 236,000 patients diagnosed with COVID-19 for six months. Overall, one-third of them were diagnosed with a neurological or psychological disorder during follow-up. And these COVID-19 patients were 46 percent more likely to get diagnosed with anxiety, depression, or mood disorders than would have been the case if they had the flu, researchers estimated. Big picture, doctors and patients alike need to be on the lookout for mental health problems that may have developed during the pandemic, Al-Aly says. People should also try to do what they can to promote their own well-being by getting plenty of exercise and rest, connecting with family and friends, and reducing stress when possible, Al-Aly advises. If you do feel like your mental health is taking a turn for the worse, know that you’re not alone. “There are millions of people around the world with the same condition,” Al-Aly says. “Seek help and talk to your doctor about your symptoms.”
