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

• Published in: BMJ Open
• Main Authors: Saevarsdóttir, Karen Sól, Hilmarsdóttir, Hildur Ýr, Magnúsdóttir, Ingibjörg, Hauksdóttir, Arna, Thordardottir, Edda Bjork, Gudjónsdóttir, Ásdís Braga, Tomasson, Gunnar, Rúnarsdóttir, Harpa, Jónsdóttir, Harpa Lind, Gudmundsdóttir, Berglind, Pétursdóttir, Gudrún, Petersen, Pétur Henry, Kristinsson, Sigurdur Yngvi, Love, Thorvardur Jon, Hansdóttir, Sif, Hardardóttir, Hrönn, Gudmundsson, Gunnar, Eythorsson, Elias, Gudmundsdóttir, Dóra Gudrún, Sigbjörnsdóttir, Hildur, Haraldsdóttir, Sigrídur, Möller, Alma Dagbjört, Palsson, Runolfur, Jakobsdóttir, Jóhanna, Aspelund, Thor, Valdimarsdottir, Unnur
• Other Authors: 1Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland. 2Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland. 3Faculty of Psychology, University of Iceland School of Health Sciences, Reykjavik, Iceland. 4Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, Iceland. 5Institute for Sustainability Studies, University of Iceland, Reykjavik, Iceland. 6The Directorate of Health, Reykjavik, Iceland. 7Icelandic Heart Association, Kopavogur, Iceland. 8Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland [e-mail]. 9Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden. 10Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA.
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMJ Publishing Group 2021
• Subjects: COVID-19; epidemiology; mental health; public health; Geðheilsa; Afleiðingar sjúkdóma; Iceland
• Online Access: http://hdl.handle.net/2336/621950; https://doi.org/10.1136/bmjopen-2021-049967

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Download 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 ...